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� + ' �',��`�`>.-, City of Orono l�'r 1 Q� FQR:�[TY USE OP�"L.Y '', <br /> � � `�` `, P.O.Box 66 ���a � FJate�teeeiv€d. � Lh` Pennii# £ � <br /> :�� : �'� P ..�-�^�� f����;�L <br /> � � 2750 Kelley Parkway <br /> ;�. K�'����. ��•' Crystal Bay,MN$5323 ;�; � � � � <br /> ;���k s<�,,� ' �� <br /> � ,:},,3yo.>� (95��?49-�600 � ./` <br /> ��n�: <br /> Anrount 5 � C.L;.P Cx3ei�: <br /> .. .. ApE�io�e�I3i� �Site P]ai����' <br /> Recnm�utiils, r�� rovul Det�i&E � <br /> CITY OF ORONO-USER DEFINED/GENERAL PERMIT <br /> (All pernuts must be approved by the Building Official and/or Zoning Department) <br /> :i::..::i:�::i:i'.':4::'i:::i::::i'.'?i:::::i:i::i::i::i:}�::i:::��:5}<:i:L:i::i:::':j:i::v:::ii:::ii`iiii`i:::`::":::::i::::ii::::i:::::::::::i::::i::::i: <br /> >:���:::���e::�::�er:::�`������o�>:::::>::::>::><::»>;::::>:<:::::>::::>::>::>::>::::::::>::::>::: <br /> Site Address: 3051 Farview Lane <br /> Owner: David Delaney Mailing Address: 3051 Farview Lane <br /> City: Orono Zip: 55323 <br /> `�7� <br /> Home Phone: Alternate Phone: (952)�2-0111 <br /> :::::::::.:.:::::::::::::::::::::::::::;:::::::::::::::::::> � e y5�-�f 73�3i�1 <br /> :::�'��tra����:�<�'";�ic��it::��i:��c��t���.>::::>::::>::::;::<::>;»::<;;:»::>::: <br /> f�+ <br /> ��:::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::. <br /> ContraCtor/App.: Homeowner Contact Person: Same as above <br /> Address: Same as above State License #: n/a <br /> City: Zip: Expiration Date: <br /> Phone: Alternate Phone: <br /> ':>'::::`�:�:P��:�:L� ,..,D;:.:..,:,.<.,..,:....,,,:;..:::< >,; :<`»:::::::::>::::::::>:::;:':::>:::::::<::::<::«:>:«:::>:«::::«::::<::`:::::'«::<::«:::::::>:<<::: <br /> . ... .. ......................... <br /> ::><:<:::>:::>::;:;:::::::::::::<:::>:::::::::<::::::::<:>::::>::::>::::>::::::>:::>::::: <br /> >::>::::>:;::::>..:::<:;:>:::::;:>:::;:>;>::>::»:::>::>:<::::;«:::>:<:::: ���. .��'����3.��.���t�`�`�.................................................................. <br /> ❑ Stairwav to Lake ❑ Retaiuing Walls ❑ Temporarv Trailer <br /> General—User Defined Sureharge General—User Defined Surcharge General—User Defined <br /> *(Per UBC) * (Per UBC) *$30.00 <br /> *Estimated Cost: $ *Estimated Cost:$ <br /> ❑ Docks-42"or Greater ✓❑ Land Alteration ❑ Zoning Review <br /> General—User DeFined Sureharge General—User Defined General—User Defined <br /> . ❑ Commercial-(Per UBC) ❑✓ 0-500 Cubic Yards *ForO-75'Zone-$30.00 <br /> *Estimated Cost:$ $SO.00(Needs Site Plan) <br /> General—User DeSned ❑ 501+Cubie Yards <br /> ❑ Residential- $30.00 $SO.00(Needs C.U.P.) <br /> ❑ Tree Removal <br /> General—User Def ned <br /> *Within 0-75' -$30.00 <br /> I herby apply for a User Defined Permit and I acknowledge that the information above is complete and <br /> accurate;that the work will be in conformance with the Ordinances and Codes of the City and with the State <br /> Buildin Code;that I understand � �s r�a permit and wark is not to start without a permit; and that the <br /> wo will be �n acco e the approrjed plan. <br /> �----�,_��"�- , , ,_'/% <br /> 08/30/04 <br /> Ap�5licant �, ; . � Date <br /> � ,....... <br /> t'... R�$St3�.�fl�::::::::.:: �:3�:�u�<r�o��tiis�:s <br /> _._ .................. .................... <br /> _..._ __ ._...._....................... <br />