HomeMy WebLinkAbout2004-P08211 - retaining wall "` PERMIT
C�T�' OF ORONO Permit Number:
2750 Kelley Parkway - PO Box 66 Pos2i i
Crystal Bay, Minnesota 55323 Permit Type: user Det'�ned sur�Bu�ia�ng
(952) 249-4600 Date Issued: 11�19i2ooa
SITE ADDRESS: 4475 Forest Lake Landing
Mound,MN 55364
P I D: 07-117-23-24-0023
DESCRIPTION:
Proposed Use: Residential
Pernut Class: General
Permit Type: User Defined Surc Building Permit Sub-type(s): Retaining Wall
DETAILS:
Approved per resolution#:
Separate pernuts required:
NOTICES/REMARKS:
FEE SUMMARY: Permit Fee: $ 181.25 Valuation: $ 10,000.00
State Surcharge Fee: $ 5.50
TOTAL FEE: $ 186.75
APPLICANT: Tim's Landscaping OWNER: Jon&Gail Blackstone
4040 North Shore Dr. 4475 Forest Lake Landing
Mound,MN 55364 Mound,MN 55364
THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED
AND AGREES TO DO ALL WORK IN SI'RICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF
MINNESOTA BUILDING CODE REQUIREMENTS.
C
APPLI ANT PE ATURE ISSUED BY SIGNATURE
Copies: 1-File(Signitures Re�uired), 1-Applicant, 1-Monthlv Reports, 1-Assessine, 1-Finance Page 1
��� City of Orono FOR CITY USE ONLY
� �, �� P.O.Box 66 Date Received: Permit�
�;;,;.,,�� � 27�0 Kelley Parl.�vay
�'' I? Cr stal Ba Mt� 5�3_3
a �j 'xi�% '' ' ' Amount: $ C.U.P Filed:
� �r I:1�;,.-� � Y Y,
``"i�`yi�+jy�,� (9�2)249-4600 �
��eH° Approved By:(�� Site Plan:
Recommends: A roval �. Denial ❑
�P� 6I�f� f'�I�V�( (N 1 Z'�(`� N C'.�-.+ ��,
�� A,Ov 14ri/'4 5,v/l.t�'P�-� 17/�-'i 1__T�
CITY OF ORONO - USER DEFINED/GENERAL PERl��IT nGri i z, o y
(All pennits must Ue approved by thz Building Ofiicial andior Zonino Department)
Job Site/ Owner I��fornlation:
Site Address: � ��� �/l�G, � �j,�f���,�,�1��%G,
—��-� F --t-
Owner: �,�J ``���`�1�� Mailing Address: � �j��
City: , � Zip: �� `�j��C�
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Home Phone: �J���—y�-- Altenlate Phone: �/����7�`1`��
Contractor/ Applicant I�lformation:
Contractor/App.: Contact Person: ��j� �/���������
Address: State License �:
City: Zip: Expiration Date:
Phone: Altei�zate Phone:
TYPES OF USER DEFINED PERMITS
❑ Stairway to Lake �f Retainin�Walls ❑ Temporarv Trailer
General-User Defined Surchar�e General-User Defined Surdiar�e General-User Defined
*(Per tiBC) * (Per UBC) * $30.00
*Estimated Cost: $ *Estimated Cost: $����
❑ Docks—42" or Greater ❑ Land Alteration ❑ Zonin�Review
General-User Deiined Surchar�e General-User Defined General-User Delined
❑ Conunercial—(Per UBC) ❑ 0-500 Cubic Yards *ForO-7S Zone-$30.00
*Estimated Cost: � �SO.00 (Needs Site Plan)
Gzneral-User Defined ❑ 501+CubiC Yards
❑ Residential- $30.00 $50.00(Needs C.U.P.)
❑ Tree Removal
General-User Defined
*Within 0-75' -$30.00
I herUy apply for a User Defined Permit and I aclmowledge 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 understan this is not a permit and work is not to start without a permit;and that the work
will be in acc ance with the pproved plan.
/ C �t Date
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