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O¢0�O City of Orono FOR CITY USE ONLY <br /> P.O.Box 66 Date Received: Permit# <br /> 2750 Kelley Parkway <br /> hk <br /> Crystal Bay,MN 55323 <br /> ? � (952)249-4600 Amount: $ C.U.P Filed: <br /> f Approved BF: Vd- Site Plan: <br /> T-10 1O <br /> Recommends: Approval ❑ Denial El <br /> CITY OF ORONO - USER DEFINED/GENERAL PERMIT <br /> (All permits must be approved by the Building Official and/or Zoning Department) <br /> Job Site/Owner Information: <br /> Site Address: 3655 TOGO ROAD -(MIKE INGEMANSEN PRES.) <br /> Owner: NAVARRE CONG. OF JW's Mailing Address: 1717 AVOCET LANE <br /> City: MOUND Zip: 55364 <br /> Home Phone: (952) 495-1027 Alternate Phone: (612) 310-7706 <br /> Contractor/Applicant Information: <br /> Contractor/App.: McFARLAND BUILDERS Contact Person: JEFF McFARLAND <br /> Address: State License #: #20129870 <br /> City: Zip: Expiration Date: <br /> Phone: (952) 240-7792 Alternate Phone: <br /> TYPES OF USER DEFINED PERMITS <br /> ❑ Stairway to Lake ❑ Retaining Walls Temporary Trailer <br /> General—User Defined Surcharge General—User Defined Surcharge General—User Defined <br /> *(Per UBC) *(Per UBC) * $30.00 <br /> *Estimated Cost: $ * Estimated Cost: $ <br /> ❑ Docks—42"or Greater and Alteration ❑ Zoning Review <br /> General—User Defined Surcharge Gene User Defined General—User Defined <br /> ❑ Commercial—(Per UBC) 500 Cubic Yards *For 0-75'Zone-$30.00 <br /> * Estimated Cost: $ $-m 00(Needs Site Plan) <br /> General—User Defined +Cubic Yards <br /> F-1Residential- $30.00 $50.00(Needs C.U.P.) <br /> ❑ Tree Removal <br /> General—User Defined <br /> * Within 0-75' -$30.00 <br /> 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 of the City and with the State <br /> Building Code;that I understand this is not a permit and work is not to start without a permit; and that the <br /> work will be in accordance with the approved plan. <br /> 21'.ij 07/18/05 <br /> Applicant Date <br /> iesetform <br />