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- , , <br /> 1 ti <br /> �+�+�i E���Q' <br /> CITY OF ORONO � �� � ����� <br /> BUILDING PERMIT APPLICATION � <br /> FOR NEW STRUCTURES OR ADDITIOI�� �� ���'�� <br /> �O�O Mailing Address: Permit number: D/ �d� <br /> PO Box 66 <br /> Crystal Bay, MN 55323-0066 Date received: �/—�� —/ <br /> StreetAddress:' Received by: <br /> yF � 2750 Kelley Parkway Plan review fee: <br /> t �,� Orono, MN 55356 <br /> ��ES H�� /�, <br /> Total Fee: � LL� �5 <br /> Main: 952-249-4600 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. (P/ease print) <br /> GENERAL INFORMATION: <br /> Job Site Address: 2700 Kelley Parkway, Orono, MN 55356 <br /> Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes � No <br /> /f yes, a specia/event permit is required with Po/ice Department and City Counci/approva/60 days prior to the event. Shutt/e bus service wi//be <br /> required unless applicant demonstrates su�cient on-site parking is availab/e. Non-permitted events will not be allowed. <br /> CONTRACTOR/APPLICANT INFORMATION: <br /> Name: S�rint ,Lessee) <br /> State License# Expiration Date: <br /> Phone: (cell) 810-542-0572 SMi (office) <br /> Mailing Add�ess:SMJ International on behalf of Sprint 49357 Pontiac Trail#206 City: Wixom,MI ZIP: 48393 <br /> Contact Person: At�dra x�h1Pr Applicant is: Contractor / Homeowner (Circle One) <br /> Email 2nd/or Fax: akohlerC�smj-llc.com gent for Sprint(Lessee <br /> PROPERTY OWNER INFORMATION: <br /> Name: ��flf nro„� <br /> Phone (day): <br /> Address: City: ZIP: <br /> Email and/or Fax <br /> ARCHITECT/ENGINEER INFORMATION: <br /> �lame: <br /> Phone (day): <br /> Address: City: ZIP: <br /> Email and/or Fax: <br /> PROJECT INFORMATION: Descri tion of ro�ect: <br /> 1.Type of Project 2. Proposed Use 3.Str�actur�Type 4.Sewage Disposal& <br /> Water Supply <br /> ❑ New Construction ❑Single Family with ❑ Residence <br /> ❑Addition attached garage ❑ Garage/Accessory Bldg. ❑ Public Sewer <br /> ❑Accessory Building ❑ Single Family with ❑ Deck <br /> ❑ Relocation detached garage ❑ Office/Commercial ❑ Private Sewer <br /> � Other: (specify)�olocation on water towe ❑Multiple Family/Condo ❑Warehouse <br /> ❑ Public ❑ Storage ❑ Public Water <br /> ""Any earth movement may also require � Commercial (y� Other(specify) <br /> MCWD review&permits. ❑ Industrial colocation on water tower ❑ 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.minnehaha reek.or <br /> Estimated Construction Valuation (excluding land) $ 20,000 <br />