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11 <br /> City of Orono k [-, <br /> Building Permit Application � <br /> for Swimming Pools and Hot TubsO`Y Mailing Address: Permit number: �Q/ 2- ���1 <br /> PO Box 66 <br /> 0 Crystal Bay, MN 55323-00 V� 11 Date received: / _� 9-/ 7 <br /> Street Address: i� Received by: / c p� <br /> --'S- <br /> e, 2750 Kelley Parkway Plan review fee: ip. 5 • 579 <br /> t1 kJ!' v-�� Orono, MN 55356 ; Lt /1— Cy...�4/� <br /> s ii° Total Fee: <br /> Main: 952-249-4600 Fax: 952-249-4616 www.ci.orano.mn.us <br /> This application form must be completed in full and all required information must be submitted. <br /> Incomplete applications will be returned. (Please print) <br /> GENERAL INFORMATION: <br /> Job Site Address: 870 Windjammer Lane, Orono, MN 55364 <br /> CONTRACTOR/APPLICANT INFORMATION: <br /> Name: Prestige Pools <br /> State License# Expiration Date: <br /> Phone: 651.490.1399 Fax: 651.490.3119 <br /> Address: 87 W. County Road C City: St. Paul ZIP: 55117 <br /> Contact Person: Pat HenryContact's phone number 651.490.1399 <br /> Email -- t;c;t: t.`'a "'' ;;t-vt,t,At L.....- Com. Applicant is: ontractor Homeowner (circle One) <br /> PROPERTY OWNER INFORMATION: - <br /> Name: Ben and Sara Mitlyng <br /> Phone (day): 612.600.8460 (Ben) <br /> Mailing Address: 870 Windjammer Lane, Orono, MN ZIP: 55364 <br /> Email and/or Fax: bmitlyng(a7gmail.com <br /> EIIIIG9 E FORMATION: <br /> Name: Ibk ,,. Ju oLt4aor InnovahOrt- <br /> Phone: 1051 - q3 -- iG 1 l0 -c`4•u_- / (05 i -3255 -lGO1*o D,re 0- <br /> Address: 85 1U54" Sfr " City: HID ZIP: cz-,5035r <br /> Email: vvvvvJ. Oki dzoiInnUvft hums .ta Fax: <br /> as K' ® CIU C OOV i Yl vtOv ct hoh.b -Wyk, <br /> PROJECT INFORMATION: <br /> 1. Pool/ Hot Tub Dimensions: 4.Accessory to: 5.Type: 7. Retaining Walls? <br /> 18 x 44 feet <br /> 2. Heated? ❑X yes 0 no © Single Family 0 Above ground ❑ yes ❑ no Height * <br /> 3. Excavated materials will be: ❑ Multiple Family/Condo 0 In-ground *A building permit is required <br /> ❑ removed from site for any wall 4-feet or greater in <br /> ❑ used on site ❑ Public <br /> ❑ Other(specify) height measured from the <br /> ❑ Other: (specify) ❑ Commercial bottom of the footing to the top <br /> Total Cubic Yards ❑ Industrial of the wall, even if it replaces <br /> 6. Sewage Disposal& an existing wall. <br /> ***Any earth movement may require 0 Other: (specify) Water Supply Tiered walls are considered <br /> MCWD review and permits. one wall unless they are <br /> Minnehaha Creek Watershed District(MCWD) ❑ Public Sewer <br /> 15320 Minnetonka Blvd separated by twice the height <br /> ❑ <br /> Minnetonka,MN 55345 Private Sewer of the higher wall. <br /> Phone: 952-471-0590 ❑ Public Water <br /> Fax: 952-471-0682 <br /> www.minnehahacreek.org ❑ Private Well ICt�.klVtCl.) <br /> Estimated Construction Value $ 25,000.00 <br /> Packet Last Updated: April 2016 JAN 1 9 20 <br /> 11 <br /> Page 22 <br /> CITY OF ORONO <br />