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� <br /> � � � City of Orono <br /> � Zoning Permit Application <br /> Mailing Address: Permit number: -�.11 � y �O <br /> �Q�O PO Box 66 Date received: �(D � <br /> Crystal Bay, MN 55323-0066 <br /> Escrow#and <br /> Street Address: amount: <br /> 2750 Kelley Parkway � /� <br /> �y� � Orono, MN 55356 Permit Fee: �.T <br /> L <br /> `�kE S N v�� Fax: 952-249-4616 Approved by: � ��, j � � r <br /> Main: 952-249-4600 Notes: <br /> www.ci.orono.mn.us <br /> This application form must be completed in full and all required information must be submitted. (P/ease print.) <br /> Job Site Address: �g q 0 S�p d v w o dGr R� <br /> T <br /> CONTRACTOR I APPLICANT INFORMATION: <br /> Name: /Yl�ke F ���Pl�.. L�no�6o�a <br /> Phone: 9SZ- oo- B�LSo Fax: <br /> Address: l6 90 S�adv woo l � City: p,a�,o ZIP: S�3 9/ <br /> Contact Person: ContacYs phone number <br /> Email Applicant is: Contractor Homeowner (Circle One) <br /> PROPERTY OWNER INFORMATION: <br /> Name: Su rn e, <br /> Phone(day): <br /> Mailing Address: ZIP: <br /> Email and/or Fax <br /> Overall Project Description: Si c�►wa�kS "' Stt ���P�N�c� <br /> Boxk TYPE OF PERMIT collected whenE ermit is issued <br /> Dock, Commercial $50+engineering review costs <br /> Escrow for erosion control and engineerin review costs $2,000 <br /> Dock, Residential - Permanent dock on any lake or initial seasonal dock not on Lake $50+engineering review costs <br /> Minnetonka ermanent dock re uires CUP <br /> `/ Hardcover Permit: Driveway, Patio, Sidewalk,etc.(New or Replacement) No charge <br /> ]� Also requires is a Minor or Ma'or Land Alteration Permit <br /> Land Alteration, Major (grading, filling, or excavating) of more than 500 cubic yards $50 <br /> beyond the lakeshore setback OR more than 50 cubic yards within the lakeshore setback <br /> (also requires Conditional Use Permit) <br /> (Reference: Citv Code Sections 78-967. 78-1247 and 78-12861 <br /> Escrow for erosion control and engineering review costs As determined b CUP <br /> Land Alteration, Minor(grading, filling or excavating)of 51 to 500 cubic yards beyond the $50 +engineering review costs <br /> lakeshore setback OR 50 cubic yards or less within the lakeshore setback <br /> lReference: Citv Code Sections 78-967. 78-1247 and 78-12861 <br /> Escrow for erosion control and engineering review costs $2,000 <br /> Retaining Walls which exceed two feet in height above existing grade; or result in more $50+engineering review costs <br /> than 20 cubic yards of imported fill; or are located less than flve feet from the property line. <br /> Escrow for erosion control and engineering review costs $2,500 <br /> lReference: Citv Code Section 78-1405(5.1)1 <br /> Retaining Walls which measure more than four feet(from bottom of footings to top of wall) <br /> require a building permit. Tiered retaining walls are considered one wall unless the walls <br /> are se arated b twice the hei ht of the lower wall. <br /> Stairway or Lifts to Lake(New or Replacement) lReference: Citv Code Sections 78-12821 $50+engineering review costs <br /> Escrow for erosion control and engineering review costs $2,000 <br /> Structure Permit for other structures 200 sf or less not requiring a building permit but $50+engineering review costs <br /> regulated by the zoning code lReference: Citv Code Section 86-661 <br /> Escrow for erosion control and engineering review costs $2,500 <br /> Tree Removal or other vegetation removal within 75 feet of lakes No charge. <br /> lReference: Citv Code Section 78-12851 Pre-inspection required. <br /> Tempora Construction OfficelTrailer(associated with buildin permit) $30 <br /> Updated May 2015 <br />