Laserfiche WebLink
CITY OF ORONO <br /> BUILDING PERMIT APPLICATION � ,a�2���`�' <br /> FOR NEW STRUCTURES OR ADDITIONS r <br /> �O A,O Mailing Address: Permit number. Z� �� - ����, <br /> �w PO Box 66 <br /> Crystal Bay, MN 55323-0066 Date received: /Z -- �� - /� <br /> ,� StreetAddress:' �--- C � �Seceived by: - ��� <br /> ti�.` G�'� 2750 Kelley Parkw 1�,� _Cj� C�� �jan review fee: f S � . S I <br /> �kESHO�� Orono, MN 55356 � . _� __,____ __ y <br /> Main: 952-249-4600 Total Fee: �,�, 5% � 9-%'� <br /> Fax: 952-249-4616 www.ci.orono.mn.us <br /> This application form must be completed in full and all required information must b ubmitted. <br /> Incomplete applications will be returned. (P/ease print) <br /> GENERAL INFORMATION: <br /> Job Site Address: 'j rp�,�� <br /> Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? Yes No <br /> /iyes,a special event permit is�equired with Police Department and City Council approval 60 days prior to the evenf. Shuttle bus service wil/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: S wetrz.. ccild�rs Inc . <br /> State License# [�C oo3qaa Expiration Date: 3 3 0�0/!0 <br /> Phone: cell ( _ 38(0- BYSI office � - 7 - '� $ <br /> Mailing Address: 5// i fonk O Cit : 'n �e f ZIP: SS 3Y5 <br /> Contact Person: Applicant is: ntractor / Homeowner (Circle One) <br /> Email and/or Fax: r 5 w4rz rs.Cpr►1 <br /> PROPERTY OWNER INFORMATION: <br /> Name: _(Zobi y f�li��e� /�k,�t r <br /> Phone (day): � <br /> Address: S Q Cit : lnd enden.�c ziP: ,�,53s9 <br /> Email and/or Fax b• ��r �ri [ t'. �oM <br /> ARCHITECT/ENGINEER INFORMATION: <br /> Name: �l}L Aa��rT�cTS Ll-C. <br /> Phone (day): q5 a- �O( - (007(0 <br /> Address: 5 l /Yl i�nc�onka �(ud_ , Suitc lOo city: I11 innefon� Z�P� 5535/S <br /> Email and/or Fax: ��at (d qmA.i� . oM <br /> PROJECT INFORMATION: Description of pro'ect: �t-f i �� � ��l <br /> 1.Type of Project 2. Proposed Use 3. Structure Type 4. Sewage Disposal& <br /> ❑ New Construction Water Supply <br /> �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 ❑ Private Sewer <br /> ❑ Other: (specify) ''�n�cnor �Zt�oraf-�w� ❑ Multiple Family/Condo ❑ Retaining Wall(s) <br /> ❑ Public 4-feet or greater ❑ Public Water <br /> '"'Any earth movement may also require ❑ Commercial ❑Storage <br /> MCWD review&permits. ❑ Industrial ❑Warehouse �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.m i n n eha ha creek.or <br /> Estimated Construction Valuation (excluding land) $ �04� Q(�Qh a(� <br /> Last Updated.• January 2015 <br />