Laserfiche WebLink
� � <br /> � �. <br /> City of Orono �� <br /> . . � <br /> Building Permit Application ' <br /> for New Structures or Additions <br /> - Mailing Address: Permit number. �- � / <br /> ,-�j,0,�. . PO Box 66 <br /> � 0`•; <br /> Crystal Bay, MN 55323-0066 Date received: l D`"'ZO —1' <br /> � '�� Street Address:' Received by: <br /> . � <br /> ' 's'F, "�S� ��;. {ti G. 2750 Kelley Parkway �C� � -OI G Cj Plan revi�w fe���� �� 7 , � � <br /> `l9 ��' ��g,�. � Orono, MN 55356 <br /> kESHO <br /> Total Fee: <br /> Main: 952-249-4600 Fax: 952-249-4616 ��Jv✓w ci ,�ron�; n�n.�.�� <br /> This application form must be completed in full and all required information must be submitted. <br /> Incomplete applications will be returned. (P/ease print) <br /> GENERAL INFORMATION: <br /> � <br /> Job Site Address: �?,;��= ' - �=��c��,\f_ �" �� ��e (,�� � '' (�; �• `��, �'�/�,�? <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 wdh Police Department and City Council approva160 days prior to the event. Shuttle bus service will be <br /> required unless applicant demonstrates sufficient on-site parking is available. Non-permitted events will not be allowed. <br /> CONTRACTOR/APPLICANT INFORMATION: <br /> Name: i���� ��,a y<..,,,��e ��� ,,�-•e S <br /> State License# � ._ / Expiration Date: <br /> Phone: �i s� - '-I� � '•�o`S�I (office) �r�-�S�-��>S�c (cell) <br /> Mailing Address: �� � s �;;�., z .���, '��1 „c{ i=<,, i Cit : ��,�_ ��_� � ZIP: t-� �`� 1 <br /> Contact Person: t'v��,:�� �, \�,�_�,,, j Applicant is: ontractor / Homeowner (Circle One) <br /> Email and/or Fax: rv���a�ti _,A�,.�,�4.;`.���.v�� �, y�4,c,c�� � c� v� <br /> PROPERTY OWNER INFORMATION: <br /> Name: <br /> Phone(day): ' , <br /> Address: , `' City: ZIP: <br /> Email and/or Fax <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& <br /> Water Supply <br /> � New Construction (� Single Family with ,�C Residence <br /> Addition attached garage ❑Garage/Accessory Bldg. Ft1 p��hlic Sewer <br /> ❑Accessory Building ❑ Single Family with ❑ Deck <br /> ❑ Relocation detached garage ❑ Office/Com;�r�al � '-`�„J'�+ivate Sewer <br /> ❑ Other: (specify) __ ❑ Multiple Family/Condo ❑Warehouse� <br /> ❑ Public ❑ Storage �p�blic Water <br /> ""Any earth movement may require ❑ Commercial ❑ Other(spe�cify) <br /> MCWD review 8�permits. ❑ Industnal ___________ � �nvate 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 /> ww�.v�� � � ,��rFe_ <br /> Estimated Constructi�on Valuation (excluding land) E � S , S-c� � � '` <br /> T— <br />