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City of Orono
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<br /> -- Zoning Permit A lication
<br /> Mailing Address: P P�m��„�m b P�: �— � �
<br /> �Q�O PO B o x 66 •'"�
<br /> C�y,�a� Ba,,, M N 5 5 3 2 3-0 0 6 6 Date feC01'e°
<br /> Es«ow# e.,d � n
<br /> Street Address A m o,,,,�: ' f't
<br /> � 2750 Ke��a„ Pa�kweY Pe�m��FPe:
<br /> y� � O�o�o, MN 55356 �
<br /> G A
<br /> `�KFSHO�� Fex: 952-249-4616 ~PProvetl b,.: � , -� ((l �,��
<br /> Ma�,,: 952-249-4600 N�`B5
<br /> This applicaxion form must be completed In full anO all required informetion must be ��bm;tted. (Please print.)
<br /> Job Site Address: `�O S I��tl�/ WQ� � _ ��
<br /> CONTRACTOR/APPLICANT INFORMATION:
<br /> Name.
<br /> Pno„e: Fa
<br /> Add�e��: G�y: ZIP:
<br /> Co�ta�t Pe�=o,,: ContacYs phone number
<br /> Em��� Applica�n2�s: Co.,t�a��o� HomPo,,,,,,e� (CircleOne)
<br /> PROPERTY OWNER INFORMAT ON:
<br /> Name ti �4,�5
<br /> Pno.,P �a:,y�; a -' -
<br /> Ma����g Add�ez=: O s O o u u`'l ZIP:
<br /> Ema�� a„d/o� Fax � 0 0.�
<br /> Overall Project Description:
<br /> CBoXk TYPE OF PERMIT collected whenE ermit is issued
<br /> Dock,CommP��,e� $50 + e ee�, e,,,e�„�o
<br /> ngin ng r scs
<br /> Escrowfor e ntrol antl engineering r vlew c sts $2,000
<br /> Dock, Res�den��e�n— Pe�ma„e.,� do�k(� �Y �akP o� �,,,�,a� SeA=o„a� do�k „ot o„ LakP $50+ e�9�„ee��„9 �P„�ew�ds�=
<br /> Min etonka pe nt Oock requ s I.UPa
<br /> HardcoverPermit:Driveway,Patio,Sidewalk,etc.(NeworReplacement) No �na�9P
<br /> Also re uires is a Minor or Ma'or Land Alteration Permit
<br /> Land Alteration, Major (g�,d�.,9, f������, o� Px��„a��„9) of mo,., �h�„ 500 ��b�� ya�ds $50
<br /> t>eyontl t1�e IakeshOre vetback �R morA 2h�n 5� cub�ic ya�tls wiThi'n the I��kpshorp 5etback
<br /> (e�so �eq„�� s Co„d���o�a� Use PP m�t)
<br /> lReference:eCitv Code Sections 78-967.78-i247 and 78-12861
<br /> Eserowfo� e oi ntl .ngin , ng r vlew c sts As determinetl by CUP
<br /> Land Alteration,Minpor(9�ad��9, .,��.�g � Px�",�t,�g) of 51 to 500 �„b�� Ya�d= beYo„d�nP $50+ P„9�„ee�,,,9 �p„�pw�o��s
<br /> I�kPshore setback �t\5Q cublc ya�ds �lesti witM1in tl�e lakeshore sptback
<br /> (Reference: Ciri Code Sections 78-967.78-1247 and 78-12861
<br /> Eserow fo� e �� a.,d .�9�„ e��„g � s�s $2,000
<br /> Retaining Walls which excee 1 two ree2 in heighc above existing gratle, or result in more �5�+ englneering revlew coscs
<br /> Than 2� cubic yartlti of Impor[ed fill, or nre locatetl less [han five feet From the property line.
<br /> Eserow fo� c ncrol and nglneering revlew costs �2,5�0
<br /> lReference: Citv Code Section 78-1405(5.1)1
<br /> Retaining Walls wr,��n eTA=��e more�na., fo��feet(f�om bottom offooUng=�o�oP ofwa��)
<br /> require a builtling permlt. lieretl retaining wa�ls are consideretl onp w&II unless the wfllls
<br /> epa atetl by twice the heiyht of thp lower wall.
<br /> StairwayorLiftstoLake(NeworReplacement) lReference: CitvCodesecrions78-12821 $50 � engineering �e„�ew�o=t�
<br /> Eserowfo� e�os�o� �o.,��o� fl„d englneenng �P„�ew �os�s $2,000
<br /> Strueture Permit .o� otne� s�������Ps 200 sf o� �PSS „oz �e�����.,9 a b���d��9 Pe�m�� b„� $50 T e„9�„P�.���9 �e„�e�„ �o=�s
<br /> �e 9��,�e d b Y=�e �o���e ��d P LReference: Citv Code Section 86-661
<br /> Escrow ro� e .,«o� e.,d „9,� „9 � s�s $2,500
<br /> Tree Removal orothervegetation removalPw��n�., 75 fPet of�eke= No �ha�9e.
<br /> Reference: Ci Code Section 78-1285 Pre-inspeCtion required.
<br /> Tem ora Construction OfficelTrailer(,�_ ��a�Pd w;tn b,.��d��9 PP�m��) $30
<br /> 1�;01�• �-�i-I `Y�� � ��� ►n-�v.c� 2 �� cc f�'S Q SU
<br /> UPaa�Ad: MaY 2015 �� l S L �'�� �� r � ��
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