HomeMy WebLinkAbout2004-P07306 - land alteration � ' .
CITY OF ORONO PERMIT
2750 Kelley Parkway - PO Box 66 Permit Number: Po�3o6
Crystal Bay, Minnesota 55323 Permit Type: User Defined
(952) 249-4600 Date Issued: 3ii��2oo4
SITE ADDRESS: 1280 Bracketts Pt Rd
Wayzata,MN 55391
PID: il-il�-23-32-ooi9
DESCRIPTION:
Proposed Use: Residential
Permit Class: General
PetYnit Type: User Defined Permit Sub-type(s): Land Alteration(0-500 cu y�
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
no work below 931.5 elevation
FEE SUMMARY: Permit Fee: � 50.00
Valuation: $ 0.00
TOTAL FEE: $ 50.00
APPLICANT: Anthemis OWNER: James&Beverly Nyce
6753 Emerson Ave S 1280 Bracketts Pt Rd
Minneapolis,MN 55419 Wayzata,MN 55391
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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APPUCANT P ITEE SIG �TURE ISSUED BY SIGNATURE �
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Copies: 1-File(SiQnitures Required), 1-Applicant, 1-Monthlv Reports, 1-Assessin�, 1-Finance Page 1
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,¢�� City of Orono FOR CITY USE ONLY
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P.O.Box 66 Date Received ;'� �"� i Pern�it# e� l "`)(��'
��,� � 2750 Kelley Parkway j
ag'�,���`��� Crystal Bay,MN 55323 Amount: $ •��ti.' ` " C.U.P Filed: ���� ��
�,'�("��r��,`��,�� (952)249-4600 � � ��
����� Approved By: Site Vlan: j'U'r`7 `
Recommends: A roval Denial ❑
CITY OF ORONO - USER DEFINED/GENERAL PERMIT
(All permits must Ue approved by the Building Official and/or Zoning Department)
Job Site/Owner Information:
Site Address: G��� ����5 ��- ��`
Owner: � � Mailing Address:
City: Zip:
Hame Phone: ( ) Alternate Phone: ( )
Contraetar/Applicant Information:
Contractar/App.:�y�� Contact Person: �—�-l.trGL �LD(�
Address: �J'���J ��'Y�%G�cNI � State License #:
City: l� � l5 Zip: �'J�� Expiration Date:
Phone: ((,�L Z ) �CQ I 9) CJ t� Alternate Phone: (�f Z ) CQ 1� �j 3�
TYPES OF USER DEFINED PERMITS
❑ Stairwav to Lake ❑ Retaimn 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 ('e ral—User Defined General—User Defined
❑ Commercial-(Per UBC) �0-500' -$50.00(tveeds s�te Plan) *ForO-75'Zone-$30.00
*Estimated Cost: $ ❑ 501' +-$50.00(Needs C.U.P.)
General—User Defined
❑ Residential- $30.00 �
^- � �K� �V''i"' (�,�5 ����� �� ��� �� n
❑ Tree Removal � � _ _ �
General—User Defined � , 1 1 � I ��
*Within 0-75' -$30.00 "— �� WC�C�! " 1°'���-t� � �l '� '���iV�Q'C�Dc�
I herby apply for a User Defined Permit and I acknowledge that the information above is complete and
accurate;that the wark 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 wark is not to start without a permit;and that the work
will be in acc e approved plan.
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