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L El I <br />'LOCAL OLIVERNMENT <br />INFORMATION BYBTEM9 <br />5750 Duluth Street, Golden Valley, MN 55422-4063 <br />Main: 763.543.2600 1 Service: 763.543.2662 <br />Project Design and Cost Estimate Approval <br />Request <br />Primary Contact <br />Enter Incident# (?) Name* Member* <br />385430 David Klitzke Orono <br />Email * <br />dklitzke@oronomn.gov <br />Phone * <br />9522494615 <br />Are There Other Members/External Parties Involved In The Project <br />Yes <br />No <br />Other Participating Members/External Parties <br />Organization Name <br />Contact Name Contact Phone Contact Email <br />Do You Know The Cost Allocation For This Project (?) <br />Yes <br />No <br />Project Scope <br />Project Name* (?) <br />OR -Pump House Well #3 2250 Wayzata Blvd to CH - New Build <br />* <br />Planned <br />Unplanned <br />Planned Project Category <br />New Build <br />Repair <br />Relocate <br />Overbuild <br />Splice Only <br />Other <br />58 <br />