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� <br /> t City of Orono <br /> , Zoning Permit A plication <br /> -- Mailing Address: Permit number. �.jZ (,;� � " ����� <br /> .Q.,Q 11� PO Box 66 Date received: � � � 1 � <br /> y �`V Crystal Bay, MN 55323-0066 <br /> Q , Q Escrow#and e�/�1 <br /> � ' � <br /> ��^- StreetAddress: amount: ������� � �-��) <br /> `� , ?� �" 2750 Kelley Parkway Permit Fee: <br /> �� Z " pti� Orono, MN 55356 � <br /> �9kESFi��'� Approved by: <br /> — Fax: 952-249-4616 Notes: <br /> Main: 952-249-4600 �ci.orono.mn.us <br /> This application form must be completed in full and all required information must be submitted. (P/ease print.) <br /> GENERAL INFORMATION: <br /> Job Site Address: � 37� R��T ,�,��� c:c /1�I�,:�s( , ��,� 5;3�, �-� <br /> CONTRACTOR/APPLICANT INFORMATION: <br /> Name: Gr,,--��rst.�t �"�cC�7�1"rrc5,�� <br /> Phone: �,�y-2z�-��,yy Fax: ..— <br /> Address: �O �ot 37� EzccJ�;�:-;rvc+V 5 53'�� � � <br /> Contact Person: �j..,,, ����J- ContacYs phon <br /> Email cs� ja�ds��r���yaticr.�c��pPlicant is: Co Homeowner (CircleOne) <br /> PROPERTY OWNER INFORMATION: <br /> Name: G1��.(.� a�L �.1��:�L. ��:�1.0_-,� <br /> Phone(day): f- - S�Z-L <br /> Mailing Address: 1350 ,2e�,1' o;�t G�f. t/U1c�� , v1,1A/ ;�3t,y Z-1�: <br /> Email and/or Fax .� <br /> Overall Project Description: z�a;r exi 5�:�.v ✓'��",u n�✓�c� ��L/I. c��r wecc�S a�o( <br /> iY15t�/� cMvl��n ;vv -Gc ✓L✓, 'VC �Xc.�ti-�/cc- �o.� ne� �,' / w b. <br /> Check TYPE OF PERMIT <br /> Box COST* <br /> Dock, Residential-Permanent dock on any lake or initial seasonal dock not on $30+ engineering review costs <br /> Lake Minnetonka ermanent dock re uires CUP <br /> Dock, Commercial $50+ engineering review costs <br /> Escrow for erosion control and en ineering review costs $2,000 <br /> Driveway Permit(New or Replacement) No charge <br /> Also re uired is a Minor or Ma�or Land Alteration Permit <br /> Land Alteration, Major(grading, filling, or excavating) more 500 cubic yards or $30 <br /> more than 10 cubic yards in lakeshore setback (also requires CUP} <br /> Escrow for erosion control and en ineerin review costs As determined b CUP <br /> Land Alteration, Minor(grading, filling or excavating)-500 or less cubic yards $50+ engineering review costs <br /> outside of lakeshore setback or less than 10 yards in lakeshore setback <br /> Escrow for erosion control and en ineerin review costs $2,000 <br /> Retaining Wall measuring under four feet require a zoning permit. $50+ engineering review costs <br /> Retaining walls measuring more than four feet(from bottom of footings to top of <br /> wall) require a building permit. (Tiered retaining walls are considered one wall <br /> unless the walls are separated by twice the height of the lower wall.) <br /> Escrow for erosion control and en ineerin review costs $2,500 <br /> Stairway to Lake(New or Replacement) $50+ engineering review costs <br /> Escrow for erosion control and engineering review costs $2,000 <br /> Structure Permit for other structures not requiring a building permit but $50+ engineenng review costs <br /> regulated by the zoning code(including, but not limited to accessory building of <br /> less than 120 square feet, detached deck or platform and sport court) <br /> Escrow for erosion control and en ineerin review costs $2,500 <br /> Tree Removal or intensive ve etation removal in 0 to 75 foot zone No char e. <br /> (over) <br /> *Permit fee will be collected at <br /> the time the permit is issued. <br />