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;¢���, City of Orono FOR CITY USE ONLY <br /> ;;0 ���, N�U� B����'�' Date Received: Permit# <br /> �. ��� 27�0 hclley Parkway <br /> a p�'N• F; Crytital F3ay.MN�Si23 <br /> �' �`���•��i�,��'� (952)2494600 Amount: $ C.U.PFiled: <br /> �ss»o� � <br /> Approved By:(�G% (,ip�.� Site Plan:3�2�-0� <br /> � <br /> Recommends: A roval Denial ❑ <br /> CITY OF ORONO - USER DEFINED/GENERAL PERMIT <br /> (All permils must he appruced by the 13uilding Ot�licial�id/or Zoning Dcparunent) <br /> Job Site/Owner Information: <br /> Site Address: 849 Brown Road North <br /> Owner: Mark& Chris Schwarzmann Mailing Address: 849 Brown Road N <br /> City: Orono Z�p: 55356 <br /> Home Phone: �952)476-7924 Alternate Phone: <br /> Contractor/Applicant Information: <br /> Contractor/App.: The Nature Group Contact Person: Scott Ritter,Amy ChCG✓e�2 <br /> Address: 420 N 5th St, Suite 655 State License #: <br /> City: Mpls Z�p: 55401 Expiration Date: <br /> Phone: (612) 929-2049 Alternate Phone: 612.998.7799 SR cell <br /> TYPES OF USER DEFINED PERMiTS <br /> ❑ Stairway to Lake ❑ Retainin>�, Walls <br /> Gencral—Uscr Detined Surchargc Gcneral—Uscr Defined Surcharge ��i� � l� AL��� �V� <br /> x (Per UBC) x (Per UBC) v����� <br /> *Estimated Cost: $ x Estimated Cost: $ � �,f —�- ` (' <br /> �--`' � -�-p <br /> ✓❑ Docks —42"or Greater ❑ Land Alteration r��_ ;���^ ( <br /> Gencral—User Detined Surcharge General—User Dclined ��� �'U''-"�� <br /> ❑ Commercial—(Per UBC) ❑ 0-500 Cubic Yards <br /> " Estimated Cost: $ $50.00(Needs Si�c Plan) ��� � ,�y�� =_! � <br /> (�eneral—User Detined ❑ 501+CubiC Yards � �, <br /> ❑✓ Residential- $30.00 $50.00(Nceds CUP) �° � <br /> ❑ Tree Removal - t� <br /> Gcncral—Uscr Dcfincd � � <br /> * Within 0-75' -$30.00 <br /> I herby apply for a User Detined Permit and 1 acknowledge that th� ,,..,,...__ <br /> accurate;that the work will be in conformance with the Ordinances and Codes of the City and with the�tate <br /> Building Code; that I u��derstand this is not a permit and work is not to start without a permit; and that the <br /> w rk will be in accordance with the approved plan. <br /> � �• �jb .O �P <br /> Applica� t Date <br /> Reset Form (UserD�oadPertnit3/18/04) <br />