HomeMy WebLinkAbout2008-00329 - land alteration CITY OF ORONO PERMIT NO.: 2oos-oo329
2750 KELLEY PARKWAY
� ORONO, MN 55356- �ATE �ssUEu: 10/27/2008
� (952) 249-4600 FAX: (952) 249-4616
ADDRESS : 3409 EASTLAKE ST
PIN : OS-117-23-13-0036
LEGAL DESC : BAYSIDE ADDN TO LAKE MINNETONK
: LOT 000 BLOCK 008
PERMIT TYPE : USER DEFINED
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : LAND ALTERATION (0-500 CU YDS)
NOTE: LAND ALTERA7'ION-0-500 CUBIC YARDS
DIG FOUNDATION/SEAL AND REFILL
APPLICANT LAND ALTERATION 50.00
WIZARD SERVICE
318 XERXES AVE N TOTAL 50.00
MINNEAPOL[S, MN 55405- PAID WITH CASH 50.00
(612)377-3909
Minnesota State License#: 20230902
OWNER
SCHULTZ, MR. &MRS. ANDREW
3409 EASTLAKE ST
LONG LAKE, MN 55356
AGREEMENT AND SWORN STATEMENT
The work for which this permit is issued shall be performed according to
the approved plans and specifications,applicable City approvals,and the
State Building Code. This permit is for only the work described and does
no[grant permission for additional or related work which requires separate
permits. All provisions of laws and ordinances goveming this type of work
shall be compied with whether or not specified herein.This permit will
expire and become null and void if construction authorized is not
commenced within 180 days of the date of issuance,or if construction is
suspended for a period of 180 days at any time after work has commenced.
The applicant is responsible for assuring all reyuired inspections are
requested in confor�nanc�wik(i the State Buk4�ng Code.This permit may be
`� revoketl at any tirrie for,due cause. �� ��
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�A�pplicant Permi�'ee ignature Date [ssued I�y Signature Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
�,¢�� City of Orono FOR CITY USE ONLY ��I
� P.O.Box 66 /
0, 0 , Date Received: Pemtit# ' /��
� y� . 2750 Keiley Paricway ; �.�� 'Cv
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� � ���ti���M�.�o i�, (952)249-4600 r , !��'` ��. Ainount: $ C.U.P Filed:
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'�� APProved By: _ Site Plan: /J j� V' �
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Recommendx A roval Denial ❑
CITY OF ORONO - USER DEFINED/GENERAL PERMIT
(All pennits must be approved by the Buil ding Official and/or Zoning Department)
;Job Site/Owner Infonnation:.
Site Address: _� �� �/ L_:_�/�7`— ��/L `� �
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Owner: ���- �' L�����!"f ���'�°l�-� MailingAddress: ��1�—/ ��c-��
City: ��,��i"7" � Zip:
Home Phone: Alternate Phone:
>Contractor/.:Applicant Inforrnation �
Contractor/App.:� i, � �f%/�/�> l�c�'C'i"C�' Contact Person: /'��ic'lfi�-L�L /��5
Address; �,� ����� �` > i'1', State License #: Z-� �- 3� `�C� l�.
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City: � � Zip: %��� $xpiration Date: �� � � " �� %
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Phone: /;i,Z. � �� ��7' �">� `% Alternate Phone:
�::��a �-k.�:"u • �; .r . ;TYPES OF:U.SER DEFINED PERIVIITS -. � :;� ,., - - `�,t �, ;;
❑ Stairwav to Lake ❑ Retainine Walls ❑ Temporarv Trailer
General—User Defined Surcharge General—User Def ned Surcharge General—User Defined
* (Per UBC) * (Per UBC) *�30.00
*Estimated Cost: $ *Estimated Cost: $
❑ Docks-42"or Greater (�Land Alteration ❑ Zonin�Review
General—User Defined S urcharge � Generai—User Defined
General—User Defined
❑ Commercial-(Per UBC) 0-500 Cubic Yards *ForO-75'Zone-$30.00
* Estimated Cost: $ �50.00(Needs Site Pian)
General-User De2med ❑ 501� Cubie Z'ards
❑ Residential- �30.00 �50.00(Needs C.U.P.)
❑ Tree Removal �� i� �� �_.-�i�=' ��� H--/%�,� � �L�� �r �i�L
General—User Defined
* Within 0-75' -�30.00
I herby apply for a User Derined Permit and I acl:nowledge that the infonnation above is complete and
accurate;that the work will be in conformance with the Ordinances and Codes of the City and�vith the State
Building Code; that I understand this is not a permit and work is not to start without a pennit; and that the
���ork ���ill be in ccqJdance wi the a proved plan.
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Ap licant _. Date
Reset Form (UserDcSnndYcrmi!;;�a;�l�