HomeMy WebLinkAbout2009-00874 - land alteration � �
CITY OF ORONO PERMIT NO.: 2009-00874
2750 KELLEY PARKWAY
ORONO,MN 55356- DATE IssuEn: 12/18/2009
952 249-4600 FAX: 952 249-4616
ADDRESS : 1300 LOMA LINDA AVE
PIN : 07-117-23-41-0083
LEGAL DESC : VOLK JOHNSTON ADDN
: LOT 001 BLOCK 001
PERMIT TYPE : USER DEFINED
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : LAND ALTERATION(0-500 CU YDS)
APPLICANT LAND ALTERATION 50.00
HLJESMANN,JASON TOTAL 50.00
1300 LOMA LINDA AVE
MOLJND,MN 55364 PAID WITH CASH 50.00
OWNER
HUESMANN,JASON
1300 LOMA LINDA AVE
MOUND,MN 55364
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. 1'his permit is for only the work described and dces
not grant permission for additional or related work which requires separate
permits. All provisions of laws and ordinances governing 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 responsi e f suring all required inspections are
requested in confo e e State Building Code.This permit may be
revoked at i or .
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Appli e itee Signature Date Iss y Signature Date
SEPARATE PERMITS REQUIRED FOR WORK O HER THAN DESCRIBED ABOVE.
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,�0� City of Orono FOR ITY USE ONLY ��5 �
� � P.O.Box 66 Date Received:��l � Permit# �UlJ�d ��
a�,t 2750 Kelley Parkway
� ��'����- Crystal Bay,MN 55323 Amount: $ GU.P Filed:
'��i��+r��y�� (952)249-4600
aB�O$ Approved By: '� Site Plan:
y,j��� Recommends: A roval Denial ❑
11
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CITY OF ORONO - USER DEFINED/GENERAL PERMIT
(All permits must be approved by the Building Offieial and/or Zoning Department)
Job Site/Owner Information:
Site Address: �300 �O�`^`� L'�K� .�'v'�
Owner: �asD� �uGS c�w,wh Mailing Address: /30U Low� L�'�e�a A-��e
City: (�!''G h D Zip: ,��►
HomePhone: �o�7`'Z 3g'— L,/�fS7 AlternatePhone:
Contraetor/Applicant Information:
Contractor/App.: (7(N ►�.�C� Contact Person:
Address: State License #:
City: Zip: Expiration Date:
Phone: Alternate Phone:
TYPES UF USER DEFINED PERMITS
❑ Stairway to Lake ❑ Retainin� ❑ Temparary Trailer
General—User Defined Surcharge General—User Defined Surcharge General—User Detined
* (Per UBC) * (Per UBC) *$30.00
*Estimated Cost: $ *Estimated Cost: $
❑ Docks-One Time(tvon-�ke Ntcka) �Land Alteration ❑ Zoning Review
General—User Defined Surcharge T � ,G�en,�+�al—User Defined General—User Defined
❑ Commercial-(Per UBC) �0-500 Cubic Yards *For 0-75'Zone-$30.00
*Estimated Cost: $ $50.00(Needs Site Plan)
General—User Defined ❑ 5�1+CUb1C YBTCIS
❑ Residential- $30.00 $50.00(Needs C.U.P.)
❑ Tree Removal
General—User Defined
*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
Building Co , art I erstand this is not a permit and wark is not to start without a permit;and that the work
will be i cc da ith the approved plan.
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Ap �cant Date
(Us«vesuect i�emut osiosrc�9�
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E�.EGISTERED [1NDI:I�. GAWS OF STATE OI�' MII+INF;5()TA ' � �� y
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For Excavation Only �
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The only easements showr.are irom piats of reccud or Informalion provided by �'�� •
ctient. /
Wa hereby c�rtify that this Is a true Arid corrert rPpresentatlon of a survey�i the � �
boundarfes of the above descrtbed lanci and tho location of all buildings and vis• l /' � / , �
hments if an irom or on sald land. l ��_�_JJ�'�`(:,_.._ '� l � - --
Ibie encroac , Y, Sigi�c�.1 ,_�: __� / . - — • � _---�---�-.-.----
Surveyedbyuath�s 6th dayot J�e �g 86 " yrvo��nd A. F'ras�h, Minri. Fiey. No. 6743