HomeMy WebLinkAbout2004-P07737 - land alteration PERMIT
CITY OF ORONO Permit Number:
2750 Kelley Parkway- PO Box 66 P07737
Crystal Bay, Minnesota 55323 Permit Type: User Defined
(952) 249-4600 Date Issued: 8/24/2004
SITE ADDRESS: 3220 Watertown Rd
Long Lake,MN 55356
PID: 32-118-23-44-0013
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:
Approved driveway location on mallyvale plat
FEE SUMMARY: Permit Fee: $ 50.00
Valuation: $ 0.00
TOTAL FEE: $ 50.00
APPLICANT: Hickory Fine Homes OWNER: Mr.&Mrs.Henderson
153 E.Lake Street 3240 Watertown Rd
Wayzata,MN 55391 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.
r
VT PERMI1 EE SIGNA"&JRE ISSUED BY SIGNATURE
Conies: 1-File(Sienitures Required). 1-Applicant 1-Monthlv Reports. 1-Assessine. 1-Finance Page 1
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4 ?249-46tI�1 3
08/24/04 15.16.25
cotoNer: P07737.' 1
I PERMITS GENERAL
10 0.00 0.00 1
Base Fee
1 8 50.00 50.00
Plan RevieK
1x00 0.00 .
Mail in ieess 0+ 0.00
State SuNhharge .0.0A
E 0:00
Investigation Fee
1 @ 0.00 0.00,
St TDTAI 50.00
TAX 0.Q0
TOTAL S4 50,.00
Check Aiceived 50.00
0City of Orono FOR'C TY USE ONLY
P.O.Box 66 L 2.[ o`f' Date Received: --�-o i Permit# O 77 7
2750 Kelley Parkway al I
hki-,
Crystal Bay,MN 55323 Amount: S C.U.P Filed:
(952)2494600 $-'2�-0•(
Approved By: Site Plan:
Recommends: Approval K Denial ❑
CITY OF ORONO -USER DEFINED/GENERAL PERMIT
(All permits must be approved by the Building Official and/or Zoning Department)
Site Address: 3 -z o,o -+ low U)d�w 4�, 4.,d
Owner: ►MN_. Mailing Address: g4 &/ 2a WrCf
City: Zip:
Home Phone: 95-A ' 73 - 8Q Alternate Phone: - a 9,0 .?A
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Contractor/App.: 6�#95 Contact Person:
Address: d,t/2g ,RAO( State License
City: 6041 14 we, Zip: Expiration Date.
Phone: gjr.Z'yl3 "' o1Z9 Alternate Phone:
❑ 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 ❑ Zonina Review
General-User Defined Surcharge Gene -User Defined General-User Defined
❑ Commercial-(Per UBC) f 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 orbbl-tL%p _ pp"�/a p i�j tkuA /1 16W1 Lh (m*within 0-75' -$30.00 lJ I��'�1� rA1T4U 1L)yAJe- NJ
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 ers d this is not a permit and work is not to start without a permit;and that the work
will be in da with the approved plan.
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Applicant Date
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