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�,; <br /> /�p\ City of Orono <br /> ' ��� ��, FOR IT USE ONLY�/�Sz� <br /> � � P.O.Bo�66 <br /> � 4� _ 2750 Kelley Parkway Date Received:/ 7 Peitnit#1 �.� <br /> a �}1����- +� Crystal Bay,MN 55323 <br /> ��''�i�t'��"i���� 952 249-4600 -` <br /> ���u��' • � ) tUnount; ��• �� C.U.P Filed. _ <br /> Approved By: SitePlan: . <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 Site/Owner Iiifor�nation. � <br /> Site Address: STUBBS BAY, ;;WAN LAKE � ��- /�G v� <br /> Owner: MINNEHAHA CREEK Mailin� Address: 18202 MINNETOKA BLVD. <br /> WATERSHED DISTRICT <br /> City: DEEPHAVEN, MN Zip: 55391 <br /> Home Phone: �5�_4�� _p q� Alternate Phone: <br /> Gontrsctor/Applicant Information <br /> Contractor/App.:__SUNRAM CONST. Contact Person: PAUL KERANEN <br /> Address: 20010 75 TH AVENUE NORTH State License#: 81 15 <br /> City: CORCORA�, MN Zlp: 55340 Expiration Date: 3-31-08 <br /> Phone: �h�_4�p— � 4� AlternatePhone: 612-282-7771 <br /> '` _° . �� �.F� . 'TYPES OF'.USER DEFINED PERMITS �: ;, ._.. . <br /> ,h T.1r <br /> ❑ Stairwav to Lake ❑ Retainin� Walls ❑ Tem�orarv Trailer <br /> General—User Defined Surcharge General—User Defined Surcharge Genera(—User Defined <br /> * (Per UBC) * (Per UBC) *�3Q.00 <br /> *Estimated Cost: $ *Estimated Cost: $ <br /> ❑ Docks-42" or Greater � Land Alteration ❑ ZoninQ Review <br /> Genera!—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 Planj <br /> General-User Defined � 501+Cubic 1'ards <br /> ❑ Residential- �30.00 �50.00 (Needs C.U.P.) <br /> ❑ Tree Removal <br /> General—User Def ned <br /> * Within 0-75' -530.00 <br /> I herby apply for a User Defined Pennit and I ac{;nowled�e that the infonnation above is complete and <br /> accurate;that the work will be in confonnance with the Ordinances and Codes of the City and with the State <br /> Building Code; that I understand this is not a permit and ���ork is not to start without a pennit; and that the <br /> ���ork will be ir. accordance ���ith the appro��ed plan. <br /> � �.� �u � �a--,--, _ �Z �- ; � � �-�-7 <br /> Applicant __. Date <br /> Reset Form ��St,D_F:,_�F_rn,�,;,a;�,� <br />