Laserfiche WebLink
. <br /> , 1 <br /> . -<z:. <br /> 0 �� City of Orono -� FOR CITY USE ONLY <br /> �O¢ ���, P.O.Box 66 � 1��E r'�(�.. <br /> te Received: __�����ermit# ,�r <br /> .. 2750 Kelley Parkway �%'�^�� <br /> ,� pi'A• �-j� Crystal Bay,MN 55323 �� <br /> ���b�oaio.' <br /> (952)249-4600 Amount: $ C.U.P Filed: <br /> Approved By: ���te Plan: <br /> � . <br /> Recommends: A val Denial ❑ <br /> i <br /> CITY OF ORONO - USER DEFINED/GENERAL PER IT <br /> (All pennits must be approved by the k3uilding Official and/or Zoning Department) <br /> Job Site/Owner Information: <br /> Site Address: �6 5� �-Lr'/`d`aJ�t, �d . � , <br /> Owner: �prv�. o�e. � Sr•Wa�rG'4tti. Mailing Address: �(��j� ���r��tic � N , <br /> City: �rortb , �� �-.�53�C I Zip: `55?��i ( <br /> Home Phone: ��"j'Z • �{'�"3 '�-�-6Z Alternate Phone: �' <br /> Contractor/Applicant Information: <br /> Contractor/App.: Contact Person: <br /> Address: State License#: <br /> � - � <br /> City: Zip: Expiration Date: � <br /> / <br /> Phone: Alternate Phone: �� � <br /> TYPES OF USER DEFINED PERM�T <br /> ❑ Stairway to Lake � Retaining Walls ❑ Temporary Trailer <br /> General—User Detined Surcharge General—Uscr Dcfined Surcharge General—User Defined <br /> '�(Per UBC) *(Per UBC) * $30.00 <br /> *Estimated Cost: $ *`Estimated Cost: $� ,�d <br /> ! <br /> ❑ Docks-42"or Greater � Lan Alt rati n ❑ Zoning Review <br /> General—User Defined Surcharge Genera ser Defin�d General—User Defined <br /> ❑ Commercial-(PerUBC) ❑ - OCubic ds *ForO-75'Zone-$30.00 <br /> * Estimated COst: $ ' $50. (Ne s Site lan) <br /> General—User llefined � 5�1+ �C YaCd� <br /> ❑ Residential- $30.00 $50.00( eds c.u.P.) <br /> � <br /> ❑ Tree Removal <br /> General—User Defined <br /> * Within 0-75' -$30.00 <br /> I herby apply for a User Defined Per ' and I acknowledge that the information above is complete and <br /> accurate; he ark will be'n c nce with the Ordinances and Codes of the City and with the State <br /> Buil ' g o e• at I u der n t ot a permit and work is not to start without a permit; and that the <br /> w w' e n ccor nc r ved plan. <br /> ��� <br /> A licant Date <br /> ReSet F (User Defined Pemut 3/18/04) <br />