2006-P10083 - land alteration - Laserfiche WebLink

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,�Q\ City of Orono FOR I Y USE ONLY � O 0 P.O.Box 66 Date Received: � �� Permit# �� �� 2750 Kelley Parkway a 1 t�~ ''J/ Crystal Bay,MN 55323 ,� � ��j'�y�',,}�r�4�i,�� (952)249-4600 � ��.� �" . � . �o$ Amount; $ '��" C.U.P Filed: Approved By: �' Site Plan: Recommends: A roval ❑ Denial ❑ CITY OF ORONO - USER DEFINED/GENERAL PERMIT (Ail pennits must be approved by the Building Official and/or Zoning Department) Job Site/Owner Information: ' Site Address: � ��V �l (L ��/1 � C Owner: I�� e�) ��✓��l' Mailing Address: � VVI�- a S � �UP , ��tY: a� 2� i� Z�p: S�� 1 Home Phone: I��Z ��o �� Alternate Phone: c� �Z 7�(�� Contractor/Applicant Information: - Contractor/App.: Contact Person: ��`�� P� arb e i�-y ��t9 �'-� Address: State License #: I � City: Zip: Expiration Date: Phone: Alternate Phone: � la7�qbo�9 TYPES OF USER DEFINED PERMITS ❑ Stairway to Lake ❑ Retainin�Walls ❑ Temporary Trailer General—User Defined Surcharge General—User Defined Surcharge General—User Defined *(Per UBC) * (Per UBC) *�30.00 *Estimated Cost: $ *Estimated Cost: $ ❑ Docks-42"or Greater �Land Alteration ❑ Zonin�Review General—User Defined Surcharge General—User Defined General—User Defined ❑ Commercial-(Per UBC) � 0-500 Cubic Yards *ForO-75'Zone-$30.00 *Estimated Cost: $ �50.00(Needs 5ite Plan) General-User Defined ❑ 501+Cubic Yards ❑ Residential- $30.00 $50.00(Needs C.U.P.) ❑ Tree Removal Le� �Q� 50 t�05. l General—User Defined * Within 0-75' -�30.00 I herby apply for a User Defined Permit and I acl:nowledge that the information above is complete and accurate;that the work will be in conformance with the Ordinances and Codes of the City and with the State Building Code; that I understand this is not a permit and work is not to start without a permit; and that the wor✓%``y�ll be in accordance with the approved plan. _ � -7 /O b� APPI t _ . Date . �. Reset F�rm � (UserDefinedPemut3lLB/OS)