HomeMy WebLinkAbout2004-P07611 - retaining wall ITY F R N PERMIT
C � � � � Permit Number:
2750 Kelley Parkway- PO Box 66 P07611
Crystal Bay,��llinnesota 55323 P81'Rllt Typ@: User Defined Surc Building
(952) 24��-4600 Date Issued: 6/17/2004
SITE ADDRESS: 1366 Rest Point Rd
Mound,MN 55364
P I D: 07-117-23-32-0060
DESCRIPTION:
Proposed Use: Residenrial
Pernut Class: General
Permit Type: User Defined Surc Building Pemut Sub-type(s): Retaining Wall
DETAILS:
Approved per resolurion#:
Separate permits required:
NOTICES/REMARKS:
Small secrion,removing&replacing with keystone,to deal with d
FEE SUMMARY: Permit Fee: $ 111.25 Valuation• $ 5,000.00
State Surcharge Fee: $ 3.00
TOTAL FEE: $ 114.25
APPLICANT: Structures Unlimited,Inc. OWNER: James&Shiela Langhans
5425 Clayton Drive 1366 Rest Point Rd
Maple Plain,MN 55359 Mound MN 55364
Tf�UNDERSIGNED BY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED
AND AGREES TO WORK IN STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF
MINNESOTA Bi�I, G CODE REQUIREMENTS.
AN ITEE SIGNATURE ISSUED BY SIGNATURE
Conies: 1-File(SiQnitures Required), 1-Auulicant 1-Monthlv Revorts, 1-Assessing, 1-Finance Page 1
,¢��, City of Orono FOR CITY USE ONLY
P.O.Box 66 Date Received: Permit#
��,..�,, � 27j0 Kelley Parkway �
� ��'�r���. � Crystal Bay,MN 55323 Amount: $ C.U.P Filed:
�' 'i����+;��h�,� (952)249-4600
��HO$ Approved By: o���� Site Plan:
Recommends: A roval Denial ❑
CITY OF ORONO - USER DEFINED/GENERAL PERMIT
(All pem�its must be approved by the Building Official and/or Zoning Department)
�7ob�Site/Owner Information:
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Site Address: � �
Owner: �2� � l�D�� Mailing Address: [ �� 1�3� ��� j�
c�ty: (��� z�p: Me-�,.�� �53�y
Home Phone: / � Z: ��z ��3 � Alternate Phone:
Connactor/Applicant Information: j
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Contractor/App.: v]`r'�e—���4,� ��VN1��j�Contact Person: ��� � �
Address: Jr�ZS C�Ct�i 7�i:� Q12 State License#: �-�17��'
c�ty: /�c�Ie ��f� z�p: .�S 35 9 Expiration Date: ���
Phone: ��3^`17� � '0 y � Alternate Phone: �Z- 3"� ��06 s�j
TYPES OF USER DEFINED PERMITS
❑ Stairwav to Lake �etaining 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 ❑ 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
*Estimated Cost: $ $50.00 (Needs Site Plan)
General-User Defined ❑ 501+Cubic Yards
❑ Residential- $30.00 $50.00 (Needs C.U.P.)
❑ Tree Removal
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 Pcrurit 3l18t04)
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