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�� � <br /> /�p � City�of Orono FOR IT U5E ONLY�/�/ <br /> � ` P.O.Box 66 ,�- 7'f��� <br /> (� � - Date Received:/ Pemiit#t <br /> 4 _ 2750 Kelley Parl.lvay <br /> � �}1y���_y�. �� Cryscal Bay,MN 55323 _, _ <br /> �' a�ttl�'iY'y� (952)249-4600 <br /> ���o� Amountt ��' � C.U.P Filed: <br /> Approved By: Site Pian: <br /> Recommends� A roval ❑ Denial ❑ <br /> CITY OF ORONO -USER DEFINED/GENERAL PERMIT <br /> (All penni�s must be approved by[he Buil ding Official and/or Zoning Department) <br /> ;Job Site/Owner Tiifonnation: <br /> Site Address: STUBBS BAY, .�WAN LAKE /g,� ������ ���_ <br /> Owner: MINNEHAHA CREEK Mailinj Address: 18202 MINNETOKA BLVD. <br /> WATERSHED DISTRICT <br /> City: DEEPHAVEN, MN Zip: 55391 <br /> Home Phone: g5 ._471 -0 A1 Alternate Phone: <br /> Contractor/Applicant Iriformation - <br /> Contractor/App.: _SUNRAM CONST. Contact Person: PAUL KERANEN <br /> Address; 20010 75 TH AVENUE NORTH State License #: 8115 <br /> City: CORCORA�, MN Zlp: 55340 Expiration Date: 3-31-08 <br /> Phone: 7h3_4 �.0- 14� AlternatePhone: 612-282-7771 <br /> ° � TYPES OF.USER DEFINED PERIVIITS �: <br /> �'h <br /> ❑ Stairwav to Lake ❑ Retainine Walls ❑ Temporar Trailer <br /> General—User Defined 5urcharge General—User Defined Surchazge General—User Defined <br /> * (Per UBC) * (Per UBC) *�30.00 <br /> *Estimated Cost: $ * Estimated Cost: � <br /> ❑ Docks-42" or Greater X❑ Land Alteration Re�ie <br /> ❑ ZoninQ �' w <br /> General—User Defined Surcharge General—User Defined General—User Defined <br /> ❑ Comnlercial-(Per UBC) ❑ 0-500 Cubic Yards *ForO-75'Zone-$30.00 <br /> * Estimated Cost: $ $50.00(Needs SitePlan) <br /> General-User Defined [� 501+Cubic Yards <br /> ❑ Residential- $30.00 g50.00 (Needs C.U.P.) <br /> ❑ Tree Removal <br /> General—User Defined <br /> * Within 0-75' -530.00 <br /> I herby apply for a User Defined Permit and I acl:nowledge that the infonnation above is complete and <br /> accurate;that the work wifl 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 ���ork is not to start �ti�ithout a pennit; and that the <br /> ���ork�vill be in accordance ���ith the appro��ed plan. <br /> ._ _ �:: �rv �'� ��1'-� __ t Z - i �1 � ��`� <br /> Ap�licant __. Date <br /> Reset Form (UserDeEn_dFcmit3lla-�y� <br />