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, ' .� <br /> City of Orono � <br /> Buildin Permit A lication � � <br /> 9 pp J <br /> 1 <br /> for New Structures or Additions <br /> Mailing Address: Permit number. G'/ � "�'l�'� <br /> '��0��, PO Box 66 <br /> Q � Crystal Bay, MN 55323-0066 Date received: - 9 —/ � <br /> �/ ' � Street Address:' � ._,�_!_ Received by: ��� <br /> � � � �,' 2750 Kelley Parkway �- --��3----- —' <br /> `\'� ,� ��% Orono, MN 55356 � � C`�- I �-`� <br /> Plan review fee: � � <br /> �����r���`�`i Main: 952-249-4600 TotalFee: �� � <br /> �— Fax: 952-249-4616 ����:-�-:^�!�.:i oror�o.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: 3472 L ric Ave Orono, MN 55319 <br /> Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? Yes No <br /> If yes,a specia/event pe�mit is required with Police Department and City Council approva/60 days prior to the event. Shutt/e bus service will be <br /> required un/ess applicant demonstrates sufficient on-site parking is availab/e. Non-permitted events will not be allowed. <br /> CONTRACTOR/APPLICANT INFORMATION: <br /> Name: Joshua/Markum Builders, Inc. <br /> State License# BC631542 Expiration Date: 03/31/2018 <br /> Phone: (cell) 612-998-7818 (office) <br /> Mailing Address: 7867 Eastwood Road City: Mounds View ZIP: 55112 <br /> Contact Person: Mark Olson Applicant is: Contractor / Homeowner �c�rcie one� <br /> Email and/or Fax: mar joshuamarkum.com <br /> PROPERTY OWNER INFORMATION: <br /> Name: SAME AS ABOVE <br /> Phone(day): <br /> Address: City: ZIP: <br /> Email and/or Fax <br /> ARCHITECT/ENGINEER INFORMATION: <br /> Name: Littfin Design Mitch <br /> Phone(day): {320)-224-7844 <br /> Address: 449 Lake trail City: Winsted ZIP: 55395 <br /> Email and/or Fax: mlittfinQhotmail.com <br /> PROJECT INFORMATION: Descri tion of ro�ect: �`�''-�-' �-�< <=�r�"�'�- <br /> 1.Type of Project 2.Proposed Use 3.Structure Type 4.Sewage Disposal8� <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 ❑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 require ❑Commercial ❑Storage <br /> MCWD review 8�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 /> �'�� �k. <br /> Estimated Construction Valuation (excluding land) $ $300,000 <br /> Packet Last Updated: August 2015 <br /> Page 21 <br />