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� ,¢��, City of Orono FOR C11'Y USE ONLY <br /> • Q � P.O.Box 66 Date Received; •-iZ C� Permit# yL���,� <br /> 2750 Kelley Parkway <br /> a � '`• � Crystal Bay,MN 55323 <br /> ¢+��''�. •y�:' (9521249-4600 Amount: $ �fi,c�C.U.PFileci: <br /> 2+traao�',' <br /> -(��C � , proved f3y: �� Site Plan: �I -Z��os <br /> �1��y�` ,-�.�C �N���� <br /> �_� . 7� <br /> Rewmmends: A roval Denial <br /> CITY OF ORONO-USER DEFINED/GENERAL PERMIT <br /> (All Fxrmits must be appr�vcd by the Huilding Ot7icinl and/ur 7,oning Department) <br /> Job Site/Owner Information: <br /> Site Address: 2760 Country Side DR West <br /> Owner: Molly and Jon Sterns Mailing Address: 2�60 Countryside Dr W <br /> C��,: Orono Z�p; 55356 <br /> Home Phone: (952)476-7330 Alternate Phone: <br /> Contractor/App(icant lnformation: <br /> Contractor/App.: Oh'Landscapes LLC Gontact Person: Junior <br /> Address: 25070 Smithtown Rd State License #: <br /> City: Shorewood Z�p: 55331 Expiration Date: <br /> Phone: (952)470-6848 Alternate Phone: 612-919-369a-3��� <br /> TYPES OF USER DEFINED PERMITS <br /> ❑ Stairwav to Lake ❑ Retainin� Walls ❑ Temporary Trailer <br /> General-User Detined Surcharge Cienceal-User Detined Surcharge General-User Detined <br /> *(Per UBC) *(Per UBC) *$30.00 <br /> *Estimated Cost:$ * Estimated Cost: $ <br /> ❑ Docks-42"or Greater � Land Alteration ❑ Zonin�Review <br /> General-Use�Uetined Sw•charge Cieneral-User Detineci Generul-User Detined <br /> ❑ Commercial-(Per UBC) � 0-500 Cubic Yards *ForO-75'Zone-$30.Oi1 <br /> * Estimated Cost: $ $50.00(Needs Site Plan) <br /> General-User Detined ❑ 501+Cubic Yards <br /> ❑ Residential- $30.00 $50.00(Needs C.U.P.) <br /> ❑ Tree Removal <br /> General-User Def ined <br /> * Within 0-75' -$30.00 <br /> 1 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 /> , � �%���!'� `--� /1 ���=�5 <br /> Applicant �; Date <br /> Reset Form (UserDMSnedFemrir3/IH� <br /> J�� �_ ����� �� <br />