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1 CITY OF ORONO <br /> BUILDING PERMIT APPLICATION <br /> FOR NEW STRUCTURES OR ADDITIONS �ry <br /> O^, Mailing Address: Permit number: ‘730/7.O 8 5V <br /> `vO PO Box 66 <br /> Crystal Bay, MN 55323-0066 Date received: �� 9-a40/ -7 <br /> Z Street Address:' �1 PO Received by: � t <br /> `� 2750 Kelley Park ay , Plan review fee: .� � 335.?O <br /> �ik£sHo��` Orono, MN 55356 Q�—ee $L9 <br /> Main: 952-249-4600 �, Total Fee: c <br /> Fax: 952-249-4616 www.ci.orono.mn.us --,5W 10 <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: Q j7 5 Vic.-Uc.O f u Cit Cd. \ <br /> Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? C 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 ll 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 Cy: Minnetonka ZIP: <br /> Contact Person: Kevin Cummins Applicant is: ontracto>r / 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 rnjohnson@dwhomes.com <br /> ARCHITECT/ ENGINEER INFORMATION: <br /> Name: MVluihern&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: Descri•tion of •ro.ect: <br /> 1. Type of Project 2. Proposed Use 3. Structure Type 4.Sewage Disposal& <br /> Water Supply <br /> ❑ New Construction ❑ Single Family with ❑Accessory Bldg./Garage <br /> ❑ Addition attached garage ❑ Deck ❑ Public Sewer <br /> ❑Accessory Building ❑ Single Family with ❑ Office/Commercial <br /> ❑ Relocation detached garage ❑ Residence 0 Private Sewer <br /> ❑ Other: (specify) ❑ Multiple Family/Condo 0 Retaining Wall(s) <br /> ❑ Public 4-feet or greater ❑ Public Water <br /> **Any earth movement may also require 0 Commercial ❑ Storage <br /> MCWD review&permits. 0 Industrial 0 Warehouse <br /> ❑ Private Well <br /> Minnehaha Creek Watershed District(MCWD) ❑ Other: (specify) ❑ 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 /> RECEIVED <br /> Estimated Construction Valuation (excluding land) $ 250,000 <br /> JUL 1 9 2017 <br /> CITY OF ORONO <br /> Last Updated: January 2016 <br />