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CITY OF ORONO �3 �,75 <br /> BUILDING PERMIT APPLICATION / <br /> FOR NEW STRUCTURES OR ADDITIONS <br /> O Mailing Address: Permit number: 090/3^ O6S5�� <br /> PO Box 66 <br /> � � Crystal Bay, MN 55323-0066 Date received: DE 'Z� -�3 <br /> ^ Street Address:' Received by: �8s <br /> y � 2750 Kelley Parkway Plan review fee: 3 S��i.B <br /> �`qkFSHO� � Orono, MN 55356 ap�3_ OaS�f 7 <br /> � <br /> Total Fee: <br /> Main: 952-249-4600 Fax: 952-249-4616 wwiw.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. (P/ease print) <br /> GENERAL INFORMATION: <br /> Job Site Address: 475 Oxford Rd. - Orono - MN <br /> Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes � No <br /> lf 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 sutficient on-site parking is available. Non-permitted events will not be allowed. <br /> CONTRACTOR/APPLICANT INFORMATION: <br /> Name: Thomas Bren Homes, Inc . <br /> State License# BC128144 Expiration Date: <br /> Phone: (cell) 612-759-5610 (office) 952-475-6777 <br /> Mailing Address: 2073 Wayzata Blvd W. #5Q City:Long Lake ZIP: 55356 <br /> Contact Person: Tom Bren Applicant is: on ractor / -Homeoamsr- (Circle One) <br /> Email and/or Fax: <br /> PROPERTY OWNER INFORMATION: <br /> Name: CKO Vacation Properties, LLC. <br /> Phone (day): 612-919-4 4 5 7 <br /> Address: 575 Oxford Rd. City: ZIP: <br /> Emai{ and/or Fax `,�C1f�{,�'. Ch('I-<� Q rv►Ca.� 1 <br /> ARCHITECT/ENGINEER INFORMATION: <br /> Name: DFP Planning & Design <br /> Phone (day): 763-780-8004 <br /> Address: City: ZIP: <br /> Email and/or Fax: <br /> PROJECT INFORMATION: Descri tion 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 � Residence <br /> ❑Addition attached garage ❑Garage/Accessory Bldg. � Public Sewer <br /> ❑Accessory Building ❑ Single Family with ❑ Deck <br /> ❑ Relocation detached garage ❑ Office/Commercial ❑ Private Sewer <br /> ❑Other: (specify) ❑ Multiple Family/Condo ❑Warehouse <br /> ❑ Public ❑ Storage ❑ Public Water <br /> **Any earth movement may also require ❑Commercial ❑Other(specify) <br /> MCWD review&permits. ❑ Industrial � Private Well <br /> Minnehaha Creek Watershed District(MCWD} ❑Other: (specify) <br /> 18202 Minnetonka Blvd I <br /> Deephaven, MN 55391 <br /> Phone: 952-471-0590 <br /> Fax: 952-471-0682 <br /> www.minnehahacreek.or <br /> Estimated Construction Valuation (excluding land) $ �U(J � <br />