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i <br /> � ,: � <br /> � CITY OF ORONO <br /> BUILDING PERMIT APPLICATION <br /> FOR NEW STRUCTURES OR ADDITIONS <br /> �� Mailin Address: <br /> ���/�� g PeRnit number: /�-CO�7Z� <br /> � �� PO Box 66 <br /> Crystal Bay, MN 55323-0066 Date received: ��tS�/5 <br /> �` �, � ,� StreetAddress:' Received by: � '� <br /> '`.�, �;� 2750 Kelley Parkway /I� �s D67 lan review fee: � �j' ~ <br /> �,�k f ��,`' Orono, MN 55356 G _ (p � <br /> s H o� --�,---;,—_., �, �� --- ' <br /> Total Fee: . s l . -�,i -- <br /> Main: 952-249-4600 Fax: 952-249-4616 wsvw.ci.ororo m^.us (� t < -�� d- ✓ <br /> This application form must be completed in fuil and all required information must b ubmitted. <br /> Incomplete applications will be returned. (Please print) � �Y`l; �-��`�/ �5 <br /> GENERAL INFORMATION: <br /> Job Site Address: 2755 Ethel Ave., Orono,MN 55391 <br /> Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes � No <br /> lf 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 availab/e. Non-permitted events will not be allowed. <br /> CONTRACTOR/APPLICANT INFORMATION: <br /> Name: Everlast Enterprises, Inc. <br /> State License# BC591566 Expiration Date: 3-31-16 <br /> Phone: _(cell) 612-868-0748 (office) 952-472-7287 <br /> Mailing Address: 4109 No Shore Drive City: Orono ZIP� 55 64 <br /> Contact Person: James Cleary Applicant is: � on rac or � / Homeowner (Circle One) <br /> Email and/or Fax: 952-472-5870 <br /> PROPERTY OWNER INFORMATION: <br /> Name: Everlast Entemrises,Inc. <br /> Phone(day): 612-868-0748 <br /> Address: 4109 No Shore Drive Cit : Orono ZIP� 55364 <br /> Email and/or Fax iim@EverlastEnterprises.com <br /> ARCHITECT/ENGINEER INFORMATION: <br /> Name: none <br /> Phone (day): � <br /> Address: City: ZIP� <br /> Email and/or Fax: <br /> PROJECT INFORMATION: Descri tion of ro�ect: �:.r �� �I + <br /> 1.Type of Project 2. Proposed Use 3.Structure Type 4.Sewage Disposal& <br /> [�New Construction Water Supply <br /> �Single Family with �Residence <br /> ❑Addition attached garage ❑ Gara e/Accesso Bld <br /> ❑Accesso Buildin g rY 9 �Public Sewer <br /> ry g ❑ Single Family with ❑ Deck <br /> ❑ Relocation detached garage ❑ Office/Commercial <br /> ❑Other: (specify) ❑ Private Sewer <br /> ❑ Multiple Family/Condo ❑Warehouse <br /> ❑ Public ❑Storage �Public Water <br /> ""Any earth movement may also require ❑Commercial ❑ Other(specify) <br /> MCWD review 8�permits. ❑ Industrial <br /> ❑ 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 /> vwv�v.minnehahacreek o�c� <br /> Estimated Construction Valuation (excluding land) $ � „��� Cx� <br />