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� <br /> p � City of Orono <br /> ��' �V'a� ��, FOR TT USE ONLY <br /> P.O.Box 66 <br /> 2750 Keltey Parkway Date Received:/ ' y Pemiit#�//�� <br /> �' �I�"��%-� '� C stal Ba MN 55323 <br /> � �I. �Y Y, <br /> ��"a?t;�;n�`�� (952 249-4600 . <br /> ���o��' • ) Amount: $��'� C.U.P Filed: <br /> Approved By: Site Plan: <br /> Recommends: A roval ❑ Denial ❑ <br /> CITY OF ORONO -USER DEFINED/GENERAL PERMIT <br /> (All penniu must be approved by the Buil ding Official and/or Zoning Department) <br /> Job Site/Owner Information. <br /> Site Address: STUBBS BAY, ,;WAN LAKE /8� ,��,� .5�� <br /> Owner: MINNEHAHA CREEK Mailing Address: 18202 MINNETOKA BLVD. <br /> WATERSHED DISTRICT <br /> City: DEEPHAVEN. MN Zip: 55391 <br /> Home Phone: �5 2-4 7� -0 q� Alternate Phone: <br /> Gontractor/.Applicant Iriforrnation ��'�•;; <br /> Contractor/App.: SUNRAM CONST. Contact Person: PAUL KERANEN <br /> Address; 20010 75 TH AVENUE NORTH State License#: 81 15 <br /> City: CORCORA�, MN zlp. 55340 Expiration Date: 3-31-08 <br /> Phone: 7�,3_4��-2� q� Alternate Phone: 612-2 8 2-7 7 71 <br /> ' ` ' 'TYPES OF.USERDEFINED PERIVIITS . ..,' <br /> _ e.=;fr. T<.. : F <br /> ❑ Stairwav to Lake ❑ Retainin Walls ❑ Teinporar Trailer <br /> General—User Defined Surcharge General—User Defined Surcharge General—User Defined <br /> * (Per UBC) * (Per UBC) *$30.00 <br /> *Estimated Cost: $ *Estimated Cost: $ <br /> ❑ Docks-42" or Greater 0 Land Alteration ❑ ZoninQ Review <br /> Genera!—Use�Defined Surcharge Generai—User Defined Gencral—User Defined <br /> ❑ Commercial-(Per UBC) ❑ 0-500 Cubic Yards *ForO-75'Zone-$30.00 <br /> * Estimated Cost:$ $50.00(Needs Site Plan) <br /> General-User Defined [� 501�Cubic Yards <br /> ❑ Residential - �30.00 �50.00 (Needs C.U.P.) <br /> ❑ Tree Removal <br /> General—User Detined <br /> * Within 0-75' -530.00 <br /> I herby apply for a User Defined Permit and I acl;nowledge that the infonnation above is coi��plete 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 ���ithout a pennit; and that the <br /> ���ork will be in accordance with the approved plan. <br /> �. � �.��a��-, �z - ► -� � c�-� <br /> Applicant __. — <br /> Date <br /> Reset �orm (UserDcfinedYcrnit3;12;�y, <br />