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HomeMy WebLinkAbout2006-P09738 - land alteration - '` PERMIT GtITY OF ORONO Permit Number: 2750 Kelley Parkway- PO Box 66 P09738 Crystal Bay, Minnesota 55323 Permit Type: User Defined (952) 249-4600 Date Issued: 4/27/2006 SITE ADDRESS: 3555 Frederick St U►,it# Wayzata,MN 55391 PID: 20-117-23-12-0017 DESCRIPTION: Proposed Use: Residential Permit Class: General Permit Type: User Defined Permit Sub-type(s): Land Alteration(0-500 cu y� DETAILS: Approved per resolution#: Separate permits required: NOTICES/REMARKS: FEE SUMMARY: Pernut Fee: $ 50.00 valuation: $ 0.00 TOTAL FEE: $ 50.00 APPLICANT: Lemmerman Const. Inc. OWNER: Timothy&Lynn Brady 9037 Cty. Rd 17 SE 3555 Frederick St Delano,MN 55328 Wayzata,MN 55391 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. � �--, �����- /� � APPL[C NT PERMITEE SIGNATURE SSU D BY SIGNATURE Copies: 1-File(Signatures Reguired), 1-Applicant, 1-Monthly Reports, 1-Assessing,(If Septic, 1-Septic) Page 1 4 � � ,�—��� City of Orono �� � FOR ITY USE ONLY %��� �A', P.O.Bo�.66 Date Received: �-� U 0 v' Permit#����?�� { � 1 2750 Kelley Parkway `�t���.,,�,.c �� �1���;-- �i Crystal Bay,MN 55323 ✓� Q7 �' '"' r •�G� (952)249-4600 ��. �_'*� `�� Amount. $ C.U.P Filed: \�� Approved By:�`�[��Site Plan: Recommends: A roval Denial ❑ CITY OF ORONO - USER DEFINED/GENERAL PERMIT (All permits must be approved by the Building Official and/or Zoni�g Department) Job�Site/Owner Information: � � �� Site Address: `=L��� ����yLk '� ��� : (�wner: ���� ���� ��`" �`V/' Mailing Address: � S�� l�''�«�S'7/c`'c�7' �' (�.�� c��: z�p: S�S3R I Home Phone: �5� ��� ��� Alternate Phone: ��� ��'� �� y� Contractor/Applicant Information: �� � Contractor/A �MMEP.�+., �_ 7�� pp�=__ ��C��� Contact Person: Address: �1�37 �C �p j�J S� State License #: ��S`� City: �Clh�.� Zip: 55�2�, Expiration Date: /Y7�� i,'�7 Phone: 71v3-y"7�-3i.�G3 Alternate Phone: �7b3-� ZZ`1 -23f���y TYPES OF USER DEFINED PERMITS '- ❑ Stairwav to Lake ❑ Retaining Walls ❑ Temporary Trailer General—User Defined Surcharge General—User Defined Surchazge General—User Defined *(Per UBC) *(Per UBC) *$30.00 *Estimated Cost: $ *Estimated Cost: $ � ❑ Docks—42"or Greater � Land Alteration ❑ Zonin�Review General—User Defined Surcharge General—User Defined General—User Defined ❑ Commercial—(Per UBC) ,�0-500 Cubic Yards *ForO-75'Zone-$30.00 * Estimated Cost: $ $5�.��(Needs Site Plan) General—User Defined ❑ rds ❑ Residential- $30.00 $50. u.P.) ❑ Tree Removal General—User Defined * Within 0-75' -$30.00 I�L�2 - �'o��� 5�,�.� �(s, 3 �� � I herby apply for a User Defined Permit and I acknowledge that the information above is complete and accu te;that the work will be in conformance with the Ordinances and Codes ofthe City and with the State Bui�l�ng Code; that I understand this is not a permit and work is not to start without a permit; and that the wPrk wi}i be 'n c dance with the approved plan. . ��� �-l� �� � Applicant - Date �� �. Re$et F��'m � (UserDefinadPecmit3/18/04j �'t,:... . __..