HomeMy WebLinkAbout2004-P08208 - retaining wall w .
CITY OF ORON PERMIT
� Permit Number:
2750 Kelley Parkway- PO Box 66 Pos2os
Crystal Bay, Minnesota 55323 Permit Type: User Defined Surc Building
(952) 249-4600 Date Issued: 11/23/2004
SITE ADDRESS: 2765 Kelly Ave
Excelsiar,NIN 55331
P I D: 21-117-23-23-0001
DESCRIPTION:
Proposed Use: Residential
Permit 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: $ 38•75 Valuation: $ 1,000.00
State Surcharge Fee: $ 1.00
TOTAL FEE: $ 39.75
APPLICANT: �reinatshow OWNER: Alain Bina-Kashani
2765 Kelly Ave 2765 Kelly Ave
Excelsior,MN Excelsior,MN 55331
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.
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APPLICAN PERMITEE SIG ATURE SUED BY SIGNATURE
Conies: 1-File(SiQnitures Required), 1-Avplicant, 1-Monthlv Renorts, 1-Assessin¢, 1-Finance Page 1
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,���\ City of Orono FOR CITY USE ONLY ,
P.O.Box 66 Date Received: 'i;i�;,�! Permit# ���
��;�;.:,,;� � 27�0 Kelley Parkway •� �
� �1'�r�'<<'- '� Cr stal Ba MN 55323 , � � , ;�i 1 '�C^,
,y q �_ti - �, Y Y, ,� �, Amount: $ C.U.P Filed:
�`'�kr�t;�1�$�, (952)249-4600 � �\� � �.(�
ssxo� � �" �' \''':: APproved By: Site Plan:
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Recommends: A roval ❑ Denial ❑
CIT1' OF ORONO - USER DEFINED/GENERAL PERl�ZIT
(All pennits must Ue approved Uy the Buildin�UfTicial and/or Zonin�Depar[menl)
JoU Site/Owner I�Zfornlation:
Site Address: � /��7 � I������� ;`����
Owner: ;''�//nl //i �/,��'(� 1��� Mailing Address:
City: �����1 j� Zip:
Home Phone: �� �,������ � ��� Altenlate Phone:
Cont�-actor/Applicant I�iformatio :
,
Contractor/App.: , � Contact Person:
Address: State License #:
City: Zip: Expiration Date:
Phone: Alternate Phone:
TYPES OF USER DEFINED PERMITS
❑ Stairway to Lake � Retaining Walls ❑ Teinporarv Trailer
General—User Defined Surcharge General—User Defined Surcharge General—User Defined
* (Per UBC) * (Per UBC) m� * $30.00
*Estimated Cost: $ *Estimated Cost: $�p o� �
❑ Docks—42" or Greater ❑ Land Alteration ❑ Zonin2 Review
General—User Delined Surcharee General—User Defined General—User Deiined
❑ Conunercial—(Per UBC) ❑ 0-500 Cubic Yards *For 0-75'Zone-$30.00
*Estimated Cost: $ $SO.00 (Needs Site Plan)
General—User Detined ❑ 501+CubiC YaTds
❑ Residential- �30.00 $50.00(Needs C.u.P.)
❑ Tree Removal
General—User Defined
*Witlun 0-75' -$30.00
I herUy apply for a User Defined Permit and I aclrnowledge 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 understand this is not a pei�nit and work is not to start without a permit;and that the work
will Ue in accordance with t�_ap�plan.
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