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,¢�� City of Orono FO��E ONLY ./ <br /> O O P O.Box 66 Date Received: . � Permit#�I 19 I� <br /> , � 27�0 Kelley Parkway , „�A � <br /> , � � R:r � Crystal Bay,MN 55323 ���' �7p q� <br /> ,���j%�;��,��� (952)249-4600 ����i� Amount: �! • �J C.U.P Filed: �� � <br /> ssxo <br /> Approv�d By: �r'T Site Plan: <br /> � <br /> �� Recommends: A roval Denial ❑ <br /> 3 � CITY OF ORONO - USER DEFINED/GENERAL PERMIT <br /> �� (NI pennits must be approved by the Building Official and/or Zoning Department) <br /> � ^ <br /> �� Job Site/Owner Information: <br /> � � <br /> S� � Site Address: 1354 Rest Point Circle <br /> l <br /> � � Owner: Denny Walsh Mailing Address: Same as above <br /> � Orono 55364 <br /> � � City: Zip: <br /> 1 �� Home Phone: (612) 414-5055 Alternate Phone: <br /> � � <br /> � � Contractor/ Applicant Information: <br /> � � Contractor/App.: Natural Environments Corp. Contact Person: Terry Sanders <br /> \ � 6040 Olson Memorial Hwy. 20232607 <br /> � Address: State License #: <br /> V <br /> � City: Golden Valley Zlp: 55422 Expiration Date: <br /> � <br /> � � (763) 544-8002 <br /> � Phone: Alternate Phone: <br /> � <br /> � , � TYPES OF USER DEFINED PERMITS <br /> � <br /> � � 0 Stairway to Lake ❑ Retainin� Walls ❑ Temporarv Trailer <br /> � General—User Defined Surcharge General—User Defined Surcharge General—User Defined <br /> V� �/ *(Per UBC) x (Per UBC) *$30.00 <br /> v � FEstimated Cost: $ 8,500.00 * Estimated Cost: $ <br /> �� ❑ Docks—42"or Greater ❑ Land Alteration ❑ Zoning Review <br /> 3 � General—User Defined Surcharge General—User Defined General—User Defined <br /> � � ❑ Commercial—(Per UBC) ❑ 0-500 Cubic Yards *ForO-75'Zone-$30.00 <br /> (' , * Estimated Cost: $ $50.00(Needs Site Plan) <br /> �J � General—User Defined ❑ 501+CubiC Yards <br /> j ❑ Residential - $30.00 $50.00(Needs c.[7.p.) <br /> h <br /> V � � ❑ Tree Removal <br /> � General—User Defined <br /> �� * Within 0-75' -$30.00 <br /> � p) I herby apply for a User Defined Permit and I acknowledge that the information above is complete and <br /> � accurate;that the work will be in conformance with the Ordinances and Codes ofthe City and with the State <br /> Building Code; that [ understand this is not a permit and work is not to start without a permit; and that the <br /> � work ' e in accordan with the approve�lan. <br /> � <br /> � 04/09/08 <br /> Applicant Date <br /> Reset Form c°S�D�,°�ape�;t3"�°'> <br />