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� , , � y , City of Orono <br /> � Zonin Permit A li i n �{�'"�-� �u� <br /> g pp cat o <br /> Permit number: c�U�� � �/� �.15 <br /> �O� Mailing Address: I <br /> PO Box 66 Date received: � '�� <br /> � Crystal Bay, MN 55323-0066 <br /> Escrow#and � � �,,/� <br /> Street Address: amount: ��n �-� c/���9 <br /> y � 2750 Kelley Parkway Permit Fee: ��'zl � <br /> � Orono, MN 55356 <br /> �� C' � Approved by: ` ��-r � ��L `� �(� J��`�•\ <br /> q kf S H��� Fax: 952-249-4616 ��� Notes: <br /> Main: 952-249-4600 W`�✓`^'ci.orono.mn.us <br /> This application form must be completed in full and all required information must be submitted. (Please print.) <br /> Job Site Address: ` �$O �N�4bY1�00D lZ,OAD <br /> CONTRACTOR/APPLICANT INFORMATION: <br /> Name: S ar.S L.�c.,�, La,,,< ��, c. <br /> Phone: bld- 3 6 ' 9a 7 S Fax: 76 j-- y 7�-O 3 O U <br /> Address: 0 b Cit : W� � � ZIP: SS `j <br /> Contact Person: �n � �.. ContacYs phone n �y a- 3 - � 7 <br /> Email $a�s/uy�(Sr.�c O �i r.c��.�or. Applicant is: Contractor Homeowner (CircleOne) <br /> —T <br /> PROPERTY OWNER INFORMATION: <br /> Name: h/��.0 a,-w. � R�kc».1Dh O Ml.t� <br /> Phone (day): co�2- glpp - foy 3/ <br /> Mailing Address: �g/oo St+ADyWooD iZoab W�Y�atu� MN ZIP: 55391 <br /> Email and/or Fax <br /> Overall Project Description: �ZaP11k,cr�e�tT� oF � �c1��rfoN � �,x�sriNc� �4}q,�linl� WA�� <br /> Check TYPE OF PERMIT <br /> Box COST* <br /> Dock, Residential -Permanent dock on any lake or initial seasonal dock not on $50 +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 ineerin review costs $2,000 <br /> Hardcover Permit: Driveway, Patio, Sidewalk, Etc. (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 $50 <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 /> X 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+engineering 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 other ve etation removal in 0 to 75 foot zone No char e. <br /> Tem ora Construction Office/Trailer associated with buildin ermit $30 <br /> (over) <br /> *Permit fee will be collected when the permit is issued. <br /> Updated: November 30,2012 <br />