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. <br /> ,�i <br /> ' ��� City of Orono �, F4R�j[TY C!SE ONL1' .� <br /> P.O.Box 66 vt�j�' Date Received: d��`a� �"�+"' Permit#�,/Ci�;--'j Z, <br /> � �`'' 2750 Kelley Parkway ��� <br /> a = �' Crystal Bay,MN 55323 <br /> ��` y �! (952)249-4600 � � � �� Amount: $ C.U.P Filed: <br /> ....L�Y�BtsoY'�` r���",� � �\.J <br /> �' � Appro�'ed B�: Site Plan: <br /> � ^ C <br /> � �. <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 D rtment) <br /> :Job Site /Owner Information: <br /> � <br /> `Site ,Address: 3275 Carm n Road <br /> ��wner: Mitch Olson Mailing Addre$ : same <br /> Orono 55331 <br /> �City: Zip: <br /> Home Phone: 471-0082 Alternate Phone: <br /> tContractor/Applicant Inforination: <br /> �Contractor/App.: Concept Landscaping Contact Person: Jim Smith <br /> Add�ess: 3153 Priest Lane State License#: <br /> ��ity: �ound Zlp: 55364 Expiration Date: <br /> II'hone: (952)472-4118 Alternate Phone: <br /> TYPES OF LTSFR DEFINED PERMITS __„ <br /> � Stairway to Lalce Q Retainin�Walls ❑ Temporary Trailer <br /> General—User Defined Surcharge General—User Defined Surcharge General—User DeYined <br /> �(Per UBC) * (Per UBC) " $30.00 <br /> *Estimated Cost: $ * Estimated Cost: � �"� ,�cv <br /> � Docks—42" or Greater ❑ Land Alteration ❑ Zoning Review <br /> General—Uscr Uetiired Surcharee General—User Uefined General—User Defined <br /> ❑ Commercial—(Per �,'BC) ❑ 0-SOOCubicYards *ForO-75'Zone-$30.00 <br /> � Estimated Cost: $ $50.00(Needs Site Plan) <br /> Cieneral—User Defined ❑ J��+C,UbIC l'�cdS <br /> ❑ Rzsidential - $30.00 �50.00�Needs C.<<P> <br /> (;� �ree Removal <br /> General—User Defineci <br /> * Within 0-75' -$30.00 <br /> :I herby apply for a User Defined Pennit and i acknowledge that the information above is complete and <br /> �accurate;tllat the work will be in conformance with the Ordinances and Codes of the�ity and with the State <br /> iBuildina Code; that I understand this is not a permit and work is not to start without a permit; and that the <br /> ��.vork will be i�n accordance with the approved plan. <br /> ,, <br /> . � � <br /> � , <br /> �. ; i , . ; �.. r <br /> �.:xs f� - !-�'�.✓(i 1 ,� ' / � <br /> __�'�-(lnrv _ , - � �c � <br /> applicant � � Date <br /> �" Reset Form IUserUttintdFermtt3:IS6J) <br />