HomeMy WebLinkAbout2009 - 00185 - land alter - sand volleyball court •
CITY OF ORONO PERMIT NO.: 2009-00185
2750 KELLEY PARKWAY
ORONO, MN 55356- DATE ISSUED: 05/04/2009
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 875 WINDJAMMER LA
PIN : 07-117-23-12-0030
LEGAL DESC : PIRATES COVE
: LOT 003 BLOCK 001
PERMIT TYPE : USER DEFINED
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : LAND ALTERATION(0-500 CU YDS)
NOTE: INSTALLING A SAND VOLLEYBALL COURT-68'X 32'
APPLICANT LAND ALTERATION 50.00
BROGHAMMER, BRENT&CAROLYN TOTAL 50.00
875 WINDJAMMER LA
MOUND,MN 55364
OWNER
BROGHAMMER,BRENT&CAROLYN
875 WINDJAMMER LA
MOUND,MN 55364
AGREEMENT AND SWORN STATEMENT
The work for which this permit is issued shall be performed according to
the approved plans and specifications,applicable City approvals,and the
State Building Code. This permit is for only the work described and does
not grant permission for additional or related work which requires separate
permits. All provisions of laws and ordinances governing this type of work
shall be compied with whether or not specified herein.This permit will
expire and become null and void if construction authorized is not
commenced within 180 days of the date of issuance,or if construction is
suspended for a period of 180 days at any time after work has commenced.
The applicant is responsible for assuring all required inspections are
requested in conformance with the State Building Code.This permit may be
revoked at a rhe c use.
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Applicant Permitee Signature Date f ed By ignature Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
' p City of Orono _
04 O P.O.Box 66 D.'. ,- :ived r`er� oN t#
LlAr- 2750 Kelley Parkway ��
IAt Crystal Bay,MN 55323 C [UDF
s jilt, 6 (952)249-4600
Amount 3'• C,U.P Piled:
Approved By.c.Q. IOU Site Plan
Recommends: Approval O :-Denial .0
CITY OF ORONO USER DEFINED/GENERAL PERMIT 3\-7
(All permits must be approved by the Building Official and/or Zoning Department)
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Job Site/Owner Information "
Site Address: `A 5 W I-k o. CLvY1 NV'IV La-0-e-,
Owner: �j\''e 4 C C v O - v�
Mailing Address: �c �-L� Gl S G����/2_
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City: -V\ 0 -IL,Li
' I Zip: r N II q
Home Phone: a' `�� 2Alternate Phone: i a_ DD (o U r7 Ci Y
:Contractor/AppiieiiitIrrforrnii0bi Ar'br�'
Contractor/App.: Contact Person: �`.Ctv--6
Address: State License #:
City: Zip: Expiration Date:
Phone: Alternate Phone:
:. . 61/2%„ -< � "_ ��,: . TYPES OFUSERDEINED,PER�IITS i
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❑ Stairway to Lake ❑ Retaining Walls ❑ Temoorary Trailer
General-User Defined Surcharge General-User Defined Surcharge General—User Defined
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*Estimated Cost: $ *Estimated f ) $30.00
Cost: S
❑ Docks—42"or Greater / Land Alteration S�,r� , ❑ Zoning Review
General-User Defined Surcharge General-User Defined , t} 1 7 ' General-User Defined
E Commercial- UBC) 4,f `•
(Per Q 0-500 Cubic Yards *For O-75'Zone-$30.00
*Estimated Cost:S $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-with the approved plan.
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Applicant , Reset.. .. y. Date
eset Form (User Defined Permit 3/18/41
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CERTIFICATE OF suqyEy
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. We hereby certify that this is a true and correct representation of a survey of
, the boundaries of the land above described and of the location of all bui I dlng• 4
if any, thereon, and all visible encroachments, if any, from or on said land.
Dated this 14th day of February , .1567 EGAN, FIELD & NOWAK
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File No. 0[ Book No. 1762-50 by
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