Laserfiche WebLink
� ' i . <br /> CITY OF ORONO t� <br /> ��..s�, 9.5 <br /> BUILDING PERMIT APPLICATION <br /> FOR NEW STRUCTURES OR ADDITIONS <br /> O Mailing Address: Permit number: aOIJ�-D�D D <br /> PO Box 66 <br /> � O , <br /> Crystal Bay, MN 55323-0066 � i IC J__ ..Q Date received: ���-S -�J <br /> � K-�a Tu�rt.auc. <br /> Street Address:' Q �y Received by: �� <br /> Z� � 2750 Kelley Parkway U ��'' D Plan reviewfee: � S , <br /> t `' Orono, MN 55356 <br /> �kfsHo�E Total Fee: ��� s OU�p� <br /> Main: 952-249-4600 Fax: 952-249-4616 www.ci.orono.mn.us o?O/,5-DO�oU�'- <br /> This application form must be completed in full and all required information must be submitted. . <br /> Incomplete applications will be retur�ted. �lease print) ���� r���--�Q� r/ <br /> GENERAL INFORMATION: � �,U"- '� � 1 CSCYOIN �0'�✓ _v <br /> Job Site Address: 2735 Deer Run Trail li '� \ <br /> Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes 0■ 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 /> Na�'pg: NIH Homes <br /> State License# BC419931 Expiration Date: 20�� <br /> Phone: (cell)6,2-zz,-,853 (office) <br /> Mailing Address: ssao2�scna�e CIt�/. ElkRiver ZIP: ss3so <br /> Contact Person: coic Applicant is: Contractor / Homeowner (CircleOne) <br /> EfT181� af1C��01' FaX: colt@nihhomes.com <br /> PROPERTY OWNER INFORMATION: <br /> Na�pg: NIH Homes <br /> Phone(day): <br /> Address: City: ZIP: <br /> Email and/or Fax <br /> ARCHITECT/ ENGINEER INFORMATION: <br /> Name: <br /> Phone(day): <br /> Address: City: ZIP: <br /> Email and/or Fax: <br /> PROJECT INFORMATION: Description of pro'ect: NEwHome <br /> 1. Type of Project 2. Proposed Use 3. Structure Type 4. Sewage Disposal 8� <br /> Water Supply <br /> ❑✓ New Construction ❑� Single Family with ❑✓ 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&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) $—�-`' �� � �''��'� 6�c ���" <br />