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. ��: S�' C'�ll...rz�.C�� <br /> ,-_ ;-�, �"�_��-r-r,��;-. �� Zol�-G1"Zl.n�j <br /> CITY OF ORONO ' � � <br /> / �� � <br /> BUILDING PERMIT APPLICATION �(P <br /> FOR NEW STRUCTURES OR ADDITIONS / <br /> �O�O Mailing Address: Permit number: ��Q—� / [� <br /> PO Box 66 <br /> Crystal Bay, MN 55323-0066 Date received: ����—( <br /> Street Address:� Received by: T <br /> y�, L� 2750 Kelley Parkway �y�� �� Plan review fee: �O.b � <br /> �qkFSHo��. Orono, MN 55356 � � �U/ �U �d 3 , <br /> Main: 952-249-4600 , <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 submitted. <br /> Incomplete applications will be returned. (Please print) <br /> GENERAL INFORMATION: . � , � De�� t _ � <br /> Job Site Address: � e = ��_ ��J� j�� <br /> Will this be a Parade of Homes, emodelers 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 ll be <br /> required unless applicant demonstrates sufficient on-site parking is available. Non-permitted events will not be allowed. <br /> CONTRACTOR/APPLICANT I FO MATI � <br /> Name: � �.(� �l,l (� (,� <br /> State License# G Expiration Date: 3 I <br /> Phone: cell) — � office) S�' 3��J ''�J <br /> Mailing Address: .— Cit : � ny�, wZIP: b""S <br /> Contact Person: Applicant is• Contractor / Homeowner (Circle One) <br /> Email and/or Fax: ��V�:, � j,�,}J� a. e c,c� (�QS. ���^. <br /> PROPERTY OWNER INFORMATION: <br /> Name: ''p v.� � L.L. C , � � <br /> Phone (day): — 8� <br /> Address: v. ,s��3 Cit : ;.,.�. ZIP: S �j <br /> Email and/or Fax � ' , <br /> ARCHITECT/ ENGINEER IfV�OgMATI�i�I� � <br /> Name: �.c�.oU`.�' f���d�L� <br /> Phone (day): QS.�-- � � 1,,- <br /> Address: � `7 — �2.�Qt� Cit : yY�i r1r���1�C,ZIP: ��� <br /> Email and/or Fax: u,t, , <br /> PROJECT INFORMATION: Description of project: t�J r� � .0% U -^-' � <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 /> ❑ Addition attached garage ❑ Deck �ublic 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 4-feet or greater ❑ Public Water <br /> `*Any earth movement may also require ❑ Commercial ❑ Storage <br /> MCWD review&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.orq <br /> Estimated Construction Valuation (excluding land) $ ( �� d O d. <br /> Last Updated: January 2016 <br />