Laserfiche WebLink
- - <br /> - ,��� City of Orono FOR�jIT�y,�ONLY <br /> P.O.Bo�66 Date Received: c�—(D—� Permit# �� <br /> �a;,�,�.,,�. �1 27�0 Kelley Parkway <br /> a �1?�=�:f'� '� Cr stal Ba MN 55_23 <br /> �. �:1:,{k•,.� ,c Y Y� Amount: � C.U.P Filed: <br /> �"t'�I�;k�7t;i�$�`•I �952)249-=t6U0 <br /> '�seaog� Approved By: �a�i�� Site Plan: �_ <br /> ���- <br /> Recommends: A roval � Denial ❑ <br /> CITY OF ORONO - USER DEFI�'ED/GENERAL PERI�ZIT <br /> (Ail penni[s must Ue approved by the Buildine Official andior Zonino Department) <br /> JoU Site/O�«ier I�iforniation: <br /> Site Address: ��� ��--� �� ^ /� � f�.14� <br /> Owrizr: .,��r �.�f�-C� Mailing Address: ��5� i` � � <br /> City: /�✓�G'l,�J Zip: ��35'� <br /> Home Phone: !-�����1�'-�� � � Alternate Phone: ��'7 Z-- �,5�— ���g <br /> Conh-actor/Applicant I�ifornlation: <br /> Contractor/App.: �}�a(Vqt✓aC e� �ZG'Ca.y�,�'�'�'t� Contact Person: �Ii� �e�/"�S'O�� <br /> Address: T�O a/l/'���R ���',Y State License �: Z�y� <br /> /�C �C /�la<i'�G � <br /> City: Zip: I�1� Expiration Date: j l•—� — O' <br /> Phone: ��"�7�' �`� Alternate Phone: �`��/�r'��� <br /> TYPES OF USER DEFINED PERMITS , <br /> ❑ Stair���ay to Lal:e ❑ RetaininQ Walls ❑ Temporarv Trailer <br /> Genzral—User Defined Surcharge General—User Defined S�uchar�e Generai—User Defined <br /> * (Per UBCj * (Per UBC) * $30.00 <br /> *Estimated Cost: � *Estimated Cost: $ <br /> ❑ Docks—42" or Greater Land Alteration ❑ Zonin�Re��ie�� <br /> General—User Detined Surcharse Gener —User Detined General—User Detined <br /> ❑ Conunercial-(Per UBC) [�-500 Cubic Yards *ForO-75'Zone-$30.00 <br /> * Estimated Cost: $ �50.00 (Needs Site Plan) <br /> General—User Dellned ❑ 501+Cubic�'at'd5 <br /> ❑ Residential- 530.00 $50.00(?.eeds C.u.�'.) <br /> ❑ Tree Removal <br /> General-User Def ned <br /> *Within 0-75' - $30.00 <br /> I herUy apply for a User Defined Permit and I acknowledge that the information above is complete and <br /> accurate; that the work«�ill be in conforniance with the Ordinances and Codes of the City and with the State <br /> Building Code;that I un is is not a pei-mit and work is not to start without a permit;and that the work <br /> will be in n wi t pproved plan. <br /> �/5�(� � <br /> Annlicant Tl.,+o <br />