HomeMy WebLinkAbout2004-P07922 - land alteration C�T'Y OF ORONO PERMIT
2750 Kelley Parkway - PO Box 66 Permit Number: Po�922
Crystal Bay, Minnesota 55323 Permit Type: user Defined
(952) 249-4600 Date Issued: llili2oo4
SITE ADDRESS: 3051 Farview Lane
Long Lake,MN 55356
P I D: 04-117-23-33-0009
DESCRIPTION:
Proposed Use: Residential
Pernut Class: General
Permit Type: User Defined Permit Sub-type(s): Land Alteration(0-500 cu y�
DETAILS:
Approved per resolution#:
Separate pernuts required:
NOTICES/REMARKS:
FEE SUMMARY: PermitFee: $ 50.00
Valuation: $ 0.00
TOTAL FEE: $ 50.00
APPLICANT: David&Francine Delaney OWNER: David&Francine Delaney
3051 Farview Lane 3051 Farview Lane
Long Lake,MN 55356 Long Lake,MN 55356
THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED
AND AGREES TO DO ALL WORK IN STWCT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF
MINNESOTA BUILDING CODE REQUIREMENTS.
,
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�� APPLICANT PERMITEE SIGNATURE I SUED BY S[GNATURE
Copies: 1-File(Sienitures Required), 1-Aoolicant. 1-Monthlv Reports, 1-Assessine, 1-Finance Page 1
� + ' �',��`�`>.-, City of Orono l�'r 1 Q� FQR:�[TY USE OP�"L.Y '',
� � `�` `, P.O.Box 66 ���a � FJate�teeeiv€d. � Lh` Pennii# £ �
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� � 2750 Kelley Parkway
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� ,:},,3yo.>� (95��?49-�600 � ./`
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Recnm�utiils, r�� rovul Det�i&E �
CITY OF ORONO-USER DEFINED/GENERAL PERMIT
(All pernuts must be approved by the Building Official and/or Zoning Department)
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Site Address: 3051 Farview Lane
Owner: David Delaney Mailing Address: 3051 Farview Lane
City: Orono Zip: 55323
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Home Phone: Alternate Phone: (952)�2-0111
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ContraCtor/App.: Homeowner Contact Person: Same as above
Address: Same as above State License #: n/a
City: Zip: Expiration Date:
Phone: Alternate Phone:
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❑ Stairwav to Lake ❑ Retaiuing Walls ❑ Temporarv Trailer
General—User Defined Sureharge 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 Sureharge General—User Defined General—User Defined
. ❑ Commercial-(Per UBC) ❑✓ 0-500 Cubic Yards *ForO-75'Zone-$30.00
*Estimated Cost:$ $SO.00(Needs Site Plan)
General—User DeSned ❑ 501+Cubie Yards
❑ Residential- $30.00 $SO.00(Needs C.U.P.)
❑ Tree Removal
General—User Def ned
*Within 0-75' -$30.00
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
Buildin Code;that I understand � �s r�a permit and wark is not to start without a permit; and that the
wo will be �n acco e the approrjed plan.
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08/30/04
Ap�5licant �, ; . � Date
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