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��/�-"' City of Orono rOR CITY USE ONLY <br /> �� P.O.Box 66 Date Received: �-( ( t� Permit# ���t�d <br /> f�, ���ti � � <br /> • �t,i,.,,,. 2750 Kelley Parkway <br /> s,��jj i��,,;;:. �� Crystal Bay,MN 55323 <br /> ������!}�4�� (952)249-4G00 Amount: $ C:U:P Filed: <br /> � �lf@eHO� . <br /> ApProvedBy: . • •' `�SitePlan:� . <br /> Recommends: A rovnl ❑ Denial ❑ <br /> CITY OF ORONO-USER DEFINED/GENERAL PERNIIT <br /> (All permits must be npproved by ihe Building OtTicinl and/or Zoning Department) <br /> z �ob S7�e/Owner Information °}'���{����F''�'`31��'�t'Ak <br /> E:�. n. . ?r... _...� n . - ..F- ,-:d11�y1 �,bv.iS,�>3���', �1v�,,- <br /> Site Address: 1400 Bracketts Point <br /> Owner: Jo Ann.lundt Mailing Address: same <br /> City: Orono Zlp: 55391 <br /> Home Phone: 473-9524 AIternate Phone: <br /> ' ,Coiit"racto"r°IsA°" lican�Informatton��` �`�` t'"�' �' <br /> `���'�.���ry��Y� <br /> ��Pl?<::. r:. �6�.,� �, .��. .� .,�rn;��.�� <br /> Contractor/App.: Concept Landscaping Contact Person: Jim Smith � <br /> Address: 3153 Priest Lane State License#: <br /> City: Mound Zlp: 55364 Expiration Date: <br /> Phone: (952)472-4118 Alternate Phone: <br /> _..,_ ] <br /> z2���:its�S'�il-" k�rt"� r°iP 't,�s 0 . ,i . , �., .,w . ...� �1� � K 1*�;. <br /> 3 ��k"�a t s M �� � 'ic� �X�.� t ..... , . �y�v "�.J '�r� �� �'�,:"`S;�P�`! '�,.�- <br /> ,,.���.����,.:�.��'��a �3���,�x+��.r,r•��TYPES,OF�iJSERfDEFINED`PERIVIITS,.y���,.��., ..,.�;�-�� �,�`�,�rk�..��i'T.y°� <br /> �� Stairwav to Lake ❑ Retaining Walls ❑ Temporary Trailer <br /> General—User Defined Surchazge General—User Defined Surcharge General—User Defined <br /> *(Per UBC) *(Per UBC) *$30.00 <br /> *Estimated Cost:$ 8,000.00_ *Estimated Cost:$ <br /> j0 ;Docks—42"or Greater � Land Alteration ❑ Zonin�Review <br /> �General—User Defined Surchurge General—User Defined Generel—User Defined <br /> [❑I 4Commercial—(Per UBC) � 0-500 Cubic Yards *ForO-75'Zone-$30.00 <br /> ''*1�StlmAted COSt:$ $50.00(Needs Site Plan) <br /> tGaneml—User Defined ❑ 50.1+Cubic Ya[ds <br /> (� IResidential- $30.00 $50.00(Needs C.U.P.) <br /> i = Tree Removal <br /> General—User Defined <br /> *Within 0-75'-$30.00 <br /> I llerby apply for a User Defined Permit and 1 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 tliat the <br /> work will be in accordance with the approved plan. <br /> Applicant •4•t�,Ytiv �y���= 5���� a 5� Date. �.. <br /> �` '�}��'Reset Formxl � � (Use�DcfincdPcrmif3(IBlti4) <br /> IS�J.1 i1 �:� �! <br /> �,E�`.�,'�tti?k.�e�:aiT:�P-hT4._o nk's 4d�1S.t4i.�+? <br />