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� <br /> �,�p� City of Orono �� FOR IT USE ONLY <br /> O O� P.O.Box 66 �//Q� <br /> Date Received:/ � petm�t# U <br /> �a�..�� 2750 Ketley Parl.tivay <br /> (� �1 y�i:�-- k Crystai Bay,Mlvr 55323 �_ <br /> ���'tl�.��`y�� (952)249-4600 �7 <br /> �o� Ainount; S c�,al/ C.U.P Filed: <br /> Approved By: Site Plan: <br /> Recommends: A roval ❑ Denial ❑ <br /> CITY OF ORONO -USER DEFINED/GENERAL PERMIT <br /> (All penniu must be approved by the Building Official and/or Zoning Department) <br /> ;Job S:i-fe/Owner Information: ' <br /> Site Address: STUBBS BAY, SWAN LAKE l,j,�j ���/'1�� �j�� <br /> Owner: MINNEHAHA CREEK Mailin� Address: 18202 MINNETOKA BLVD. <br /> WATERSHED DISTRICT <br /> City: DEEPHAVEN, MN Zip: 55391 <br /> Home Phone: 952-471 —0 A� Alternate Phone: <br /> Contractor./.Applicant Iriformation = <br /> Contractar/App.: _SUNRAM CONST. Contact Person: PAUL KERANEN <br /> Address: 20010 75 TH AVENUE NORTH State License #: 81 15 <br /> City: CORCORA�, MN zip: 55340 Expiration Date: 3-31-08 <br /> Phone: 7 h 3_4 2 0-�t 4n Alternate Phone: 612-2 8 2-7 7 71 <br /> _` ' ` 'TYPES QF:USER DEFINED PEIZMITS ' . - <br /> e•,h Y � <br /> ❑ Stairwav to Lake ❑ Retainin� Walls ❑ Temporarv Trailer <br /> General—User Defined Surcharge General—User Defined Surcharge General—User Defined <br /> * (Per UBC) * (Per UBC) *�30.00 <br /> *Estimated Cost: $ *Estimated Cost: � <br /> ❑ Docks—42"or Greater � Land Alteration <br /> ❑ Zonine Review <br /> General—User Defined Surcharge General—User Defined General—User Defined <br /> ❑ Commercial—(Per UBC) ❑ 0-500 Cubic Yards *ForO-7S'Zone-$30.00 <br /> * Estimated Cost:$ $SO.00(Needs Site Plan) <br /> General—Use;Defined � 501�CUbiC 1'aCdS <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 Perrnit and I acl:nowled�e that the infonnation 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 «�ithout a pennit; and that the <br /> ���ork will be in accordance ���ith the approved plan. <br /> � �� �� '� ��'Y'1 t L � i �1 � C��� <br /> Applicant __. Date <br /> Reset Form (UserDeFnecYcmic3;13;�:; <br />