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� � CITY OF ORONO <br /> BUILDING PERMIT APPLICATION <br /> FOR NEW STRUCTURES OR ADDITIONS <br /> �O�O Mailing Address: Permit number: � �"v��7� <br /> PO Box 66 ��-J � <br /> Crystal Bay, MN 55323-0066 Date received: <br /> � ,, Sireet Address:� <br /> Received by: <br /> y G� 2750 Kelley Parkway Plan review fee: <br /> F <br /> �qk�.SH���c. Orono, MN 55356 <br /> Main: 952-249-4600 Total Fee: / l 7• �� <br /> Fax: 952-249-4616 wwv�✓.ci.orono n�n us <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: a7 as ���5��-� �� • <br /> Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? Yes <br /> If yes,a special event permit is required wdh Police Department and Ciry Council approva160 days prior to the evenL Shunle bus service wil/be <br /> required unfess applicant demonstrates sufficient on-site parking is available. Non-permitted events will not be allowed. <br /> CONTRACTOR/APP C T INFO ATIO • <br /> Name: �'� � �^ S I/� <br /> State License# Expiration Date: <br /> Phone: cell . � o�ce r <br /> Mailing Address: Cit ZIP: c� <br /> Contact Person: Applicant is: ontract / Homeowner (Circle One) <br /> Email and/or Fax: r' r.L S o <br /> PROPERTY OWNER INFOR ATION: <br /> Name: <br /> Phone (day): r <br /> Address: �"�1�hp . City: ZIP: <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 pro"ect: <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 /> ❑ Fjelocation detached garage esidence ❑ Private Sewer <br /> [�Other: (specify) ❑ 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) $ � /�J � <br /> Last Updated: January 2016 <br />