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<br /> Ze�ning Per�it Application
<br /> Mailing Address. Permit number: ��� "OO g
<br /> ��� PQ Box 66 Date received: �'��' �Y-
<br /> � Crystai Bay,MN 55323-0066
<br /> Escrow#and
<br /> Street Address: amount:
<br /> � ' ,a, 2750 Kelley Parkway Permit Fee:
<br /> � Orono,MN 55356
<br /> �< <' Approved by:
<br /> �kFSH��� Fax: 952-249-4616 Notes:
<br /> Main: 952-249-4600 �vNrw.ci.orono.mn.us ----
<br /> This application form must be compieted in full and ali required information must be submitted. (Please print.)
<br /> Job Site Address: ��� ,��j�(>�,1.(����j�� �����J�A- ,"�j� 3� �
<br /> CONTRACTOR!APPLICAN7 INFORMATION� �
<br /> Name: _ SU �L�,4�1 ����-� -- — —
<br /> Phone: ___� •° - - � Fax:
<br /> Address: �1�.lZ`,��� �¢.;�jo � CitY� [id'D Yl c� ZIP: �'�'? �/_
<br /> Contact Person: ���dh ('���� ContacYs phone number (a t 2. - 2l p - l (p 4(„
<br /> Email s�a_�_,�5� � 2�����],Applicant is: Contractor Homeowner (Circle On r--�r��t- �
<br /> PROPERTY OWNER INFO�MATION:
<br /> �T���`�`� CStS-I�rc� �orrrE-'ri�°I`�r�
<br /> Name: f.: `,'r'- � ;. I>�,ir��,y —
<br /> Phone(day): , �' .. :. R_. r� - -
<br /> MailingAddress: ���:,J�o t �'�k�.3�vt �2d.. �`�,��1 �`�s�_s;,;�;,��vt ZIP ;�.�;;,r q .,,
<br /> Emailand/orFax ,�.,:;.b��,,��}<� �a�:, 4�' �,,-��,�a �ir�;,�;�-,� ..
<br /> Overall Project Descr�ption �- � lc� �1.� � v�C� C�1^ - Y'CC'� l.( � ' E_�_
<br /> Cc�l'n ���{-�-� Y' � t � :clC' e1 - L, "LU�,��
<br /> Check TYPE OF PERMIT COST* �� ����
<br /> Box +.�.��
<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 engineering review costs As determined by 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 controi and engineering review costs $2,000
<br /> Structure Permit for other structures not requiring a building permit but $50+enyineering 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 /> Temporary Construction Officel7railer(associated with building permit) _ $30
<br /> (over)
<br /> *Permit fee will be collected when the permit is issued.
<br /> Updated: November 30,2012
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