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HomeMy WebLinkAbout2005-P09006 - land alteration � � PERMIT CITY OF ORONO Permit ►vumber: 2750 Kelley Parkway- PO Box 66 P09006 Crystal Bay, Minnesota 55323 Permit Type: User Defined (952)249-4600 Date Issued: 7/26/2005 SITE ADDRESS: 4300 Sixth Ave N Unit# LONG LAKE,MN 55356 PID: 31-118-23-12-0022 DESCRIPTION: Proposed Use: Residential Permit Class: General Permit Type: User Defined Permit Sub-type(s): Land Alteration(0-500 cu yc DETAILS: Approved per resolution#: Separate permits required: NOTICES/REMARKS: FEE SUMMARY: Permit Fee: $ 50.00 Valuation: $ 0.00 TOTAL FEE: $ 50.00 APPLICANT: Owner/Self OWNER: ROBERT&MARILYN GEHRMAN MN 4300 SIXTH AVE N LONG LAKE MN 55356 THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED AND AGREES TO DO ALL WORK IN STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF MINNESOTA BUILDING CODE REQUIREMENTS. � SZi ' \� `%� . �_-�`�� APP CANT RMIT A ISSUED BY SIGNATURE Copies: 1-File(Signatures Required), 1-Applicant, 1-Monthly Reports, 1-Assessing,(If Septic, 1-Septic) Page 1 r � ,��� City of Orono FOR CITY USE ONLY P.O.Bo�6G Date Received: Permit# ��;,.;. � 275o Kelley Parl.way �, h�)'��.��,r- � Crys[al Bay,MN 55�2_ Amount: $ C.U.P Filed: �''�;.yg'�jh��y�� (952)2�19-4G00 �sssae• Approved By: Site Plan: '1'26 ��� Recommends: A rov Denial ❑ CITY OF ORONO - USER DEFINED/GENERA.L PERII�IT (All ponnits must be appro��ed by the Building Official and/or Zonine Departmen[) 7ob Site/O�t�:ier I�lforniation: Site Address: Owiler: l'�D�"ZQ_,1�r(V1� Mailin;Address: �3C� 1����,v City: Zip: �j3FJ(D Home Phone: ��Jc�— �7(a— �� '�(� Alteniate Phone: C�(a—50�—��d� Conh-actor/Applicant Itlfornlation: Contractor/App.: Contact Person: Address: State License#: City: Zip: Eapiration Date: Phone: Alternate Phone: TYPES OF USER DEFINED PERNIITS ❑ Stairwav to Lalce ❑ Retainin�Walls ❑ Temuorarv 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 ❑ Zonine Review General-User Detined Surchar_e Gener Us�r Detined General-User Detined ❑ Coiiunercial-(Per UBC) �-0-�00 Cubic Yards *ForO-75'Zone-$30.00 *Estimated Cost: $ SSO.00(Needs Site Plan) Ceneral—User Detined ❑ 501+Cub1c Yards ❑ Residential- �30.00 �50.00(Needs C.U.t�.) ❑ Tree Removal � General—User Defined *Within 0-75' - $30.00 I herUy apply for a User Defined Pennit and I aclmowledge that the information above is complete and accurate; that the �vork«�ill 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�vork will be in accordance with the approved plan. � , p� " '�� A���,,��y4_I' .. t. ,�i � `'� �'.� �`,�, � "�.��, . �Y�' �,.', . . �i��^�:. :� �.. 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