Laserfiche WebLink
. . , City of Orono <br /> � Building Permit Application <br /> for New Structures or Additions <br /> Mailin Address: C��� �, <br /> g,O,j� PO Box 66 Permit number: ��� — �� ���% <br /> � �, � <br /> Crystal Bay, MN 55323-0066 Date received: � � <br /> �N y^':-v <br /> �,,� �( -;` �, , Street Address:� Received by: � <br /> ,. � ---- <br /> \�',�,t y���,�j„�Gti�' 2750 Kelley Parkw y ,�; G/� -�>(oQJ Plan review fee: �(D S � � f �C� . <br /> �EeH�� Orono, MN 55356 _ � �fj <br /> �-_= Total Fee: <br /> Main: 952-249�600 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: <br /> Job Site Address: �,��� �jx�j� �y��yj�j�Mi7 . ������ � <br /> Will this be a Parade of Homes, Remodelers Showcase Horne or other Display Home? ❑ Yes �o <br /> If yes, a special event permit is required with Police Deparfinent and City Council approval 60 days prior to the event. Shuttle bus service will be <br /> required unless applicant demonstrates sufficient on-site parking rs available. Non-permitted events will not be allowed. <br /> CONTRACTOR I APPLICANT INFORMATION: <br /> Name: _ _. <br /> State License# Expiration Date: <br /> Phone: (office) (cell) <br /> Mailing Address: f City: ZIP: <br /> Contact Person: Applicant is: Contractor / Homeowner (Circle One) <br /> Email and/or Fax: <br /> PROPERTY OWNER IN OR ATION: ' - <br /> Name: j �L� . <br /> Phone (day): 5 �--S — <br /> ss: ,�j, Cit : ZIP: � <br /> Em ' and/or Fax � ' /Y) <br /> ARCHITECT/ENGINEER INFORMATION: <br /> Name: <br /> Phone (day): <br /> Address: City: ZI P: <br /> Email and/or Fax: <br /> PROJECT INFORMATION: <br /> 1.Type of Project 2. Proposed Use 3. Structure Type 4. Sewage Disposal 8� <br /> Water Supply <br /> ❑ New Construction [� Single Family with esidence <br /> ❑Addition attached garage ❑ Garage/Accessory Bldg. ❑ Public Sewer <br /> ❑Accessory Building �ingle Family with ❑ Deck <br /> ❑ ocation ��� /f detached garage ❑ Office/Commercial ❑ Private Sewer <br /> Other: (specify) �Y1L�(`U' ❑ Multiple Family/Condo ❑Warehouse <br /> ❑ Public ❑ Storage ❑ Public Water <br /> ""Any earth movement may require ❑ Commercial ❑ Other(specify) <br /> MCWD review&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) $ �i o C)� J <br />