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CITY OF ORONO t� swj BUILDING PERMIT APPLICATION <br /> FOR NEW STRUCTURES OR ADDITIONS <br /> Mailing Address: Permit number: dl <br /> PO Box 66 <br /> O ` Crystal Bay, MN 55323-0066 Date received: <br /> I' Street Address: Received by: <br /> y i 2750 Kelley Parkway Plan review fee: <br /> Orono, MN 55356 <br /> Main: 952-249-4600 Total Fee: <br /> Fax: 952-249-4616 www.ci.orono.mn.usy 0��• �/� <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: 2A60 Gnlric+ornri Wad <br /> Will this be a Parade of Homes, Remodelers Showcase Home or other 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 sufficient on-site parking is available. Non-permitted events will not be allowed. <br /> CONTRACTOR/APPLICANT INFORMATION: <br /> Name: David Weekley Homes <br /> State License# BC697545 Expiration Date: <br /> Phone: (cell) 612.716.2627 (office) <br /> Mailing Address: 12800 Whitewater Drive,Suite 20 City: Minnetonka ZIP: 55343 <br /> Contact Person: Kevin Cummins Applicant is: Contractor / Homeowner (Circle One) <br /> Email and/or Fax: kcummins@dwhomes.com <br /> PROPERTY OWNER INFORMATION: <br /> Name: *same As Above' <br /> Phone (day): Melissa Johnson 612.462.6932 <br /> Address: *Same As Above* City: ZIP: <br /> Email and/or Fax mjohnson@dwhomes.com <br /> ARCHITECT/ ENGINEER INFORMATION: <br /> Name: Mulhern&Kulp <br /> Phone (day): 215.646.8001 <br /> Address: 20 South Maple Street,Suite 150 City: Ambler,PA ZIP: 19002 <br /> Email and/or Fax: <br /> PROJECT INFORMATION: Description of project: <br /> 1.Type of Project 2. Proposed Use 3. Structure Type 4. Sewage Disposal & <br /> Water Supply <br /> Fx_1 New Construction 0 Single Family with ❑ Accessory Bldg./Garage <br /> ❑Addition attached garage ❑ Deck El Public Sewer <br /> ❑Accessory Building ❑ Single Family with ❑ Office/Commercial <br /> ❑ Relocation detached garage ❑ Residence ❑ Private Sewer <br /> ❑ Other: (specify) ❑ Multiple Family/Condo ❑ Retaining Wall(s) <br /> ❑ Public 4-feet or greater 0 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 /> org RECEIVED <br /> Estimated Construction Valuation (excluding land) $ 2S0,000 ADR I 1 ?818 <br /> CIN OF ORONO <br /> Last Updated: January 2016 <br />