HomeMy WebLinkAbout2005-P08603 - land alteration PERMIT
�ITI�' OF ORONO Permit Number:
2750 Kelley Parkway - PO Box 66 Pos6o3
Crystal Bay, Minnesota 55323 Pe►-mit Type: User Defined
(952) 249-4600 Date Issued: a�22�2oos
SITE ADDRESS: 2760 Countryside Dr w
Long I,ake,MN 55356
PID: 04-117-23-12-0011
DESCRIPTION:
Proposed Use: Residential
Pernut Class: General
Permit Type: User Defined Permit Sub-type(s): Land Alteration(0-500 cu yc
DETAILS:
Approved per resolution#:
Separate pernuts required:
NOTICES/REMARKS:
FEE SUMMARY: Pernut Fee: $ 50.00 Valuation: $ 0.00
TOTAL FEE: $ 50.00
APPLICANT: Oh Landscapes LLC OWNER: 7on&Molly Stern
25070 Smithtown Road 2760 Countryside Dr W
Shorewood,MN 55331 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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P L .ANT PERMIT ,SIGNATURE SUED BY SIGNATURE ,�
Copies: 1-File(Signitures Required), 1-Anplicant, 1-Monthlv Reports, 1-Assessine, 1-Finance Page 1
� ,¢��, City of Orono FOR C11'Y USE ONLY
• Q � P.O.Box 66 Date Received; •-iZ C� Permit# yL���,�
2750 Kelley Parkway
a � '`• � Crystal Bay,MN 55323
¢+��''�. •y�:' (9521249-4600 Amount: $ �fi,c�C.U.PFileci:
2+traao�','
-(��C � , proved f3y: �� Site Plan: �I -Z��os
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Rewmmends: A roval Denial
CITY OF ORONO-USER DEFINED/GENERAL PERMIT
(All Fxrmits must be appr�vcd by the Huilding Ot7icinl and/ur 7,oning Department)
Job Site/Owner Information:
Site Address: 2760 Country Side DR West
Owner: Molly and Jon Sterns Mailing Address: 2�60 Countryside Dr W
C��,: Orono Z�p; 55356
Home Phone: (952)476-7330 Alternate Phone:
Contractor/App(icant lnformation:
Contractor/App.: Oh'Landscapes LLC Gontact Person: Junior
Address: 25070 Smithtown Rd State License #:
City: Shorewood Z�p: 55331 Expiration Date:
Phone: (952)470-6848 Alternate Phone: 612-919-369a-3���
TYPES OF USER DEFINED PERMITS
❑ Stairwav to Lake ❑ Retainin� Walls ❑ Temporary Trailer
General-User Detined Surcharge Cienceal-User Detined Surcharge General-User Detined
*(Per UBC) *(Per UBC) *$30.00
*Estimated Cost:$ * Estimated Cost: $
❑ Docks-42"or Greater � Land Alteration ❑ Zonin�Review
General-Use�Uetined Sw•charge Cieneral-User Detineci Generul-User Detined
❑ Commercial-(Per UBC) � 0-500 Cubic Yards *ForO-75'Zone-$30.Oi1
* Estimated Cost: $ $50.00(Needs Site Plan)
General-User Detined ❑ 501+Cubic Yards
❑ Residential- $30.00 $50.00(Needs C.U.P.)
❑ Tree Removal
General-User Def ined
* Within 0-75' -$30.00
1 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 �; Date
Reset Form (UserDMSnedFemrir3/IH�
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