Laserfiche WebLink
¢0� City of Orono ': � :: FOR CITY USEDNLY ` <br /> P.O.Box 66 Date Received D Permit#. <br /> . . Qg+ � 2750KelleyParkway • �; L��. <br /> , � ���. 'j�� +� Crystal Bay,MN 55323 Amount � $ •C U P Filed � ' <br /> �� °� (952)249-0600 . . <br /> ��O$� �APP�vedBy: : • ':�•SttePlani , <br /> 'Recbminends: A roval .� '' . Denial �'..",� � <br /> . . . . - fr��� " <br /> GITY OF ORONO -USER DEFILVFi�DJ.���t���Pt • i ' � �'-��� 4="'�`�;;� <br /> (All permits mustbe approved by the Building Official an� ;7� D p . pt) - <br /> � 4 <br /> �y;-: �.e� t.-� tx:.. i�. a: ,,).} . -y� .;� ��!-` .�a. . . � ��� . � . . . <br /> �Job S5�tel;Own,er,sIn.�orn�ation �4t��'t.�,��a��'��z �' <br /> .f.�.,.,�,.. ,.,.., : ..,�._..: �.,_��_.. .. .:� _ .... _ , ..._. : ....,� <br /> '—(SS 1 ..:1�4:i�t� ,ai i�=n�,�:c�rf <br /> .Site Address: � r1 k�-uc�---� <br /> . Owner: � ��SS� Sc��--�e� Mailin�Ad�.��ss: .� - -- - 't�rt�F <br /> City: �r��J Zip: <br /> . � Home Phone:• ' ' � Alternate'Phone: �� �Z�� S � ' G `� (T <br /> .�F . � 7 �F�:�. x -� � �:, x ,y . .. <br /> "„� ��;oni'rac�oz/��1rP,p`=licantl�ormation�-����a�'��,.�. ;;: °�: <br /> .i _ • . <br /> Contractor/App.: ��� —����� �-�c. . � Contact Person: . �' G ����a-r-iz <br /> Address: ?1�v ��f � �v�. State License#: ! �I � - � <br /> � City: �������J z�p: Ss 3?3 E�piration Date: <br /> Phone: ���3,�7 7 f � ( �� Altemate Phone: CG ��--� �G�- �'z�L� <br /> r-tc2M�.J��wL' k�'+�"�. � a s�, �� •,14,,,,.. - _.,g, ; , , ,.. - 7�?�y�i+,r�s �'ira? � d�����7y�K�y�1i y'i��1f"� j .. : ... . . <br /> -._ ..._ .��. j �yy <br /> s, i4:�f:��^�t��+..vt'.��:Y^+.w.�4%�A�1�a'l���V<.�S."�. + ��S�O��TJ�S�R�FF��D�pE�'RNIIyI'Sr���Y':�MtYr�.�ti,�r�3i� . •Si��-f���iE�4jV[Y5� �. <br /> .-f _ <br /> . to e ❑ Retainin�Walls ❑ Temgorarv Trailer <br /> Gen r efine rcharge General—User Defined Surcharge General—User Defined <br /> C *(Per UBC) * 530.00 <br /> Es ' ed . �v� *Estimated Cost: � <br /> 0 Docks—42"or Greater �Land Alteration ❑ Zonin�Review . <br /> General—User Defined Surcharge General—User Defined General—User Defined <br /> � ❑ Commercial—(Per UBC) � 0-500 Cubic Yards *ForO-75'Zone-$30.00 <br /> *Estimated Cost:$ $50.00 (Needs Site P►an) <br /> General—User Defined ❑ 501+Cubic Yards <br /> ❑ Residential- �30.00 $50.00(Needs C.U.P.) <br /> ❑ Tree Removal _ . , . <br /> General—User Defined "'''�� <br /> *Within 0-75' -$30.00 . ' <br /> I herUy apply for a User Defined Pernut and�I aclmowledge 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 pemut;and that the work <br /> will be in accordance with the approved plan. <br /> A �� s����� <br /> Applicant ` Date <br /> � fUs¢De6ned Pemut 3/18tt1a1 <br />