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� City of Oroi DR�CIT�SE ONLY <br /> O¢ �O P.O.Box 66 Date Received: � ' Permit# ��>���Ll 1� <br /> 2750 Kelley Parkway �� <br /> -� ` � Crystal Bay,MN 55323 <br /> s� :,. , <br /> (952)249-4600 Amount: $ �57 ZSC.U.P Filed: <br /> . � f���o$SG.� <br /> Approved By: Site Plan: <br /> Recommends: A roval ❑ Denial ❑ <br /> CITY OF ORONO -USER DEFINED/GENERAL PERMIT <br /> (All permits must be approved by the Building Official and/or Zoning DeparGnent) <br /> Job Site/Owner Information: <br /> Site Address: 1400 Bracketts Point <br /> Owner: Jo Ann Jundt Mailing Address: same <br /> City: Orono Zlp: 55391 <br /> Home Phone: 473-9524 Alternate Phone: <br /> Contractor/Applicant Information: <br /> Contractor/App.: Concept Landscaping Contact Person: .1im Smith <br /> Address: 3153 Priest Lane State License#: <br /> City: Mound Z�p. 55364 Expiration Date: <br /> Phone: (952)472-4118 Alternate Phone: <br /> TYPES OF USER DEFINED PERMITS <br /> 0 Stairwav to Lake ❑ Retaining Walls ❑ Temporarv Trailer <br /> General—User Defined Surcharge General—User Defined Suroharge General—User Defined <br /> *(Per UBC) *(Per UBC) *$30.00 <br /> *Estimated Cost:$ 8,000.00 *Estimated Cost:$ <br /> ❑ Docks-42"or Greater � Land Alteration ❑ Zonin�Review <br /> 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 /> 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;- I understand this is not a permit and work is not to start without a permit; and that the <br /> work wiil be in a ordance 'th appr ved plan. <br /> L..____..___.7t'- <br /> Applica�C `" Date <br /> Reset Form �����P��3/���� <br />