HomeMy WebLinkAbout2005 - P08683 - land alteration CITY OF ORONO PERMIT
2750 Kelley Parkway- PO Box 66 Permit Number: P08683
Crystal Bay, Minnesota 55323 Permit Type: User Defined
(952) 249-4600 Date Issued: 5/4/2005
SITE ADDRESS: 2845 Wear Cir
Long Lake,MN 55356
PID: 33-118-23-34-0009
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: Susan&Klein Johnson
MN 2845 Wear Cir
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.
1
APPLICANT PERMITEE SIGNATURE JSSUEDBY SIGNATURE
Conies: 1-File(Sienitures Required), 1-Applicant, 1-Monthly Reports, 1-Assessin¢, 1-Finance Page 1
Og'OHO City of Orono FOR CITY USE ONLY
' P.O.Box 66 Date Received: Permit#
VON 2750 Kelley Parkway
hyrJr Crystal Bay,MN 55323 Amount: $ C.U.P Filed:
t�-V (952)249-4600
Approved By: Site Plan:
Recommends: Approval ❑ Denial ❑
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: 2'a45 WQ�)''r are C`Q
Owner: -42-101 jck✓15 Mailing Address:
City: Q0i 'VC7 Zip: 5-5356
Home Phone: �SZ- 70- zJ ! Alternate Phone: 651 -3ow
Contractor/Applicant Information:
Contractor/App.: Contact Person:
Address: State License#:
City: Zip: Expiration Date:
Phone: Alternate Phone:
TYPESOF USER DEFINED PERMITS
❑ Stairway to Lake ❑ RetaininQ 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 W Land Alteration ❑ Zoniniz Review
General—User Defined Surcharge ( a ral—User Defined General—User Defined
❑ Commercial—(Per USC) 0-500 Cubic Yards *ForO-75'Zone-$30.00
*Estimated Cost: $ A $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 g' i accord e with the approved plan.
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