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, � CITY OF ORONO <br /> BUILDING PERMIT APPLICATION <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: �v�� —� <br /> StreetAddress:' Received by: ✓�. <br /> y � 2750 Keiley Parkway ( �� Plan review fee: <br /> `�tq �,�' Orono, MN 5535 �l� <br /> kFsxo� Total Fee: ���7, �� <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: -.��..�j J �� �i )���, r � r� <br /> Job Site Address: .� � 11 ✓ <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 ill e <br /> required unless appficant demonstrates su�cient on-site parking is available. Non-permitted events will not be allowed. <br /> CONTRACTOR I APPLICANT INFORMATION: <br /> Name: <br /> State License# Expiration Date: <br /> Phone: (cell) (office) <br /> Mailing Address: City: ZIP: <br /> Contact Person: Applicant is: Contractor / Homeowner (Circle One) <br /> Email and/or Fax: <br /> PROPERTY OWNER INFORMATI N: /"`� G1� <br /> Name: �� � � <br /> Phone (day): /� � � <br /> Address: Cit : �lC�/ ZIP: <br /> Email and/or Fax �-(\[ �,—� l /_1 e , r � /' n. <br /> � . <br /> � <br /> ARCHITECT/ENGINEER INFORMATION: <br /> Name: <br /> Phone (day): <br /> Address: 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 rivate 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 8�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) $ <br />