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� � ��`zr <br /> City of Orono <br /> Zon�ng Perm�t A licat�on <br /> '� �°��'� <br /> , Mailing Address: <br /> Permit number: Q/ -�`(� �p� <br /> � �O PO Box 66 Date received: - o� — / <br /> Crystal Bay, MN 55323-0066 <br /> Escrow#and <br /> Street Address: amount: <br /> -� �. 2750 Kelley Parkway Permit Fee: <br /> �'�c. � Orono, MN 55356 <br /> �q �,�' Approved by: <br /> kFs H�� Fax: 952-249-4616 Notes: <br /> Main: 952-249-4600 -- <br /> This application form must be completed in full and all required information must be submitted. (Please print,J <br /> Job Site Address: Z�i9��,�hQdy�j� �jp�� �,�'pit/(�� �J%j� 5.���/ <br /> CONTRACTOR/APPLICANT INFO��ON: � <br /> Name: _�_Crl�S � �l�i t�✓r?L�''�. <br /> Phone: ,Z 7/ — / 7S'" Fax: Sf��� <br /> Address: liJ Cit : O,�D o ZIP: 33 / <br /> Contact Person: � �1,es �I''" Contact's phone number � o��,//—OS7 <br /> Email ���,��or�/�,���,�/_ � Applicant is: Contractor omeowner (Circle One) <br /> PROPERTY OWNER IN ORMATION: / �� /� <br /> Name: [�i��'tf 5 � �r2s'td4 L(J2r1'!P'Y' <br /> Phone (day): /q,�,2) �7/—�075 <br /> MailingAddress: z.L43 Sh l,JO K6Ccc(; �J2U/�/O, /I�l�/ ZIP:�,s�� I <br /> Email and/or Fax (,cJQ�,�,�✓� /,� �J'15rJ_y'p,�,� <br /> OveralJ Project Description: /,�o Sq_ �T C4rH.�✓e/ 5' ✓a.�'� hc S ru� C'>'C <br /> Check TYPE OF PERMfT <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 c�ibic y�rds o�- $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 /> 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 permit $30 <br /> (over) <br /> *Permit fee will be collected when the permit is issued. <br /> Updated: November 30,2012 <br />