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. Q��l,.�. <br /> 5 ��L �� � _ <br /> ` - 6a. � -�o/ <br /> �s��� �� �� <br /> av �a -do,3�7 ``� <br /> City of Orono <br /> Building Permit Application <br /> for New Structures or Additions � I 9�. � <br /> Mailing Address: Permit number: �Dl�-b�Z 7 <br /> g,�,� PO Box 66 <br /> � Q Crystal Bay, MN 55323-0066 Date received: _ �-�p_10 __ <br /> ���`'' Received b Cl�S <br /> a ��"� ., s. Street Address:� y <br /> `:�'.�nt:��'&t}���`Y��. 2750 Kelley Parkway Plan review fee: ����p� <br /> \ '�k�sxo�`` Orono, MN 55356 <br /> aD/0-�DO <br /> Total Fee: <br /> Main: 952-249-4600 Fax: 952-249-4616 'J!V✓\N.:;I.OfO110.fl1i_,IIS � <br /> This application form must be completed in full and all required information must be submitted. <br /> Incomplete applications will be returned. (Please prinf) <br /> GENERAL INFORMATION: 2700 Eth2I AVet1Ue <br /> Job Site Address: <br /> Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes � No <br /> If yes,a specia/event permit is repuired with Police Dep�rtment and City Counci!approval 60 days prior fo the even(. Shuttle bus service w�l!be <br /> required unless applicant demonstrates suffrcient on-site parking is available. Non-permitted evenfs will not be allowed. <br /> CONTRACTOR/APPLICANT INFORMATION: <br /> NBme: Brennan Properties LLC <br /> State License# zossiaio Expiration Date: o3-3�-2o�� <br /> Phone: 6�2-6�6-444� (office) <br /> Mailing Address: 8452 153rd Place Cjty Savage,MN ZIP� sss�s �cell) <br /> Contact Person: �oe eren�a� Applicant is: n r r / Homeowner (Circle One) <br /> ---- - -—- _ -— ---- ---- <br /> EIY181� 2fld/Of FBX: )oe.brennan@mchsi.com,952-856-5081 <br /> PROPERTY OWNER INFORMATION: <br /> N2me: Lori Gherardi <br /> Phone (day): s�z-s�o-a22s - <br /> Address: 1010 Willow view Drive, City Orono ZIP: <br /> Email and/or Fax LoriGherardi@yahoo.com - � <br /> ARCHITECT/ENGINEER INFORMATION: <br /> Name: NA <br /> Phone (day): <br /> Address: City� ZIP <br /> Email and/or Fax: <br /> PROJECT INFORMATION: <br /> - _--- __ <br /> 1.Type of Project 2.Proposed Use 3.Structure Type 4.Sewage Disposal 8� <br /> ❑ New Construction Water Supply <br /> X Addition � Single Family with ❑ Residence <br /> ❑ attached garage Q Gara e/Accessor Bld <br /> ❑Accessory Building ❑ Single Family with ❑ Deckg y g' ❑ Public Sewer <br /> ❑ Relocation detached garage ❑ Office/Commercial <br /> ❑ Other (specify) ❑ Multi le Famil /Condo ❑ Private Sewer <br /> P Y ❑Warehouse <br /> ❑ Public ❑ Storage ❑ Public Water <br /> *'Any earth movement may require ❑ Commercial ❑ Other(specify) <br /> MCWD review 8 permits, ❑ Industrial ❑ Private Well <br /> Minnehaha Creek Watershed District(MCWD) ❑ Other: (speci(y) <br /> 18202 Minnetonka Blvd <br /> Deephaven,MN 55391 <br /> Phone: 952-47�-0590 i <br /> Fax: 952-471-0682 I <br /> www.mi nnehahacreek.or <br /> Estimated Construction Valuation (excluding land) $ g,5oo <br /> Last Updated: 9/29/2009 <br /> - 17- <br />