HomeMy WebLinkAbout2005 - P09110 - land alteration . ' ` PERMIT
CITY OF ORONO
2750 Kelley Parkway- PO Box 66 Permit Number: P09110
Crystal Bay, Minnesota 55323 Permit Type: User Defined
(952) 249-4600 Date Issued:
9/8/2005
SITE ADDRESS: 1010 Willow View Dr Unit#
Long Lake,MN 55356
PID: 28-118-23-41-0013
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:
FEE SUMMARY: Permit Fee: $ 50.00 Valuation: $ 0.00
TOTAL FEE: $ 50.00
APPLICANT: Owner/Self OWNER: Richard&Lori Gherardi
MN 1010 Willow View Dr
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./LA �
APPLICANT PERMITEE SIGNATURE dUED BY SIGNATURE
e
Copies: 1-File(Signatures Required), 1-Applicant, 1-Monthly Reports, 1-Assessing,(If Septic, 1-Septic) Page 1
I
\Q/ 40 City of Orono FOR CITY USE ONLY ,41--)(11441
( d 41.0 P.O.Box 66 .{.tY" ;Tv t ld C)
Date'Received: g a Permit#
V2750 Kelley Parkway
Crystal Bay,MN 55323
;�, 4, (952)249-4600 Amount: $ C.U.P Filed:
\
Approved By: 011414-1"---Site Plan: 9. 5 • 0
Recommends: Approval,,a' 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: \O\C? W.\�_ 3 3 t.�'.: 1t..g2, Oc,� .c' `3 S-S5 6,
Owner: 76 ry,A.S ( ' c\i, Mailing Address: \DSC) ice`,.\\a.,;LX ; nt,.-C'
City: OXoc t Zip:
Home Phone: W...- (6-24.).-'4U. Alternate Phone: 02:- (� -)--?iS'
Contractor/Applicant Information:
Contractor/App.: Contact Person: --c.'\S"1 S;Tw1
Address: State License#: Y.t,C. r;,ue.vyc.n .
City: 0-,Q� ,,,. Zip: Expiration Date:
Phone: qcZ..-ZA.Z-.77(c.a)( Alternate Phone:
TYPES OF USER DEFINED PERMITS
❑ Stairway to Lake Retaining Walls;liCA MO �Dck u. \ ❑ Temporary Tra .
General—User Defined Surchame i ' General—User Defined Surcharge General—User Define
*(Per UBC) '- ' ' ''''' *(Per UBC) *$30.00
*Estimated Cost:$ *Estimated Cost:$ A01?-00
❑ Docks—42"or Great c 1-4G tZ p Land Alteration ❑ Zoning Review
General—User Defined Surcharg JO• General—User Defined General—User Defined
❑ Commercial—(Per UBC) 0-500 Cubic Yards *For 0-75'Zone-$30.00
*Estimated Cost: $ $50.00(Needs Site Plan)
General—User Defined84t arils
E Residential- $30.00 $5.O0(L(,Needds--U-P:)1,":S.:,—, 1
�i't!�
❑ Tree Removal ��;>' '5,°:. ivw,)
General—User Defined
* Within 0-75' -$30.00 ' 1;1:1'14 -?�r `1
, ifiOC:,, .,Jail' (i t t)1v1-- ,? 1-.\--6511,-
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I herby apply for a User Defined Permit and I acknowledge that the information above is complete and
accurate;that wo will be in conformance with the Ordinances and Codes of the City and with the State
Building d ;tha I u derstand this is not a permit and work is not to start without a permit; and that the
work will,be in ac'orld nce with the approv plan.
C e_ J Gtr ti "Iii; f' ZU� j
App scan Date /
Reset Form (User Defined Ponta 3/18/04)