HomeMy WebLinkAbout2005-P09416 - land alteration PERMIT
CITY OF ORONO Permit Number:
2750 Kelley Parkway- PO Box 66 P09416
Crystal Bay, Minnesota 55323 Permit Type:
User Defined
(952) 249-4600 Date Issued: 11/14/2005
SITE ADDRESS: 450 Big Island Unit#
Excelsior,MN 55331
PID: 23-117-23-32-0070
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:
Permit to hookup electric cable to excel power pole on Cirty right-of-way on B.I
FEE SUMMARY: Permit Fee: $ 50.00 valuation: $ 0.00
TOTAL FEE: $ 50.00
APPLICANT: RobertNahs OWNER: Gabriel7abbour
6320 Post Lane 985 Tonkawa Rd
Edina,MN 55439 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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APPI,ICANT PERMITEE SIGNATURE ISSUE BY SIGNATURE
Copies: 1-File(Signatures Reguired), 1-Applicant, 1-Monthly Reports, 1-Assessing,(If Septic, 1-Septic) Page 1
,r�(��� City of Orono F R I Y U,$E ONLY
/O�' �r�, P.O.Box 66 Date Received: Q� Permit#
� a� 2750 Kelley Parkway
,� 3�i�y��}- ��� Crystal Bay,MN 55323
+ .t�r�V�i�/ (952)249-4600 Amount: $ C U P Filed
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Approved By: __(.� Site Plan:��J
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Recommends: A roval 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: '
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Site Address: 7 �
Owner: c /% e� f Mailing Address: �,?�/ ('j � �j�vt1��v/
City: �7 r� v r'1 � Zip: �
Home Phone: Alternate Phone: � � 2 -��� � ���
Contractor/Applicanf Information:
Contractor/App.: J�'4`�L f�7' /�'���5 Contact Person: s� /s�
Address: �3�a j'ds� �-�ti'L-- State License #:
City: G- /i� � . Zip: �S��3� Expiration Date:
Phone: �.3�-2 — ��/� —.3,� !� Alternate Phone: y"7y .-�;,Zy►�
TYPES OF US�R DEFINED PERMITS
❑ Stairway 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 0 Land Alteration ��fj�� �l�. ❑ Zonin�Review
General—User Defined Surcharge General—User Defined�� � y General—User Defi�ed
❑ Commercial—(Per UBC) �' 0-500 Cubic Yards 11���C� *ForO-75'Zone-$30.00
*Estimated Cost: $ $50.00(Needs Site Plan) L� �
General—User Defined ❑ 501+CublC YaCds
❑ Residentia]- �30.00 $50.00(Needs C.U.P.)
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❑ Tree Removal � � W �,''�1�� �U �C(��C�/'r�1 �,}�C�� l C� (�Ol IQ��
General—User Defined
* Within 0-75' -$30.00
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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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�,;�� R��set Form� '�s �u�ner�ea�«�c3i�sroaj
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f ��, UNDERGROIJND PIERCING, INCo
' 14320�lAMES ROAD • ROGiERS, MN 55374
. Phone (763) 428-7930 • Fax (763) 428-7934
' ugpi@charterinternet.com
Project ��� I�l�rc� �c�:3� �-c �,�y 1c �siL4.�1 Date
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