Laserfiche WebLink
. ? <br /> , , ! <br /> , CITY OF ORONO � ,59 <br /> BUILDING PERMIT APPLICATION 7�6 <br /> FOR NEW STRUCTURES OR DITIONS <br /> ��O Mailing Address: � ��✓��j Permit number. L��� � �� c� <br /> � PO Box 66 <br /> / Crystal Bay, MN 55323-0066 b Date received: �� � � <br /> f ' <br /> ; --- --- Reeeived.b. __._ ._ .. <br /> E StreetAddress:' �- �' ----- <br /> y ; 2750 Kelley Parkw �.��( S—���� � Plan review fee: U� � s� � I'Z <br /> `� G Orono, MN 55356 � <br /> `�k�s��'�� Total Fee: .-. ,-,,L ,, ,,I,�, <br /> Main: 952-249-4600 Fax: 952-249-4616 www.ci.orono.mn.us �;x,Y(N/ - � rQQ�"i�i'`I I�wu� cS�1Q� <br /> This application form must be completed in full and all required information must be subtnitted. <br /> Incomplete applications will be returned. (P/ease print) <br /> GENERAL INFORMATION: <br /> Job Site Address: 4565 Bayside Drive Orono,MN 55391 <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 sen�ice 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 /> rvame: Denali Custom Homes Inc. <br /> State License# BC175394 Expiration Date: 03/31/2015 <br /> Phone: (cell) 763-452-8347 (office) 952-476-2679 <br /> nnai�ing Address: 18352 Minnetonka Blvd cit : ee aven z�P: 55391 <br /> Contact Person: Joe MailhOt Applicant is: ontractor / Homeowner (Circle One) <br /> Email and/or Fax: .)02'S Cell Phone: 763 452.8347 <br /> � J�-m�(�Q,r'�I►c,(� mhorru��c� <br /> � PROPERTY OWNER INFORMATION: <br /> .c� Name: Tir � ��ek <br /> � Phone (day): TIt71': (612)801 .3076 <br /> v Address: 170�" s� City: Eden Prairie z�P: 55347 <br /> � Email and/or Fax tjdOU� . ,_ .a��.COfI'1 <br /> ARCHITECT/ENGINEER INFORMATION: <br /> rvame: Alexander Design Group <br /> Phone (day): 952-473-8777 <br /> Address: 401 East Wayzata Blvd ciry: Wayzata ziP: 55391 <br /> Email and/or Fax: <br /> PROJECT INFORMATION: Description of pro�ect: <br /> 1. Type of Project 2. Proposed Use 3. Structure Type 4. Sewage Disposal & <br /> Water Supply <br /> � New Construction � Single Family with Q� Residence <br /> ❑ Addition attached garage ❑ Garage/Accessory Bldg. ❑ Public Sewer <br /> ❑ Accessory Building ❑ Single Family with ❑ Deck <br /> ❑ Relocation detached garage ❑ Office/Commercial � Private Sewer <br /> ❑ Other: (specify) ❑ Multiple Family/Condo ❑ Warehouse <br /> ❑ Public ❑ Storage ❑ Public Water <br /> **Any earth movement may also require ❑ Commercial ❑ Other(specify) <br /> MCWD review 8�permits. ❑ Industrial � Private Well <br /> Minnehaha Creek Watershed District(MCWD) ❑ Other: (SpeCify) <br /> 18202 Minnetonka Blvd <br /> Deephaven, MN 55391 <br /> Phone: 952-471-0590 <br /> Fax: 952-471-0682 <br /> www.minnehahacreek.or <br /> Estimated Construction Valuation (excluding land) $ �,27�,�0�.0� <br />