Laserfiche WebLink
'.. <br /> � � � CITY OF ORONO �q� <br /> y`f' ,5! r'�. �o� <br /> BUILDING PERMIT APPLICATION �� <br /> FOR NEW STRUCTURES OR ADDITIONS <br /> /�OA:.., Mailing Address: Permit number: aol �--�/L <br /> �yO\ PO Box 66 <br /> %� \, Crystal Bay, MN 55323-0066 Date received: j % <br /> � � ,� Street Address:� ived ✓� <br /> ti�.` � 2750 Kelley Parkway p 15�" � t Plan review fee: 5 , � � <br /> � Orono, MN 55356 J`��� �� <br /> �kfSH��'� Total Fee: <br /> ��__� <br /> Main: 952-249-4600 Fax: 952-249-4616 www.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. (Please print) <br /> GENERAL INFORMATION: ,� ,, <br /> Job Site Address: ����� ��������' � � �Y�v� �. � � � <br /> Will this be a Parade of Homes, Remodelers Showcase Home or o her Display Home? Yes ❑ 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 su�cient on-site parking is availab/e. Non-permitted events wil/not be a/lowed. <br /> CONTRACTOR/AP�LICAN INFORMATION: <br /> Name: � �1�,C , <br /> State License# '-�1 r' � Expiration Date: � : <br /> Phone: cell -�'1 - 3� office �. - qa-6►p <br /> Mailing Address: �`�^') h�, l�i,,�� ca\ r�v@ Ci : ;�L�,cx 7= ZIP: 5��7 <br /> Contact Person: n Applicant is: Contractor / Homeowner (CirGe One) <br /> Email and/or Fax: r;.r w. oc �. <br /> PROPERTY OWNER INFORMA ION: <br /> Name: �� � c�- <br /> Phone da � - " ' <br /> � Y)� _ .��� <br /> Address (' `� � �r '� ;� Ci : �o�F j-•i ZIP: �'�,��i� <br /> Email and/or Fax p,r r., c' • <br /> ARCHITECT/ENGINEER INFORMATION: �IY�C•CQY�1 <br /> Name: <br /> Phone (day): <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 8�permits. ❑ Industrial ❑ Private Well <br /> Minnehaha Creek Watershed District(MCWD) ❑ Other: (Specify) <br /> 18202 Minnetonka Blvd <br /> Deephaven,MN 55391 <br /> Phone: 952-471-0590 <br /> Fax: 952-471-0682 <br /> www.minnehahacreek.or <br /> Estimated Construction Valuation (excluding land) $ <br />