Laserfiche WebLink
r � n, <br /> � • �.1TY OF ORONO ��� ' Q <br /> � v� ��� <br /> SUILDING PERMIT APP �"v �" <br /> LICATIQN <br /> FOR NEW STRUCTURES OR ADDITIONS <br /> ���r Maili O Box�66: Pertnit number: 020 fS—C���/�i <br /> fY0 <br /> Crystal Bay,MN 55323-0066 Date received: 9- 02/ l S � <br /> � � � � Str�set Address:' � Received by: /�� { <br /> � � ' 2750 Kelley Parkway ( Plan review fee: o� . � <br /> !,��� � Ororro,MN 55356 i <br /> c s rt<�F . I Total Fee: oZU!S-O/oZ/ � <br /> Main: 952-249-4600 Fa�c: 952-24 9-4 81 6 � � �... x I (•�(✓ <br /> This application form must be completed in full and all required information must be s mitted. <br /> {ncomplete applications will be retumed. (Please printt <br /> ;:icRAL INFORMAT(ON: <br /> „oi�Site Address: <br /> �II this be a Parade of Homes. Remodefers Showcase Home or other Display Home? Yes No <br /> �f}res,a Spedal event permit is required with Police Department and City Council approval BO days orior to the event. Shuttle bus service wrk o- <br /> requir�d uMess applicant demonstrates sufficient on-site parkina is availa6le. Non-nemlitted evenrs wrn nor ne arw:.,,, <br /> CONTRACTOR I APPLICANT INFORMATIOR: <br /> Name: i`1�! /J �'�I°Ml � ,�S i 1�' � <br /> �tate License# �xniration Date� �y��� ���.. <br /> �hone: cell � 1 office <br /> iviamna Aaaress i 2 � J y. t;icv: �� L«�t�f''rv <br /> Contact Persort: 5 . Applicant is: ontracto / Homeowner tcc►ue o�e: <br /> Emai1 andlor Fa;: _�M� �r.E�,.c o,�_�'� � ���� r ����� <br /> PROPERTY OWNER INFORMATION: <br /> Name: Ta.v�s t SAaa W�wr-�;�_a� <br /> Phone lday?� �I 3�-gb�i- k'�I`fi <br /> Addres� iN 3.1 �1� A��u A�,v�, Ci#v: Zi� S.;3�y <br /> Emai!and/or ra; fi�,�s;.,a;►cQe✓,inernl� ai�na��l.c�::n <br /> � <br /> �RCHITECT 1 ENGINEER INFORMATION: <br /> Name: �' <br /> Phone(day�: <br /> Adaress: C��. ��c <br /> Emai1 andior Fa>. <br /> PROJECT INFORMATION: Descri�tion of project: <br /> � 1.Type of Project � 2.Proposed Use � 3.Structure Type � 4.Sewage Disposal8� j <br /> � ❑New Construction Water Supply <br /> � ❑Singte Family with j ❑Residence <br /> l ❑Addition attached garage i ❑Garage/Accessory Bldg. � ❑Public Sewer � <br /> I ❑A c c e s sory Bui l ding j ❑ Sing le Fami ly wit h �$.Deck � <br /> ❑Refocafion � detached gara g e � �]OffiCe�Qommercial � ❑Private Sewer � <br /> � ❑Other:(speafy) � ❑Multiple Family/Condo � ❑Warehouse � <br /> I ❑Public ❑Storage � ❑Public Water <br /> Any earth movement may also require ❑Commercial ❑Other(specifjr} � <br /> MCWD review&permits. ❑Industrial ( ❑Private Well <br /> Minnehaha Creek Watershed District(MCWD) ❑Other:(specify) � ! <br /> I 18202 Minnetonka BNd , ; <br /> f deephaven,MN 55391 � � � <br /> Phone: 952-471-059Q <br /> Fax: 952�71-0682 <br /> '�9r�M�� 1 - . <br /> Estimated Construction Valuation(excludina land) ' f,��,�Op <br />