Laserfiche WebLink
, CITY OF ORONO � 7 ��, �� <br /> . BUILDING PERMIT APPLICATION � 7 <br /> FOR NEW STRUCTURES OR ADDITIONS <br /> �O� MalI1P Box 66, Permit number. ���' — �`�J <br /> � Crystal Bay, MN 55323-0066 Date received: 7� '�3 <br /> Street Address:' � Received by: <br /> �.� `�" 2750 Kelisy Parkway /► l��(\` Plan review#ee: 010 -' O� �7 Z- <br /> �'�kesHo��'G Orono, MN 5535B ��V B b-�,� I�S c�/ 7• lp � <br /> Tatal Fee: <br /> Main: 952-249-4600 Fax: 952-249-4616 www.ci.orono.mn.us <br /> This application form must be compieted in full and all required information must be submitted. <br /> lncomplete applications will be returned. (Piease prinf) <br /> GENERAL INFORMATION: <br /> Job Site Addr9ess: � � '7 C� S�l� G'�� ��-E Qf�On°�� �'�/� 55���1� <br /> Will this be a Parade of Homes, Remodelers Shawcase Home or other Display Home? ❑ Yes No <br /> !f yes,a specra!event permlf rs raqulred with Police Departrnent end City Gouncr!appmval 60 deys prlor M the event. Shuttfe bus service wftJ be <br /> required unless applicanf demonstrates su�cisnf on-stte parking!s avellable. Non-petmftted evenfs wlll not 6e allowed. <br /> CONTRACTOR!APPLICANT INFORMA710N: <br /> ►vame: S%O/VE WOD� LLC% <br /> State License# 2 D S q�3�5 E�cpira4ion Date: <br /> Phone; cell � ofFice <br /> Mailing Address: � �f� /q�}Z�17�Q� LL'/� City;�Il�LS ZIP, 55.3 9/ <br /> Contact Person: Applicant is: Contractor 1 Homeowner �c��a o�e> <br /> Email and/or Fax: <br /> PROPERTY OWNER INFORMATION: <br /> Name: ,_j�E L���CIt C/?l« � �,e/5 �J °ROt,�'�� <br /> Phone(day): � � —�1��J <br /> Address: � � �7 C/`�S(�� Gi,��-� city:O�cJN� ��l/11 Z�P: S5 3 Sf_ <br /> Email and/or Fax <br /> ARCHITECT 1 ENGINEER INF�RMATION: <br /> Name: <br /> Phone (day): <br /> Address: C�tY� Z�P� <br /> EmaiE 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 8 <br /> Water Suppfy <br /> �ew Construction �`Single Family with Residence <br /> p Aaaition / `attached garage �'Garage/Accessory Bldg. �Public Sewer <br /> ❑Accessory Bullding �Single Family with Deck <br /> ❑ Refacation detached garage ❑ Office/CommerciaE ❑ Private Sewer <br /> ❑Other: (spedfy) I ❑ Multiple Famiiy/Condo ❑Warehouss <br /> ❑ Public ❑ Storage "�Public Water <br /> **Any earth movement may also require ❑ Commercial ❑ Ofher(specify) <br /> 'MCWD review&permits. ❑ fndustrial ❑Private Well <br /> Minnehaha Creek Watershed Dishict(MCWD) ,�pther: (spa�Cify) <br /> 98202 Minnetonka Blvd ��p��' �-o��- <br /> Deephaven,MN 55391 <br /> Phone: 952-471-0590 <br /> Fax: 952-471-0682 <br /> n <br /> Estimated Construction Valuation (excluding land) $ � �-�`Z , l.c� � ��� <br />