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City of Orono `��( 7 <br /> � . <br /> Building Permit Application <br /> for New Structures or Additions <br /> Mailing Address: Permit number: <br /> PO Box 66 <br /> NO Crystal Bay, MN 55323-0066 Date received: 1? —/-7 <br /> Street Address:' 11, Received by: �'Y) <br /> 2750 Kelley Parkway "1 �s <br /> y � ` Plan review fee: i <br /> F c,` Orono, MN 55356 \ <br /> �qJ EQ Ho�� Main: 952-249-4600 Total Fee: �/� —ZD/4) ^7 g _ <br /> Fax: 952-249-4616 www.ci.orono.mn.us I 0Z0/7—D <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: 2425 Old Beach Road Wayzata MN 55391 <br /> Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes ® No <br /> ff yes,a special event permit is required with Police Department and City Council approval 60 days prior to the event. Shuttle 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 /> Name: Suburban Dream Homes LLC <br /> State License# BC638212 Expiration Date: March 31.2018 <br /> Phone: (cell) 952-491-3744 (office) 952-491-4020 <br /> Mailing Address: 10340 Viking Drive Suite 138 CitT.-f den Praire ZIP: 55344 <br /> Contact Person: Ryan Pederson Applicant is: Contractor / Homeowner (circle One) <br /> Email and/or Fax: Ryan@SDHmn.com <br /> PROPERTY OWNER INFORMATION: <br /> Name: Frederick and Elizabeth Weiner <br /> Phone (day): 612-718-9262 <br /> Address: <br /> - - <br /> Address: 2425 Old Beach Road City: Wayzata ZIP: 55391 <br /> Email and/or Fax FredericklweinerOgmail.com <br /> ARCHITECT/ENGINEER INFORMATION: <br /> Name: <br /> Phone (day): <br /> Address: City: ZIP: <br /> Email and/or Fax: <br /> PROJECT INFORMATION: Descri tion ofproject:Addition to side of the home- storage room, mudroom &upper bedroom closet <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 M 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 ❑ 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 /> www.minnehahacreek.or <br /> Estimated Construction Valuation (excluding land) $ 157,000 <br /> Packet Last Updated: August 2015 <br /> Page 21 <br />