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, Twin Cities Dental 612-782-7005 p.3 APPLICANT/OWNER ACKNOWLEDGEMENT: • ApplicanUQwner agrees to prov�de al!information required or requested by the Planning Department; • Owner agrees to pay the City of Orono for engineering consultant re�iew costs where applicab�e; • ApplPcant/Owner certifies that #he information supplied is true and correct to the best of his/her knotiviedge. 7he applicant recognizes that they are solely responsible for submit6ng a complete application being aware that upon failure to do so, the staff has no alternGtive but to reject ft until it is complete; • AppGcant acknowledges the attached Escrow Agreement is completed and signed by Owner; • ApplicanUOwner understands their project may require an initial and as-buift survey per City Code Sectio�88-68. • Same or a!t of the inforrnation that you are asked to provide on this applica#ion is classified by State law as either private or confidential. Private data is information which generelly cannot be given to the public but can be given to the subjecf of Ehe data, Confidential data is information which genera(ly cannot be given t�either the pubfic or the subject of the data. Our purpose and inte�ded use of this information is to annually update our records and recards of other ovemmental a encies re uired b law. If ou refuse!o sup I the informadon, the a lication ma not be Issued. The undersigned certi'ry±hat the information suppiied is true and correct to the best of their knawledge. Applicant's Signature: u�,.� Date; j.z l�J�C►i 3 � '!� / �-T•-� - r Properh�r Owner's Signature: i��' , Date: �_?�j b� Zc� I 3 Typ��PE��.: SUBMISSION REQUIREIV�ENTS: Except for tree rernoval permits, all permits require a campletec! applicatlon form, escrow agreement(signed by the property owner} and escrow chec[c from owner, two capies of all plans, and three copies of a11 grading plans or surveys/site plans Dock,Residential Seasona(Dodc�surve showin Y g propased dock �ermarlerrt DoCk—p12n5 aS appCoved 6y CUP and copy of LMCD permit(if a�p(icable) ' Dock,Commercial 1. Structural plans for the dock 2. Sur�ey showing the proposed location of the dock 3. Copy of LMCD permit Hardcover Permit �, All Minor or Pdajor�and Alteration Permit requfrements apply as appropriate 2. Hardcover calculations, existing and proposed 3. Plans E.and Alteratian, Major 1. Plans as approved by C�nditional Use Perrnit 2. Erosion control ptan or copy of MCWD Erosion Control Permit Land Alteratio�, Minor 1. Survey/grading plan inc�uding existing and proposed contour5 {Less fhan 10 cu.yds.within 75'of 2. Amount of fill to be imported and/or exported and haul route lake or less than 501 cu.yds 3. Amount of earth to be movecf around on site elsewhere.) i 4. Erosion control plan or copy of MCWD Erosior�Control Permit RefainingWalt 1. Plansforwall(s) 2. Unless repair or exact replacement of existing wall,submit an updated survey with grading p�an including existing and proposed conEours 3. Hardcover caleulation worksheefs�f in shoreland district 4. Erosion control lan or co of MCWD Erosion Control Permit 5tairwdy to Lake �, Construction plans for sEairway,including footings 2. Topographicai survey of property with proposed stairs shown 3. Erosion corttrol plan or copy of MCWD Erosior�Control Permit - Structure Permit 1. Construction plans. 2. Survey of property with proposed structure shown and with setbacks to property lines, ather structu�es on property and the septic system ind�cated.The general location of any sewer and water services should be shown if appricable. 3. Grading pian if grading is proposed. 4, Hardcover calculatian worksheets 5. Erosion contro� lan or co of MCWD Erosion Cantrol Permit � , Tree Removal � Call; 952-249-4600 to schedule a single b^ee removal inspection. A re-planting plan! management lan requirad for clear cuttin , buc:kthom or other intansive vegetaticn removal. Upaated: Novemher 30,2012