Laserfiche WebLink
� • � l� ��:'- ,l� <br /> CITY OF ORONO �.�.�� <br /> BUILDING PERMIT APPLICATION ��jo�. `t� <br /> FOR NEW STRUCTURES OR ADDITIONS <br /> �O�O Mailing Address: Permit number: �/ �� ,� <br /> PO Box 66 <br /> Crystal Bay, MN 55323-0066 Date received: '�� �� <br /> StreetAddress:' Received by: <br /> yF � 2750 Kelley Parkway Plan review fee� <br /> �,�' Orono, MN 55356 � <br /> `�'�ESH�� ��a, �9 <br /> Total Fee: <br /> Main: 952-249-4600 Fax: 952-249-4616 www.ci.orono.mn.us <br /> This application form must be completed in full and all required information must be submitted. <br /> Incomplete applications will be returned. (Please print) <br /> GENERAL INFORMATION: <br /> Job Site Address: (� C�ne v C�uSe- � r� <br /> Will this be a Parade of Homes, Remodelers howcase 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 service ill b <br /> required unless applicant demonstrates sufficient on-site parking is available. Non-permitted events wifl not be allowed. <br /> CONTRACTOR/APPLICANT INFORMATION: �Z�1S� <br /> Name: �jut�l�r �� ; �-LL <br /> State License# Z $ Expiration Date: - 3 J <br /> Phone: cell (� �Z - O- `1 office <br /> Mailing Address: q(�Z o S, Lo� � Sa v�a D r� Cit : c ,� ' ZIP: 5 35 ;� <br /> Contact Person: � z Applicant is: Contractor / Homeowner (Circle One) <br /> Email and/or Fax: i,�,��,-3�,; � ;,.� ('.,�; . ��,.� <br /> PROPERTY OWNER INFORMATION• <br /> Name: pe �v�;� �o �V�Sov� <br /> Phone (day): �(''�j Z- �7(o - 4 I 5� <br /> Address: (p eV C c{,Se. Y , Cit : �M�oNCJ ZIP: � 3� <br /> Email and/or Fax s ( c <br /> ARCHITECT/ENGINEER INFORMATION: <br /> Name: a e,r- �� I � L� <br /> Phone (day): Z- O - <br /> Address: �M�. City: ZIP: <br /> Email and/or Fax: _ � � <br /> PROJECT INFORMATION: Description of project: <br /> 1.Type of Project 2. Proposed Use 3.Structure Type 4. Sewage Disposal & <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) $ 5 ` � �� 1 <br />