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City of Orono <br /> Building Permit Application <br /> for New Structures or Additions <br /> — Mailing Address: Permit number: C�K o�— D��C4g <br /> 0 PO Box 66 <br /> � � Crystal Bay, MN 55323-0066 Date received: �y�� <br /> � 0','•, <br /> �a �j�'1�� : �,'' StreetAddress' Received by: <br /> �`�'� j����x� ��. 2750 Kelley Parkway � PI n review fee: � 7 . / , <br /> � �qk�sxo�`'�'�� Orono, MN 55356 � �' ���— � 1 <br /> = o?O/p"�- �0��' �' <br /> - Tota-TF-ee'----___-------- ; <br /> Main: 952-249-4600 Fax: 952-249-4616 www.ci.orono.mn.us (�G, , 'j ' <br /> This application form must be completed in full and all required information must be s mitted. <br /> Incomplete applications will be returned. (Please print) <br /> GENERAL INFORMATION: <br /> Job Site Address: 3980 Dahl Road Mound, MN 55364 <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 service wrll 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: Narr Construction, Inc. <br /> State License# BC003785 Expiration Date: _ 3/31/2014 <br /> Phone: 952-938-8781 (office) 612-816-1091 (cell) <br /> Mailing Address: p n Rnx .�i(1C17 Cit : Hopkins Z�P: 55343 <br /> Contact Person: Greg Narr Applicant is: Contractor / I��,�Q�x (Circle One) , <br /> Email and/or Fax: �narr C�naCfCOnStfU�tlOn COri1 952-931-0449 <br /> PROPERTY OWNER INFORMATION: <br /> ►vame: Tom and Toni McGlynn <br /> Phone(day): F1�-751-2519 <br /> Address: same as site address City: ;T;�? <br /> Email and/or Fax tom(cr�atownrealty.com _ <br /> ARCHITECT/ ENGINEER INFORMATION: <br /> Name: Sharratt Desiqn Company <br /> Phone(day): _�52-470-9750 <br /> Address: 464 Second St Suite 100 City:Excelsior ZIP: 55331 <br /> Email and/or Fax: msharratt(ci)sharrattdesign.com <br /> PROJECT INFORMATION: <br /> 1.7ype 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 require ❑Commercial ❑ Other(specify) <br /> MCWD review&permits. ❑ Industrial <br /> � Private Well <br /> Minnehaha Creek Watershed District(MCWD) ❑Othef:(SpeCify) <br /> 18202 Minnetonka Blvd <br /> Deephaven,MN 55391 <br /> Phone: 952-471-0590 <br /> Fax: 952-471-0682 <br /> www.minnehahacreek.or <br /> Estirr;ated Construction Valuation(excluding land) $ 1,000,100.00 <br />