Laserfiche WebLink
, . � � c� ,�` <br /> CITY OF ORONO �� � 7 50 <br /> �� � .�-�. <br /> BUILDING PERMIT APPLICATION <br /> FOR NEW STRUCTURES OR ADDITIONS <br /> �O�O Mailing Address: Permit number: o�/—��p <br /> PO Box 66 <br /> Crystal Bay, MN 55323-0066 Date received: �� <br /> StreetAddress:' Received by: <br /> y� � 2750 Kelley Parkway Plan review fee: �� <br /> �,� Orono, MN 55356 <br /> `�k�SH�� Total Fee: d0/y— <br /> Main: 952-249-4600 Fax: 952-249-4616 www.ci.orono.mn.us C <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 ,,_, <br /> Job Site Address: � Q.� �S� '2� �T /1�-- <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 approva/60 days prior to the event. Shuttle bus service will be <br /> required unless applicant demonstrates sufficient on-srte parking is available. Non-permitted events will not be allowed. <br /> CONTRACTOR/APPLI ANT INFOR ATION: <br /> Name: Z U. �Lc��-�2.5 � � <br /> State License# ' � Expiration Date: <br /> Phone: cell � — � office �' — <br /> Mailing Address: ' �? Ci � IP: , � <br /> Contact Person: Z Applicant is: ontractor / Homeowner (Circle One) <br /> Email and/or Fax: Z � ��av, <br /> PROPERTY OWNER INFO. ATION: <br /> Name: �L1�full�4U� , � � <br /> Phone (day): � <br /> Address: Cit : ZIP: <br /> Email and/or Fax � �.��rV� <br /> � <br /> ARCHITECT/ENGINEER INFORMATIO <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 ingle Family with ❑ Residence <br /> �Addition attached garage ❑ Garage/Accessory Bldg. ❑ Public Sewer <br /> ❑ Accessory Building ❑ Single Family with �Cfeck <br /> ❑ Relocation detached garage ❑ Office/Commercial ❑ Private Sewer <br /> ❑ Other. (specify) �� ❑ Multiple Family/Condo ❑Warehouse <br /> i'- ��^,� ❑ Public ❑ Storage ❑ Public Water <br /> **Any earth movement may 1'so 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 />