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� p, <br /> � . ��• ! RECEIVED <br /> (�l7 <br /> • City of Orono AUG 2 4 2016 <br /> Buiiding Permit Application <br /> for New Structures or Additions C�NOFORONO <br /> Mailing Add�ss: Permit number: ����'��� � <br /> OA, PO Box 66 �i 4 � / <br /> � `vQ Crystal Bay, MN 55323-0 ���N Date received: O '�T� � <br /> Street Address:' �lN iV Received by: i,// <br /> y ,�* 2750 Kelley Parkway � � Plan r view fee: � � S• � <br /> � �` Orono, MN 55356 P�r ,�� <br /> �"�K�SHOQ`� Main: 952-249-4600 Total Fee: d�� t'^� ��� � <br /> Fax: 952-249-4616 www.ci.orono.mn.us � <br /> This application form must be completed in full and all required information must be sub tted. <br /> Incomplete applications will be retumed. (Please print) <br /> GENERAL INFORMATION: <br /> Job Site Address: 2480 Casco Point Road,Wayzata,MN 55391 <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 required with Police Department and City Council approval 60 days prior to the event. Shutfle bus service will be <br /> required unless applicant demonstrates s�cient on-site parking is available. Non-permitted events will not be al/owed. <br /> CONTRACTOR/APPLICANT INFORMATION: <br /> Name: �N a���c,��c <br /> State License# Bcssea�z Expiration Date: o�-s�-zo�a <br /> Phone: (cell) s�2-2aa82os (OffIC@) 952�73-0781 <br /> Mailing Addr2sS: 801 Twelve Oaks Center Drive Suite 812 Ctt : Wa ata ZIP: 55391 <br /> Contact Person: r���o r,�e�� Applicant is: Contractor / Homeowner (Circle One) <br /> Efllal� 8f1C�/Of Fc'lX: raino@jnbuilt.com <br /> PROPERTY OWNER INFORMATION: <br /> Na(pg: Stephen J.Rudolph <br /> Phone (day): �ss-asa-ao5� <br /> AddfeSS: 2480 Casco Point Road CIty:Wayzata ZIP: 55391 <br /> Email and/or Fax steve.rudolph@yahoo.com <br /> ARCHITECT 1 ENGINEER INFORMATION: <br /> Na�pg: Murphy 8 Co.Design <br /> Phone(day): s�z-a�o-ss�� <br /> Add�@SS: 811 Glenwood Avenue,Suite 250 Clty: Minneapolis ZII�:55405 <br /> Efl'181� 811d�Of FBX: TJ@murphycodesign.com orjeffQmurphycodesign.com <br /> PROJECT INFORMATION: Descri tion of f0 @Ct:Addition and Remodel <br /> 1.Type of Project 2.Proposed Use 3.Structure Type 4.Sewage Disposal 8� <br /> Water Supply <br /> ❑ New Construction ❑� Single Family with ❑Accessory Bldg./Garage <br /> 0■ Addition attached garage ❑ Deck � Public Sewer <br /> ❑Accessory Building ❑ Single Family with ❑ Office/Commercial <br /> ❑ Relocation detached garage � Residence ❑ Private Sewer <br /> ❑ Other: (specify) ❑ Multiple Family/Condo ❑ Retaining Wall(s) <br /> ❑ Public 4feet or greater � Public Water <br /> "*Any earth movement may require ❑Commercial ❑Storage <br /> MCWD review 8 permits. ❑ Industrial ❑Warehouse ❑ Private Well <br /> Minnehaha Creek Watershed District(MCWD) ❑ Other: (specify) ❑Other(specify) <br /> 15320 Minnetonka Blvd <br /> Minnetonka,MN 55345 <br /> Phone: 952-471-0590 <br /> Fax: 952-471-0682 <br /> www.minnehahacreek.or <br /> Estimated Construction Valuation (excluding land) � �,000,000.00 <br /> Packet Last Updated: August 2015 <br /> Page 21 <br />