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From:Michael Tharp Fax:(763)333-2445 To:9522494616@rcfax.con Fax: +19522494616 Page 3 of 4 11/O6/2015 11:17 AM <br /> , t ' <br /> CITY OF ORONO <br /> BUILDING PERMIT APPLICATiON <br /> FOR NEW STRUCTURES OR ADDITIONS <br /> �O A T MailiPO B xr66 Permit number, �D/,S� d� �3 <br /> �V� <br /> Crystal Bay, MN 55323-OOS6 Date received: �— l <br /> Street Address:' ' Received by: <br /> y� G� 2750 Kelley Parkway Pian review fee: <br /> �,�x�SHo�� Clrono,MN 55356 • <br /> Total Fee: ��, � <br /> Main: 952-249-4600 Fax: 952-249-4616 www.ci.orono.mn.us <br /> This application form must be completed in ful{and ail re.quired information must be submitted. <br /> Incamplete applicatians will be returried. (Please print) <br /> GENERAL INFORMATION: <br /> Job Site Address: 485 Park Avenue, Orono MN 55356 <br /> Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? Yes No <br /> ff yes,a speciat event permit is required with Police Depariment and City Council approvat 60 days prior to the event. ShuKle bus sarvice wil!be <br /> required unless applicant demonstrates sufficient on-site parking is availabte. /Von-pe.-mitted even2s wifl not be allowed. <br /> CONTRAC70R!APPLICANT INFORMATION: <br /> tvame: Desi�nCraft Construction, Inc. <br /> State�icense# bc692134 Expiration Date: 03/31/2017 <br /> Phone: (ceN) 6 2-760-0888 (office) 763-333-2559 <br /> Mailing Address: 3333 80th Ave N City: Brooklyn Park ZIP; 55443 __ <br /> Contact Person: Joan Thar Applicant is: Contractor / Homeowner �a.�te one� <br /> Email and/or Fax: Etharp(a� esigncra con5truction.com <br /> PROPERTY OWNER INFORMATION: <br /> tvame: Catherine Mayer <br /> Phone(dayy: 952-473-7258 <br /> Address: 485 Park Avenue city: Orono ziP: 55356 <br /> Email andlor Fax <br /> ARCHITECT/ENGIPIEER INFORMATION: <br /> Name: <br /> Phone(day): <br /> Address: City: ZIP: <br /> Email andlor Fax: <br /> PROJECT INFORMATION: Qescri tion of ro'ect: <br /> 1.Type of Project 2.Proposed Use 3.Structure Type 4.Sewage Disposal& <br /> Water Supply <br /> ❑ New Constn�ction ❑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/Commerciai ❑Private Sewer <br /> �1 ocner:�S�o��yy Door Replaceme ❑Multiple Family/Conclo ❑Warehouse <br /> ❑Public ❑Storage ❑Public Water <br /> '*Any earth movement may aiso reguire ❑Conmercial ❑Other(specify) <br /> MCWD review&petmits. ❑Industrial ❑Private Well <br /> Mlnnehaha Creek Watershed Di�trict(MCWD} ❑Othe�:(speClFy) <br /> 182U2 Minnetonka Blvd <br /> Deephaven,MN 55391 <br /> Phane: 952-471-0590 <br /> Fax: 952-471-0682 <br /> www.m innehahacreek,or <br /> Estimated Construction Valuation(excluding land) $ 2,000.00 <br />