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HomeMy WebLinkAbout2009-00719 - retaining wall • � CITY OF ORONO PERMIT NO.: 2009-00719 2750 KELLEY PARKWAY ORONO,MN 55356- DATE ISSUED: 10/16/2009 . 952 249-4600 FAX: 952 249-4616 ADDRESS : 3745 SHORELINE DR PIN : 20-117-23-21-0025 LEGAL DESC : TOWNSITE OF LANGDON PARK : LOT 005 BLOCK 007 PERMIT TYPE : USER DEFINED PROPERTY TYPE : RELIGIOUS CONSTRUCTION TYPE : RETAINING WALL ACTIVITY , g VALUATION : $ 500.00 NOTE: RETAINING WALL SITE-GOOD SHEPHERD LUTHERAN CHURCH APPLICANT RETAINING WALL 25.00 ERIC BOSER STATE SURCHARGE USER DEFINED 0.25 5054 BAYPORT RD TOTAL 25.25 MOUND,MN 55364 (612)867-2060 PAID WITH CASH 25.25 OWNER CHURCH,GOOD SHEPHERD LUTHERAN 3745 SHORELINE DR WAYZATA,MN 55391 AGREEMENT AND SWORN STATEMENT The work for which this permit is issued shall be performed according to the approved plans and specifications,applicable City approvals,and the State Building Code. This permit is for only the work described and does not grant permission for additional or related work which requires separate permits. All provisions of laws and ordinances goveming this type of work shall be compied with whether or not specified herein.This permit will expire and become null and void if construction authorized is not commenced within 180 days of the date of issuance,or if construction is suspended for a period of 180 days at any time after work has commenced. The applicant is responsible for assuring all required inspections are requested in conformance with the State Building Code.This permit may be revoked at any time for due cause. �.,�-`- S'�_ �v i 16 izoo� �d i � 0 9 Applicant Permitee Signature Date Iss By Signature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. �0� City of Orono � FOR CITY S�Ep ONLY p O O P•O.Box 66 ������ '/ / � � 7�� Date Received: ermit# 1 ?y„ 2750 Kelley Parkway a �`�r � Crystal Bay,MN 55323 Amount $�� � ���- U.P Filed: �''?°�,,�'p��.yo` (952)249-4600 � o$ dBH Approved By: Site Plan: D•/r 6•ow Recommends: A roval Denial ❑ CITY OF ORONO - USER DEFINED/GENERAL PERMIT (All permits must be approved by the Building Official and/or Zoning Department) �ob:Site/Owner Information: Site Address: � ��f`� SVIU��(�'V�� �E � �'I� Sti�p��,� Lt���.���W�1/� Owner: Mailing Address: 3�G- � St�rz-t�r.e �f� City: �C�y-�c„�c� Zip; `�`�, �`'l 1 Home Phone: C �z— �I-�- 1 -' `�q-�J� Alternate Phone: �Contractor/Applicant Information: � � � Contractor/App.: �-' � ('t�L 4X%�� Contact Person: Address: �7�4 4�cx,�{x�d't � , State License #: City: ��v�,t✓1� Zip: �'3G�- ExpirationDate: Phone: � � Z — ��;�,"�--��U Alternate Phone: TYPES OF��iER DEFINED PERMITS ❑ Stairwav to Lake � Retaining Walls ❑ Temporarv Trailer General—User Defined Surcharge General—User Defined Surcharge General—User Detined * (Per UBC) *(Per UBC) *$30.00 *Estimated Cost: $ *Estimated Cost: $SO 4•�� No PG4.1 lLev��T✓ FC2j�a ❑ Docks-One Time(tvon-r�ke mcka� ❑ Land Alteration ❑ Zoning Review General—User Defined Surcharge General—User Detined General—User Defined ❑ Commercial-(Per UBC) ❑ 0-500 Cubic Yards *ForO-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 wark is not to start without a permit;and that the work will be in accordance with the approved plan. �� 1�-��--�--�' 1 � .- I � - �`� Applicant Date tu�orno�s r�it osrpa�o�� �� % /` / � �I �_ � ,�V / / ��� ��� �� �1 � . � � . ,. fr � i ."r a1La �y,, :1.tj , ' ; � , � � j / % ��t�.. . ; , - - _ _ . , < ' ` It / i N . �, � - . . , _ "3�� �5 5 ' �J, � . 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