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.�� ' . <br /> 1 <br /> City of Orono <br /> Building Permit Application <br /> for New Structures or Additions <br /> Mailing Address: Permit number: �C���v' ' (`� <br /> t3 PO Box 66 <br /> �` �(� Crystal Bay, MN 55323-0066 Date received: � � '— — <br /> Street Address:' • �, � c7( U <br /> y ; 2750 Kelley Park ay � C��(02 an review fee: ;� .�. Z � <br /> �' � Orono, MN 5535 <br /> �q'�xsy���" Main: 952-249-4600 Total Fee: <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: <br /> Job Site Address: 515 Kokesh Farm Road <br /> Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes � No <br /> !f yes,a special event permit is required with Police Department and City Council approval 60 days prior to the event. Shutt/e 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 /> N2me: NarrConstruction, Inc. <br /> State License# BCo03�85 Expiration Date: 3-31-16 <br /> Phone: (cell) 612-816-1091 (office) 952-938-8781 <br /> Mailing Address: po Box 500� City: Ho�kins Z�P� s��a� <br /> Contact Person: Greg tvarr Applicant is: Contractor / b�l�l��ri�3t (Circle One) <br /> Email and/or Fax: anarr cni narrconstruction.com <br /> PROPERTY OWNER INFORMATION: <br /> Name• Mark R AniTa I itark� <br /> Phone (day): ��?-3R�-�2ai <br /> Add�eSS: 4360 County Road#6 Cit : Orono ZIP: 55356 <br /> Email and/or Fax markliteckv@amail.com <br /> ARCHITECT/ENGINEER INFORMATION: <br /> N2me: Sharratt Desian <br /> Phone (day): 952-4�o-s�5o <br /> Address: asa�d 5t__ City: Excelsior Z�P� 5331 <br /> ECT181�alld/Of FaX: msharrattlp�sharrattdesian.com <br /> PROJECT INFORMATION: Descri tion of ro�ect: <br /> 1.Type of Project 2. Proposed Use 3.Structure Type 4.Sewage Disposal& <br /> Water Supply <br /> ❑ New Construction � Single Family with ❑Accessory Bldg./Garage <br /> �Addition attached garage ❑ Deck ❑ Public Sewer <br /> ❑Accessory Building ❑ Single Family with ❑ O�ce/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 require ❑ Commercial ❑Storage <br /> MCWD review&permits. ❑ Industrial ❑Warehouse <br /> � Private Well <br /> Minnehaha Creek Watershed District(MCWD) ❑Othef: (SpeCify) ❑ Oth2r(SpeCify) <br /> 15320 Minnetonka Blvd <br /> Minnetonka,MN 55345 <br /> Phone: 952-471-0590 <br /> Fax: 952-471-0682 <br /> www.minnehahacreek.or <br /> Estimated Construction Valuation (excluding land) $ �50,000 <br /> Packet Last Updated: August 2015 <br /> Page 21 <br />