Laserfiche WebLink
EXHiBrri <br />City of Orono <br />POBoxM <br />1 2730 K«ll«> p»l»ay <br />(952)249-4600 <br />rOR CITY tsc ONLY <br />DMtlUBa\cd PtfiBito <br />Amount S CU^FUod: <br />Aoorovoddv SifoPttfi: <br />Rccornmnds Aoorovil O Dmia) O <br />CITY OF ORONO - USER DEFEVED/GENER\L PER>UT <br />(All pamts must be appro\c<i b> the CfTicial and or Zoning Oeranment) <br />Job Site / Chvner Infonnation: <br />Site Address:H8 7 /'XV t Or <br />Owner: 4"My ^7^Mailing Address: <br />Citv: _______ Zip: <br />Home Phone: “^7^ ~ cS'‘/0 Alternate Phone: <br />h^c. <br />5T7?/ <br />Contractor / Applicant Information:______. <br />Contractor/App.: lyUl/t tnunyi Contact Person: <br />Address: f^^U'lTlCir /h/^z ^ State License #: <br />Cit>': OD/K/Ki^T^^ Zip: Expiration Date: <br />Phone: " ^*7^^ Alternate Phone: <br />TYPES OF USER DEFINED PERMnS <br />f~l Stairway to Lake <br />General - tier Defined Surcha^ <br />• (Per IBC) <br />*Etlimated Cost: S <br />□ RetaV-ng Walls <br />Genera - Lsc* Z^fined Surcharge <br />♦(PerlBQ <br />* Estimated Cost: S____ <br />□ Temporary Trailer <br />General - L'ser Defined <br />*SJ0.00 <br />n Docks - 42" or Greater <br />GenrnI - lx*Defined Surcharge <br />n Com.T.ercial - (Per L BC) <br />• Estimated Cost: S______ <br />General -1 xr Defined <br />Land Altgr2>r!on <br />Genera - I ser Def red <br />^ • S50.00 (Needs Site ^ini <br />' □ 5 :: ’ - - S75.00 (Needs CUP. <br />n Zoning Review <br />General - User Defined <br />•For 0-75* Zooc.$30J» <br />□ Residi-::al • S30.00 <br />f~l Tree Retrcval <br />C<r<nl - L m: OcfiMj <br />• Within 0-75-SJO.OO <br />•• <br />I herby apply for a User Defined Permit and I acknowledge that the information above is complete and <br />accurate: that the work w ill be in conformance w ith i-.e Ordinances and Codes of the City and with the State <br />Building Code: that I understand this is not a permit ar.d work is not to star: without a permic and that the <br />wofCKill b': V accordance with the aono\Oi plan. <br />9-/7-St 00 3 <br />Date <br />ttitfUiiiTrtiiggJtHa <br />A * ^ <br />I <br />- ... n. y