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¢0� City of Orono FO CITY USE OIYLY + ' � O O P.O.Box 66 Date Received: � Permit# � I(� I 2750 Kelley Parkway + a ,'` • � Crystal Bay,MN�� 3 Buiiding� ��dppli��d��00 1 Amount: $ C U.P Filed: D E N I E D Approved By Site Plan Recommends: A roval ❑ Denial ❑ Reayo�fqr de�iai: e y - USER DEFINED/GENERAL PERMIT 1TpRTftft51Tffl5[�Capproved by the Building O�cial and/or Zoning Department) Staff I't��t�a • Site Address: �354 Rest Point Circle Owner: Denny Walsh Mailing Address: Same as above City: Orono Zip. 55364 Home Phone: 1612) 414-5055 Alternate Phone: Contractor/ Applicant Information: Contractor/App.: Natural Environments Corp Contact Person: Terry Sanders Address: 6040 Olson Memorial Hwy State License #: 20232607 City: Golden Valley Zlp: 55422 Expiration Date: �� / O� Phone: (763) 544-8002 Alternate Phone: TYPES OF USER DEFINED PERMITS 0 Stairway to Lake ❑ Retaining Walls ❑ Tem�orary Trailer General—User Defined Surcharge General—User Defined Surcharge General—User Defined *(Per UBC) "(Per UBC) * $30.00 *Estimated Cost: $ 8,500.00 * Estimated Cost: $ ❑ Docks-42"or Greater ❑ Land Alteration ❑ Zoning Review General—User Defined Surcharge General—User Detined General—User Defined ❑ Commercial-(Per UBC) ❑ 0-500 Cubic Yards *ForO-75'Zone-$30.00 * Estimated Cost: $ $50.00(Needs Site Plan) General-User Defined ❑ 501+Cubic Yards ❑ Residential - $30.00 $50.00(Needs C U.P.) ❑ Tree Removal General—User Defined * Within 0-75' -$30.00 I herby apply for a User Defined Permit and 1 acknowledge that the information above is complete and accurate;that the work will be in conformance with the Ordinances and Codes of the Ciry and with the State Building Code; that 1 understand this is not a permit and work is not to start without a permit; and that the work. 1 be in accordance with the approved plan. i / .� � ��.._. . 08/27/07 `� Applicant Date Reset Form IUser Defined Permit 3;18/04)