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� <br /> /�p�� City of Orono ROR IT USE ONLY ,rj <br /> � ` P.O.Box 66 '�° //�� <br /> ��, a Date Received./4�Pemiit#f <br /> '� _ 2750 Keliey Parkway <br /> a ',I,�1�-- '- C stal Ba Mi�'S5323 <br /> �'t��;�L�:��.c� �Y Y, .. <br /> \�'t1�r Y�, (952)249-4600 �a. � _ <br /> �oR Amount; $ C.U.P Filed: <br /> Approved By: Site Plan: <br /> Recommends: A roval ❑ Deniai ❑ <br /> CITY OF ORONO -USER DEFINED/GENERAL PERMIT <br /> (All pennits must be approved by[he Bui]ding Official and/or Zoning Department) <br /> Job S'ite/Owner Tiifoi-mation: <br /> Site Address: STUBBS BAY, ,�WAN LAKE �� e�cr��t P/Q� <br /> Owner: MINNEHAHA CREEK Mailin�Address: 18202 MINNETOKA BLVD. <br /> WATERSHED DISTRICT <br /> City: DEEPHAVEN, MN Zip: 55391 <br /> Home Phone: �5 —47� -0 � Alternate Phone: <br /> Contractor/Applicant Information <br /> Contractor/App.: SUNRAM CONST. Contact Person: PAUL KERANEN <br /> Address: 20010 75 TH AVENUE NORTH State License#: 8115 <br /> City: CORCORA�'�i, MN Zlp, 55340 Expiration Date: 3-31-08 <br /> Phone: 7h3_4 •_0— 1 4(1 Alternate Phone: 612-282-7771 <br /> ° 'TYPES OF USER DEF<INEU PERIVIITS ' .' <br /> _ , <br /> ❑ Stairwav to Lake ❑ Retainin Walls ❑ Temporarv Trailer <br /> General—User Defined Surcharge General—User De£ned Surcharge Generaf—User Defined <br /> * (Per UBC) * (Per UBC) *530.00 <br /> *Estimated Cost: $ * Estimated Cost: $ <br /> ❑ Docks—42" or Greater � Land Alteration ❑ ZoninQ Review <br /> General—User Defined Surcharge General—User Defined General—User Defined <br /> ❑ Commercial—(Per UBC) ❑ 0-500 Cubic Yards *ForO-75'Zone-$30.00 <br /> * Estimated Cost: $ $50.00 (Needs Site PladJ <br /> General—User Defined � 501 T CubiC 1'ards <br /> ❑ Residential- $30.00 �50.00 (Needs C.U.P.) <br /> ❑ Tree Removal <br /> General—User Def ned <br /> * V✓ithin 0-75' -530.00 <br /> I herby apply for a User Defined Permit and I acl:nowledge that the infonnation above is complete and <br /> accurate;that the work will be in conformance with the Ordinances and Codes of the City and with the State <br /> Buildin�Code; that I understand this is not a permit and ���ork is not to start �vitllout a pennit; and that the <br /> ���ork ���ill be in accordance ���ith the appro`�ed plan. <br /> �. �,� ��i i� ��'�'_1 t Z �- i �1 ' C�`7 <br /> Applicant __. Date <br /> Reset Form (UsuDeEn_dYcrni!3;13-�1, <br />