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t ' <br /> g� <br /> f CITY OF ORONO 0a5I. <br /> f <br /> BUILDING PERMIT APPLICATON <br /> FOR NEW STRUCTURES OR ADDITIONS ` <br /> ci <br /> IOCMailing Address: <br /> PO Box 66 Permit number: 2- I 00 <br /> W <br /> , t Crystal Bay, MN 55323-0066 <br /> Street Address: Date received: <br /> ��� Received by: '�p <br /> ti <br /> �� Plan review fee: 1 . g 1 ___D <br /> StiO� Orono, MN 55356 4 01 —Ob I "� <br /> Main: 952-249-4600 otal Fee: <br /> Fax: 952-249-4616 www.ci.orono.mn.us Fa,ti)N—4ve� forma, <br /> This application form must be completed in full and all required information must be submitt d. <br /> Incomplete applications will be returned. (Please print) <br /> GENERAL INFORMATION: <br /> Job Site Address: 2335 Oliver Hill <br /> Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes I 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: Y oung fie-id I.loie-s dbc Gou vi-ry Toe Norig-S <br /> State License# 8C-t-2.7 6 70 Expiration Date: 3 - 31 - 17 <br /> Phone: (cell) 95'2 - 3 p 8120 (office) 95.2- 46 q - y0 66 <br /> Mailing Address: 2Z2 Co Dodd 8I lid. Cit : LAKe.Vill'- ZIP: 550"0 <br /> ' <br /> Contact Person: 5 f e,ve. ,fgt,,,b e;r Applicant is: Contractor . / Homeowner (Circle One) <br /> Email and/or Fax: SSa.k.ber' Cour JO2-1 oi'le-S. Cor`' <br /> PROPERTY OWNER INFORMATION: <br /> Name: (7.2E4 1—j'- NN 16 l7 ' AG6s5' A,Dez o <br /> Phone (day): 95Z -2'3--43-4/ mi hllan <br /> Address: (,..3£?"‘, /t,p41Eiv is AWE Ci,2C L-e City: 77,c '-tc D ZIP: y`94247-3 <br /> Email and/or Fax <br /> ARCHITECT/ENGINEER INFORMATION: <br /> Name: <br /> Phone (day): <br /> Address: City: ZIP: <br /> Email and/or Fax: <br /> PROJECT INFORMATION: Description of project: Frc.med f,,'4(e-fa.n411r koty_ <br /> 1.Type of Project 2. Proposed Use 3.Structure Type 4.Sewage Disposal& <br /> Water Supply <br /> 21.New Construction I Single Family with ❑Accessory Bldg./Garage <br /> ❑Addition attached garage ❑ Deck NI Public Sewer <br /> 0 Accessory Building ❑ Single Family with Office/Commercial <br /> ❑ Relocation detached garage Residence 0 Private Sewer <br /> O Other: (specify) El Multiple Family/Condo Retaining Wall(s) <br /> 0 Public 4-feet or greater 0 Public Water <br /> **Any earth movement may also require 0 Commercial 0 Storage <br /> MCWD review&permits. 0 Industrial ❑Warehouse a(Private Well <br /> Minnehaha Creek Watershed District(MCWD) ❑ Other: (specify) 0 Other(specify) <br /> 15320 Minnetonka Blvd <br /> Minnetonka,MN 55345 <br /> Phone: 952-471-0590 <br /> Fax: 952-471-0682 <br /> www.minnehahacreek.org <br /> Estimated Construction Valuation (excluding land) $ 3I((15"7h <br /> Last Updated: January 2016 <br />