Laserfiche WebLink
Metadata
Document management portal powered by Laserfiche WebLink 9 © 1998-2015 Laserfiche. All rights reserved.
, ,.� <br /> CITY OF ORONO <br /> BUILDING PERMIT APPLICATION <br /> FOR NEW STRUCTURES OR ADDITIONS <br /> �O� \ MailiPO Boxr66. Permit number: � 7�a� / <br /> O '� Crystal Bay, MN 55323-0066 Date received: /—/ '/7 <br /> i <br /> � Received by: <br /> � ,, Street Address:' <br /> �F �� 2750 Kelley Parkway Plan review fee: <br /> lqkESH��� Orono, MN 55356 /J <br /> 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: �O<o� ,�'_cj�-1l�' � <br /> Will this be a Parade of Homes, Remodelers Showcase Home or other Display ome? ❑ Yes No <br /> If yes,a special event permit is required with Police Department and City Council approva160 days prior to the event. Shuttle bus service will e <br /> required unless applicant demonstrates su(ficient on-site parking is available. Non-permitted events will not be allowed. <br /> CONTRACTOR/APPLICANT INFORMATION: <br /> Name: ���i .,��`� <br /> State License# Expiration Date: <br /> Phone: (cell) (office) <br /> Mailing Address: City: ZIP: <br /> Contact Person: Applicant is: Contractor / Homeowner (Circle One) <br /> Email and/or Fax: <br /> PROPERTY OWNER INFORMATION: � " <br /> Name: � �.,� � 5 <br /> Phone (day): " t 2., <br /> Address: (] (;� �-� - � c,�U�L �JL City: c�,2[.��,f� ZIP: �5 �� � <br /> Email and/or Fax <br /> ARCHITECT/ENGINEER INFORMATION: <br /> Name: � ,.� �J ��Z.� <br /> Phone (day): <br /> Address: City: ZIP: <br /> Email and/or Fax: <br /> PROJECT INFORMATION: Description 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 ❑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 also require ❑Commercial ❑Storage <br /> MCWD review&permits. ❑ Industrial ❑Warehouse ❑ Private Well <br /> Minnehaha Creek Watershed District(MCWD) ❑ Other: (SpeCify) ❑ Other(SpeCify) <br /> 15320 Minnetonka Blvd Z 1✓C'� �jl��r2,� <br /> Minnetonka, MN 55345 <br /> Phone: 952-471-0590 <br /> Fax: 952-471-0682 <br /> www.minnehahacreek.or <br /> Estimated Construction Valuation (excluding land) $ ���U �� <br /> Last Updated: January 2016 <br />