Laserfiche WebLink
.;, <br /> � +i <br /> � ` <br /> 1 <br /> 7 <br /> {J <br /> City of 4rono � � <br /> Building Perm�t Appl�cation �� �• � <br /> for a Swimming Pool <br /> � A, Mailing Address: --'r� �-. ,� , c- <br /> ��r YO PO Box 66 Permft number. •--r.� � . > � _.� <br /> Crystal Bay, MN 55323-0066 Date received: � ',, - --j r� <br /> __- -- . ' <br /> ,, � Street Address: i!, Received by: _'���' ,,���3�� <br /> y�, � 2750 Kelley Par ` y �C �5"t:�-�j�p c;� ` 1' <br /> � Plan review fee: � �� . z-�� �,'� ` <br /> Orono, MN 55356 -.-- -- <br /> `'�'rESHaRti' _ _ _....._ <br /> Total Fee: <br /> Main: 952-249-4600 Fax: 952-249-4616 www.ci.orono.mn.us � ' � r�,��-- <br /> This application form must be completed in full and all required information must be submitted. <br /> Incompiete applications will be returned. (Please print) <br /> GENERAL INFORMATION: <br /> Job Site Address: � �� .��,��L��� � <br /> , <br /> CONTRACTOR/AP ICANTINFORMATI <br /> Name: �E.�F���MAr.°iC��poL •���'A <br /> State License# _C=Sr�_r S-��cTAiSy Expiration Date: <br /> Phone: �5� -7�5- 39�Id Fax. (�,��� ��1-�.;7Z— <br /> Address: � Ct :'� -} ZIP: 5 <br /> Contact Person: � ContacYs phone number ,- y U <br /> Email: s � , '"1 A licant is: n r � Homeowner �c�►c�e ooe� <br /> PROPERTY OWNER INFORMATION: <br /> 1 <br /> Name: ` ' �-►h : . �` _�-�;, <br /> Phone(day): Z, " -11 <br /> Mailing Address: t �' � "�i?_p�;C, l Z�p: 3; � <br /> Email and/or Fax: S�Qg�q � ��q,��.�,py� <br /> ENGINEER INFORMATION: <br /> Name: <br /> Phone: <br /> Address: City: ZiP• <br /> Email: Fax: <br /> PROJEGT INFORMATION: <br /> 1.Pool Dimensions: 4.Accessory to: 5.Pool Type: 7.Retaining Walls? <br /> �� X �!O feet ❑Above�rQUIl�_ ❑yes no Height <br /> [�Single Family � <br /> � <br /> 2.Heated� ❑Multiple Family/Corido ; �Ja In-ground � *A building pennit is required <br /> �(yes ❑no �Public for any walf over 4 feet in <br /> ��Other(specify) height measured from the <br /> 3. Excavated materials will be: ❑Commercial bottom of the footing to the top <br /> ❑Industrial of the wall, even if it repfaces <br /> ❑removed from site B.Sewage Disposal& an existing wali. <br /> �used on site ❑p�er:(specify) Water Supply <br /> Tiered walls are considered <br /> ❑Other: (specify) ❑Public Sewer one wali unless they are <br /> separated by twice the height <br /> (�Private Sewer of the higher wall. <br /> __�.;__Total Cubic Yards <br /> A��.,,_ ❑Public Water <br /> �" �a <br /> Private Well <br /> Estimated Construction Value $ <br /> Packef Last Updated: 0329/93 <br /> Page 19 of 21 <br />