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HomeMy WebLinkAbout2008-00145 - land alteration r CITY OF ORONO PERMIT NO.: 2008-00145 2750 KELLEY PARKWAY ORONO,MN 55356- DATE ISSUED: 08/19/2008 (952)249-4600 FAX: (952)249-4616 ADDRESS : 265 ORONO ORCHARD RD S PIN : 02-117-23-22-0005 LEGAL DESC : UNPLATTED 02 117 23 : LOT 000 BLOCK 000 PERMIT TYPE : USER DEFINED PROPERTY TYPE : COMMERCIAL-BUSINESS CONSTRUCTION TYPE : LAND ALTERATION(0-500 CU YDS) NOTE: REPLACING PIPE APPLICANT ORONO,VILLAGE OF TOTAL 265 ORONO ORCHARD RD S WAYZATA,MN 55391 PAID WITH CASH PAID WITH CC# RECEIPT NUMBER: OWNER ORONO,VILLAGE OF 265 ORONO ORCHARD RD S WAYZATA,MN 55391 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. This permit is for only the work described and does 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 responsible for assuring all required inspections are requested in conformance with the State Building Code.This permit may be revoked at any time for due cause. S / / 9/ G 2( Applicant Permitee Signature Date Is d By Signature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. r • O¢'p City of Orono "O\ P.O.Box 66 FOR CITY.USE OM,Y ;.t. 2750 Kelley ParkwayDa 'Rtcerved Permit#t . 4 Crystal Bay,MN 55323 (952)249-4600 .41C481ca Amount: :$ C.U.P Filed Approved By I) O Site.Plan Recommends: Approval 0 Denial': CITY OF ORONO USER DEFINED/GENERAL PERMIT (All permits mustbe approved by the Buil ding Official and/or Zoning Department) rr ;Job'Site/Owner Iriformti:,'•on t Site Address: Z6.5-- inw9( 6y-c.i r /K'' _ r Owner: C7 c of ©fOK 0 Mailing Address: ,?o?( 6‘ Cyt siqf City: Zip: �333 Home Phone: '2-5W- 4/73-- 77'0 If Alternate Phone: 1.�� �76-��/ CoiMtraGtor/4ipplhcait1nfoxrnatronni4„: Contractor/App.: Contact Person: fOli `5*'F x1-iqq Address: State License#: City: Zip: Expiration Date: Phone: Alternate Phone:y /t:. ,r: ... .TYPES QF>:USERti.OVED',Pg6IITS t.,AV,Agi;_ g, 4 , r.« ❑ Stairway to Lake ❑ Retaining Walls ❑ Temporary Trailer General—User Defined Surcharge General—User Defined Surcharge General—User Defined *(Per UBC) * (Per UBC) *S30.00 *Estimated Cost:$ *Estimated Cost:$ ❑ Docks—42"or Greater Eand Alteration ❑ Zoning Review General—User Defined Surcharge General-User Defined General—User Defined ❑ Commercial-(Per UBC) ® 500 Cubic Yards *ForO-75'Zone-$30.00 *Estimated Cost:S $50.00(Needs Site Plan) General-User Defined. ❑ 501+ Cubic Yards D Residential- $30.00 $50.00(Needs C.U.P.) ❑ Tree Removal General—User Defined * Within 0-75' -$30.00 oar_„ I 19, t P 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 Code;that I understand this is not a permit and work is not to start without a permit; and that the work will be in a ordand,�•th th•; approved plan. - /P _ 8-/7- 495 Ap 1i ant Date leset Form (User Defined Permit 3/18!041