HomeMy WebLinkAbout2003-P06929 (land alteration) PERMIT
CITY �F ORONO Permit Number:
2750-Kelley Parkway - PO Box 66 P06929
Crystal Bay, Minnesota 55323 Permit Type: User Defined
(952) 249-4600 Date Issued: ioi23i2oo3
SITE ADDRESS: 3845 Bayside Rd
I.ong Lake,MN 55356
PID: OS-117-23-23-0006
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 pemuts required:
NOTICES/REMARKS:
> 10 Cubic yards of Sand at the Lakeshore-Ok'd by Lyle Oman
FEE SUMMARY: Permit Fee: $ 50.00
Valuation: $ 0.00
TOTAL FEE: $ 50.00
APPLICANT: Owner/Seif OWNER: 7ohn&Sherri Thiesse
� 3845 Bayside 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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APPLICANT PERMITEE SIGNATURE ISSUED BY SIGNATURE
Copies: 1-File(Si�nitures Required), 1-Applicant, 1-Monthlv Reports, 1-Assessin�, 1-Finance Page 1
,¢�� City of Orono FOR CITY USE ONLY
P.O.Box 66
.�� � 2750 Kelley Parkway Date Received: Permit#
• �������',�-� Crystal Bay,MN 55323 Amount: $ C.U.P Filed:
L_ �y (952)249�600
`�8� Approved By: Site Plan:
Recommends: A roval ❑ Denial ❑
CITY OF ORONO - USER DEFINED/GENERAL PERMIT
(All permits must be approved by the Building Officiai and/or Zoning Department)
Job Site,�Ow�er oimation ''`` ��
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Site Address: ,���� �-��i,�J�� ,�-�<�r�
Owner: _��-���c.,' CJ fl����Iailing Address:
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City: �/� �..-v�, Zi 5�:���� �,_:
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Home Phone: �Sz ��� ���-�` Alternate Phone: �-J� C-7L - /G� 7
Contractor/Applicant Information:
Contractor/App.: Contact Person:
Address: State License#:
City: Zip: Expiration Date:
Phone: Alternate Phone:
�� ' � ' � �� ��' TYPES OF USER DEFINED��PERNIITS :�,'; �_; v� .. ;.. �� ����� �
❑ Stairwav to Lake ❑ Retainin 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 ❑ Zoning Review
General—User Defined Surcharge / General—User Defined General—User Defined
❑ Commercial—(Per UBC) � 0-500'-550.00(Needs sice plan) *For 0-75'Zone-$30.00
*Estimated Cost: $ ❑ 501'+-S75.O0(Needs C.U.P.)
General—User Defined
❑ Residential- $30.00 �� � �'�«- y��f
❑ Tree Removal �� S�� �T ��S/��
General—User Defined /\ n
*within o-�s-�30.00 �i(�J �J���.x-�-- r o ,�3 , �3
I herby apply for a User Defined Permit and I aclrnowledge 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 pernut and work is not to start without a pernvt;and that the work
vyi}t e m ccordance wi h t approved plan.
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