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p City of Orono � <br /> ¢ � P.O.Box 66 ,� FOR I USE ONLY �//d2 <br /> �._ 0 Date Received:��Pemiit# OJ <br /> '�yw,t 2750 Kelley Pazl.tivay <br /> � y��;�� Crystal Bay,MN 55323 . � ; � <br /> �` (9S2)249-4600 h <br /> �'��'od�' Amount: . S (/.�Q C.U:P Fited: <br /> Approved By: Site Plan: <br /> Recommends: A roval , Denial Q <br /> CITY OF ORONO -USER DEFINED/GENERAL PERMIT <br /> (All permiu must be approved by the Building Officiai and/or Zoning Deparhnent) <br /> :�ob Site/Owner Iriformat'ion. :� � <br /> Site Address: STUBBS BAY, ,SWAN LAKE <br /> Owner: MINNEHAHA CREEK Mailing Address: 18202 MINNETOKA BLVD. <br /> WATERSHED DISTRICT <br /> City: DEEPHAVEN, MN Zip: 55391 <br /> Home Phone: 95 —47� —�5q� � Alternate Phone: <br /> �ontractor/A;ppltca�st Inform�.t�on � ;�� :;� � ;; <br /> Contractor/App.: _SUNRAM CONST. Contact Person: PAUL KERANEN <br /> Address: 20010 75 TH AVENUE NORTH State License #: 8115 <br /> City: CORCORA�'$, MN Zlp: 55340 Expiration Date: 3-31-08 <br /> Phone: 7��_4��— .i an Alternate Phone: 612-282-7771 <br /> ',�5��„''s�:�.� .�, .:.. r; .. :.'TYPES OF:U�ERDE�IED.PF:RII�II'I'S';�s.,.:.� t4.=�'�.� . .•� . �v:�...< <br /> ❑ Stairway to Lake ❑ Retaining Walis ❑ Temporarv Trailer <br /> General—User Defined Surcharge General—User De£ned Surcharge General—User Defined <br /> *(Per UBC) * (Per UBC) *�30.00 <br /> *Estimated Cost: $ *Estimated Cost:S <br /> ❑ Docks-42"or Greater � Land Alteration ❑ Zonin�Review <br /> General-User Defined Surcharge Generai-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 Plan) <br /> General-Uscr Defined [� 501+Cubic I`ards <br /> ❑ Residential- 530.00 550.00(Needs C.U.P.) <br /> ❑ Tree Removal <br /> General—User Defined <br /> * W ithin 0-75' -530.00 <br /> I herby apply for a User Defined Permit and I acl:nowledge ihat tlle information above is complete and <br /> accurate;that the work will be in conformance with the Ordinances and Codes of the City and with thz State <br /> Building Code; that I understand this is not a permii and work is not to start without a permit; and that the <br /> �a�ork will be in accordance with the approved plan. <br /> �. � ,�c�r�c-1 t Z - � � � a� <br /> Applicant .._. . Date <br /> Reset Form (UserDsF�edPemtiti;�e;�, <br />