Laserfiche WebLink
' p City of Orono _ <br /> 04 O P.O.Box 66 D.'. ,- :ived r`er� oN t# <br /> LlAr- 2750 Kelley Parkway �� <br /> IAt Crystal Bay,MN 55323 C [UDF <br /> s jilt, 6 (952)249-4600 <br /> Amount 3'• C,U.P Piled: <br /> Approved By.c.Q. IOU Site Plan <br /> Recommends: Approval O :-Denial .0 <br /> CITY OF ORONO USER DEFINED/GENERAL PERMIT 3\-7 <br /> (All permits must be approved by the Building Official and/or Zoning Department) <br /> 0 <br /> r:. <br /> Job Site/Owner Information " <br /> Site Address: `A 5 W I-k o. CLvY1 NV'IV La-0-e-, <br /> Owner: �j\''e 4 C C v O - v� <br /> Mailing Address: �c �-L� Gl S G����/2_ <br /> l <br /> City: -V\ 0 -IL,Li <br /> ' I Zip: r N II q <br /> Home Phone: a' `�� 2Alternate Phone: i a_ DD (o U r7 Ci Y <br /> :Contractor/AppiieiiitIrrforrnii0bi Ar'br�' <br /> Contractor/App.: Contact Person: �`.Ctv--6 <br /> Address: State License #: <br /> City: Zip: Expiration Date: <br /> Phone: Alternate Phone: <br /> :. . 61/2%„ -< � "_ ��,: . TYPES OFUSERDEINED,PER�IITS i <br /> i-1** % l A4. <br /> ❑ Stairway to Lake ❑ Retaining Walls ❑ Temoorary Trailer <br /> General-User Defined Surcharge General-User Defined Surcharge General—User Defined <br /> ) <br /> *Estimated Cost: $ *Estimated f ) $30.00 <br /> Cost: S <br /> ❑ Docks—42"or Greater / Land Alteration S�,r� , ❑ Zoning Review <br /> General-User Defined Surcharge General-User Defined , t} 1 7 ' General-User Defined <br /> E Commercial- UBC) 4,f `• <br /> (Per Q 0-500 Cubic Yards *For O-75'Zone-$30.00 <br /> *Estimated Cost:S $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 /> <___ .. . t4 i D --? / 0 <br /> 9 <br /> Applicant , Reset.. .. y. Date <br /> eset Form (User Defined Permit 3/18/41 <br />