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CITY OF ORONO <br /> BUILDING PERMIT APPLICATION <br /> FOR NEW STRUCTURES OR ADDITIONS <br /> Mailing Address: Permit number: CC c' <br /> PO Box 66 <br /> Crystal Bay, MN 55323-0066 Date received: <br /> Street Address:' <br /> bvu� 4_e� Received by: <br /> y� c` 2750 Kelley Parkway �/Z Q/�'7 Plan review fee: , C-� <br /> ESHO�� Orono, MN 55356 <br /> Main: 952-249-4600 Total Fee: � <br /> Fax: 952-249-4616 www.ci.orono.mn.us �J <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: 685 Old Crystal Bay North (Orono Intermediate School) <br /> Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes ❑X No <br /> If 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: Gordon James Construction <br /> State License# BC 531961 Expiration Date: <br /> Phone: (cell) 612-369-3736 (office)763-479-3117 <br /> Mailing Address: PO Box 306 5159 Main Street-#200 Cit le Plain ZIP: 55359 <br /> Contact Person: Joe McPherson Applicant is: ontractor / Homeowner (circle One) <br /> Email and/or Fax: ioe@gordon-james.com <br /> PROPERTY OWNER INFORMATION: <br /> Name: Orono Schools <br /> Phone(day): Justin McCoy-> 763-238-6375 <br /> Address: Same as Above City: Orono ZIP: <br /> Email and/or Fax 0mccoy(@orono.k12.mn.us <br /> ARCHITECT/ENGINEER INFORMATION: <br /> Name: Hagen , Christensen & MclLwain <br /> Phone (day): Jerry Hagen ->612-904-1332 <br /> Address: 4201 Cedar Avenue So City: Minneapolis ZIP: 55407 <br /> Email and/or Fax: hagen@hcmarchitects.com <br /> PROJECT INFORMATION: Description of project: <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) New Windows ❑ 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 <br /> Minnetonka, MN 55345 <br /> Phone: 952-471-0590 <br /> Fax: 952-471-0682 <br /> www.minnehahacreek.or <br /> Estimated Construction Valuation (excluding land) <br /> Last Updated: January 2016 <br />