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CITY OF ORONO <br /> fl-iWis17• 0 <br /> BUILDING PERMIT APPLICATION <br /> FOR NEW STRUCTURES OR ADDITIONS <br /> V0 A Mailing Address: Permit number: 40/B'`Ob 3 5/ <br /> PO Box 66 /P2/! <br /> Crystal Bay, MN 55323-0066 Date received: <br /> Street Address: <br /> Received bed: <br /> ti4. <br /> F L` 2750 Kelley Parkway Plan review fee: /� J 6J.75 ' <br /> el kES HOC". Orono, MN 55356 5 CO/10: $ l D0 U•CO �� <br /> Main: 952-249-4600 Totalee: / 1 <br /> Fax: 952-249-4616 www.ci.orono.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: 2X77 Wnnd Durk Trail <br /> Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes ❑ No <br /> If yes,a special event permit is required with Police Department and City Council approval 60 days prior to the event. Shuttle bus service will be <br /> required unless applicant demonstrates sufficient on-site parking is available. Non-permitted events will not be allowed. <br /> CONTRACTOR/APPLICANT INFORMATION: <br /> Name: David Weekley Homes <br /> State License# BC697545 Expiration Date: <br /> Phone: (cell) 612.716.2627 (office) <br /> Mailing Address: 12800 Whitewater Drive,Suite 20 Cit : Minnetonka ZIP: 55343 <br /> Contact Person: Kevin Cummins Applicant is: Contractor / Homeowner (circle One) <br /> Email and/or Fax: kcummins@dwhomes.com <br /> PROPERTY OWNER INFORMATION: <br /> Name: *Same As Above* <br /> Phone (day): Melissa Johnson 612.462.6932 <br /> Address: *same As Above* City: ZIP: <br /> Email and/or Fax mjohnson@dwhomes.com <br /> ARCHITECT/ ENGINEER INFORMATION: <br /> Name: Mulhern&Kulp <br /> Phone (day): 215.646.8001 <br /> Address: 20 South Maple Street,Suite 150 City: Ambler,PA ZIP: 19002 <br /> Email and/or Fax: <br /> PROJECT INFORMATION: Description of project: <br /> 1. Type of Project 2. Proposed Use 3. Structure Type 4.Sewage Disposal& <br /> Water Supply <br /> O New Construction El Single Family with 0 Accessory Bldg./Garage <br /> ❑Addition attached garage ❑ Deck 0 Public Sewer <br /> ❑Accessory Building 0 Single Family with 0 Office/Commercial <br /> O Relocation detached garage El Residence 0 Private Sewer <br /> O Other: (specify) 0 Multiple Family/Condo 0 Retaining Wall(s) <br /> 0 Public 4-feet or greater D Public Water <br /> **Any earth movement may also require ❑ Commercial 0 Storage <br /> MCWD review&permits. 0 Industrial 0 Warehouse 0 Private Well <br /> Minnehaha Creek Watershed District(MCWD) 0 Other: (specify) 0 Other(specify) <br /> 15320 Minnetonka Blvd <br /> Minnetonka, MN 55345 <br /> Phone: 952-471-0590 <br /> Fax: 952-471-0682 <br /> www.minnehahacreek.orq <br /> Estimated Construction Valuation (excluding land) $ 250,000 RECEIVED <br /> MAI' 2 6 2018 <br /> ast Updated: January 2016 CITY OF ORONO <br />