2009-00286 - land alteration - Laserfiche WebLink

Home Browse Search

� 4��` City of Orono FOR CI Y USE ONLY O `YO P.O.Box 66 �j � Date Received: Vermit# " Q� ay,t 2750 Kelley Parkway �� � �It��< ,E' Crystal Bay,MN 55323 Amount: $ C.U.P Filed: ��+��,�` (952)249-4600 -- °$ Approved By: Site Plan: _�_ Recommends: A roval ❑ Denial ❑ CITY OF ORONO - USER DEFINED/GENERAL PERMIT (All permits must be approved by the Building Official and/or Zoning Department) Job Site/Owner Information: '�`G , ` ; �� : Site Address: -�� C' 1`�� .: _-�¢`'�;e,�C�F �, �;/'.�7'LO, �I.� S�J v�`�� ,-� ,, Owner: �°� C� Mailing Address: ��I� City: Zip: Home Phone: Alternate Phone: Co�ntractor/Applicant Information: Contractor/App.:��Y�f�.�� Contact Person: " �,,•�y 6e%""n� Address: SD�J L'a /2cl l`�C� State License #: City: ��, Zip: Y� Expiration Date: Phone: �(�2'��,� -��y Alternate Phone: y,5�Zg��7�3 �(5 Z - yv& - i�/� ` "''' '�` � TYPES OF USER DEFINED PERN��T� ❑ Stairwav to Lake ❑ Retaining Walls ❑ Temporarv Trailer General—User Defined Surcharge General—User Defined Surcharge General—User Defined * (Per UBC) *(Per UBC) *$30.00 *Estimated Cost: $ *Estimated Cost: $ ❑ Docks—One Time �No„-�ke Mtka� � Land Alteration ❑ Zoning Review General—User Defined Surcharge General—User Defined General—User Defined ❑ Commercial—(Per UBC) []'0-500 Cubic Yards *For 0-75'Zone-$30.00 *EStlmated COSt: $ $50.00(Needs Site Plan) General-User Defined ❑ 501+CubiC Ya[ds ❑ Residential- $30.00 $50.00(tveeds C.U.P.) ❑ Tree Removal a�SO 1 Vl C��-Q-S 1^Q-��Cr�h� �3 � �2.J y� General—User Defined *Within 0-75' -$30.00 I herby apply for a User Defined Permit and I acknowledge 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 work will be in accordance with the approved plan. Applicant Date (User De6ned Pentrit OS/08/09)