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CITY OF ORONO <br /> BUILDING PERMIT APPLICATION t/a ,,7O, a 5 <br /> FOR NEW STRUCTURES OR ADDITIONS <br /> iiLIDl VO Mailing Address: Permit number: CAO 1 7—CO 7 A 5 <br /> PO Box 66 <br /> Crystal Bay, MN 55323-0066 Date received: ""� <br /> Street Address:' Received by: <br /> 614101: <br /> 2750 Kelley ParkwayPlan review fee: F2) 16 <br /> 7/. �t�k�sHo�` Orono, MN 55356 cA(3 i—J-.-n 7 <br /> Main: 952-249-4600 Total Fee: / <br /> Fax: 952-249-4616 www.ci.orono.mn.us V / , (1-/ Z2774-1 <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: 1025 OLD CRYSTAL BAY ROAD, LONG LAKE, MN 55356 <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: Rink-Tec International, Inc. <br /> State License# MB003198 Expiration Date: 8/19/18 <br /> Phone: (cell) (office)(651)481-1190 <br /> Mailing Address: 310 East County Road D City: Little Canada ZIP: 55117 <br /> Contact Person: Kyle Gillespie Applicant is: contractor)( Homeowner (Circle One) <br /> Email and/or Fax: kyle@rinktec.com <br /> PROPERTY OWNER INFORMATION: <br /> Name: ORONO ICE ARENA INC. (CONTACT: DICK LEWIS) <br /> Phone (day): (763) 257-7457 <br /> Address: 1025 OLD CRYSTAL BAY ROAD City: LONG LAKE ZIP: 55356 <br /> Email and/or Fax <br /> ARCHITECT/ENGINEER INFORMATION: <br /> Name: TOM MOORSE, HTG ARCHITECTS <br /> Phone (day): (952) 278-8880 <br /> Address: 9300 HENNEPIN TOWN ROAD City: EDEN PRAIRIE ZIP: 55437 <br /> Email and/or Fax: CONTACT JEFF ELLINGSON:JELLINGSON@HTG-ARCHITECTS.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 /> ❑x Addition attached garage ❑ Deck ❑x 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 ❑x 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) ❑X Other(specify) <br /> 15320 Minnetonka Blvd MEZZANINE ADDITION <br /> Minnetonka,MN 55345 & LOCKER ROOM <br /> Phone: 952-471-0590 <br /> Fax: 952-471-0682 ADDITIONS <br /> www.m i nnehahacreek.orq <br /> Estimated Construction Valuation (excluding land) $ $14,000(Footing& Foundation Only) <br /> Last Updated: January 2016 <br />