2005-P06168 - retaining wall - Laserfiche WebLink

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� ��. ,¢0� City of Orono � � FO�SE ONLY � / O O P.O.Box 66 � Date Received: °J - Permit# �"' �� '��G; � � _ 2750 Kelley Parkway w � ��J t�,�j � �l1� ��;� F Crystal Bay,MN 55323 ^ ��' 'a,�, Amount: $ l L"`7 � C.U.P Filed: f �'��i��,�` (952)249-4600 `„ e •�� ' `✓ ;� Approved By: Site Plan: Recommends: A roval ❑ Denial ❑ — 2� ,.� .. CITY OF ORONO - USER DEFINED/GENERAL PERMIT (Ali pe�mits must be approved by the Building Official and/or Zoning Department) Job Site/Owner Inforniation: Site Address: � �1�� c' -� , �- Owner: �� c��C�Df v� �S Mailing Address: �4-vvl L City: CT(LO�� Zip: �5 3�t I Home Phone: �S a -�7 ( - �'t a-1 g Alternate Phone: `�S� - �-I� I - �C ,�'S� Conhactor/ Applicant Information: Contractor/App.: �,�,�� Contact Person: Address: State License #: City: Zip: Expiration Date: Phone: Alternate Phone: TYPES OF USER DEFINED PERMITS ❑ Stairway to Lake [� Retaining Walls ❑ Temporarv Trailer General—User Defined Surcharge General—User Defined Surcharge General—User Defined * (Per UBC) *(Per UBC) * $30.00 *Estimated Cost: $ * Estimated Cost: $ �� (, , ❑ Docks-42"or Greater ❑ Land Alteration ❑ Zoning Review General—User Defined Surcharge General—User Defined General—User Defined ❑ Coirunercial-(Per UBC) ❑ 0-500 Cubic Yards *ForO-75'Zone-$30.00 * Estimated Cost: $ $50.00 (Needs Site Plan) General-User Defined ❑ 501+Cubic Y1Ids ❑ Residential- $30.00 $50.00 (Needs C.uP.) ❑ Tree Removal General—User Defined *Within 0-75' - $30.00 I herby apply for a User Defined Permit and I aclrnowledge that the information above is complete and accur � that the w 11 be in conformance with the Ordinances and Codes of the City and with the State Buildin C�de;t T�I u erstand this is not a permit and work is not to start without a perniit;and that the work will in a c th he approved plan. O, � ., LI .��o _ � �� Applicant Date (User DeSned.Pmmt 3/18/04)