Laserfiche WebLink
��• , <br /> , <br /> CITY OF ORONO <br /> , BUILDING PERMIT APPLICATION <br /> FOR NEW STRUCTURES OR ADDITIONS <br /> �%� Mailing Address: Permit number: � —�J '�f <br /> ��NO�� PO Box 66 ' ��3 F, <br /> Crystal Bay, MN 55323-0066 Date received: <br /> I� � I Received by: � ( <br /> Street Address:' G� <br /> y� � :i 2750 Kelley Parkway Plan review fee: O <br /> � L <br /> `�'� Orono, MN 55356 � �3 _��.� <br /> !„�k f]�i C�t'�'', <br /> Total Fee: <br /> ' Main: 952-249-4600 Fax: 952-249-4616 www.ci.orono.mn.us —SC�j r -�YQ.C�(� (0• <br /> This application form must be completed in full and all required information must be s�bmitted. <br /> Incomplete applications will be returned. (Please print) <br /> GENERAL INFORMATION: / / <br /> Job Site Address: �� �L��/111�/�Lt� Wv� L�T. <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 approva160 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/AP�LICANT INFORMATION: � <br /> Name: L.DK t� � u�. <br /> State License# po ,32'� Expiration Date: �0�� <br /> Phone: cell /� - �- office <br /> Mailing Address: � c Cit : � ZIP: �S�3$'3 <br /> Contact Person: �., t v Applicant is: Contractor / Homeowner (Circle One) <br /> Email and/or Fax: (.,���VtC,d�PS yAlaoO.C,Ov►� <br /> PROPERTY OWNE INFORMATIO : <br /> Name: L ��-�-• <br /> Phone (day): / _ � - I <br /> Address: �F 1 ?k �jZj Cit : ooK ZIP: �J^��� <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 �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 <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 />