HomeMy WebLinkAbout2004-P08078 - land alteration CITY OF ORONO PERMIT
4750 Kelley Parkway- PO Box 66 Permit Number: P08078
Crystal Bay, Minnesota 55323 Permit Type: User Defined
(952) 249-4600 Date Issued: 10/29/2004
SITE ADDRESS: 1205 Tonkawa Rd
Long Lake,MN 55356
PID: 08-117-23-13-0018
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:
5 yards fill-fill small holes&adding soil to garden only
FEE SUMMARY: Permit Fee: $ 50.00 Valuation: $ 0.00
TOTAL FEE: $ 50.00
APPLICANT: Owner/Self OWNER: Thomas&Nancy Smith
MN 1205 Tonkawa Rd
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.
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L I C A N T PERMITSI ATURE SUED BY SIGNATURE
Conies: 1-File(Skenitures Required). 1-Applicant. 1-Monthly Reports. 1-Assessine. 1-Finance Page 1
�OCity of Orono FOR CITY Uy$E ONLY
P.O.Box 66 Date Received: W-14-0 Permit# O7
O µt 2750 Kelley Parkway OQ
► t��. fi• Crystal Bay,MN 55323 Amount: $ 50, C.U.P Filed:
� 8o�yo (952)249-4600 ^\
Approved By: .44a.— Site Plan:
Recommends: Approval 21 Denial ❑
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CITY OF ORONO - USER DEFINED/GENERAL PERMIT ((
(All permits must be approved by the Building Official and/or Zoning Department)
Job Site/Owner Information:
Site Address: ---3— 7,:rW
Owner: Mailing Address:
City: Zip: 3 S
Home Phone: `�� `- L' / Alternate Phone: 1'�
Contractor%Applicant Information:
Contractor/App.: Contact Person:
Address: State License#:
City: Zip: Expiration Date:
Phone: Alternate Phone:
TYPESOF USER DEFINED PERMITS
❑ Stairway to Lake ❑ Retaining 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 `��/y D j ❑ Zoning Review
General-User Defined Surcharge General-User Defined I ^� 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 work is not to start without a permit;and that the work
will be in accordance wi the a rove plan.
41
A plicant Date
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