Laserfiche WebLink
g0 City of Orono FOR CITY USE ONLY <br /> 0 P.O.Box 66 <br /> 2750 Kelley Parkway Date Received: -/O Permit# > 0 s <br /> kmCrystal Bay,MN 55323 <br /> (952)249-4600Amount: $ + C.U:P Filed:" <br /> Approved By.0. fi Plan: <br /> �Ilo' Recommends: Approval tg= Denial ❑ <br /> CITY OF ORONO -USER DEFINED/GENERAL PERMIT <br /> (All permits must be approved by the Building Official and/or Zoning Department) <br /> ,"' aV, � <br /> .fie" asH& �M A <br /> / <br /> Site Address: '�lf'(? <br /> Owner: Mailing Address: 70, •r�a <br /> City: A a Zip: " <br /> Home Phone: S47 ° ,tA/ Alternate Phone: w-OF5-�? <br /> Contractor/App.: Contact Person: 'vp <br /> Address: State License#: <br /> City: Zip: Expiration Date: <br /> Phone: Alternate Phone: <br /> a <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: $ ?_?Q n d <br /> ❑ Docks—42"or Greater ❑ Land Alteration ❑ Zoning Review <br /> General-User Defined Surcharge General-User Defined General-User Defined <br /> ❑ Commercial—(Per UBC) ❑ 0-500 Cubic Yards *For 0-75'Zone-$30.00 <br /> *Estimated Cost: $ $50.00(Needs Site Plan) <br /> General-User Defined ❑ 501+Cubic Yards <br /> ❑ Residential- $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 /> pplicant Date <br />