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' • City of Orono <br /> Zoning Permit Application <br /> Mailing Address: Permit number: �a� (p ' � � �� <br /> �Q/�TO PO Box 66 Date received: c.� � I � �D <br /> � � Crystal Bay, MN 55323-0066 <br /> Escrow#and �,��.�� <br /> Street Address: amount: � � ��� <br /> 2750 Kelley Parkway Permit Fee: <br /> y ` Orono, MN 55356 <br /> �' G 6 <br /> f,9 �, Approved by: � z <br /> kFs H O� Fax: 952-249-4616 <br /> Main: 952-249-4600 Notes: �TM <br /> www.ci.orono.mn.us � �� ,� � , <br /> � <br /> , :' <br /> This application form must be completed in full and all required informa n must be submitted. (Please print.) <br /> Job Site Address: �� `t 0 �IA,-t:rk.a.�x-r-- �U"L � C.CTl� ?� I l�'t� r7�3� J <br /> CONTRACTOR/APPLICANT INFORMATI <br /> Name: M ��t �sv-fo� vttc�usa�s e0 <br /> Phone: � s - Fax: <br /> Address: $ Cit : ZIP: `�3 <br /> Contact Person: Contact's phone number ( 0 l � '� <br /> Email Q v11� Applicant is: Contractor Home` owne � (Circle One) <br /> �C(7W� <br /> ���_.� <br /> PROPERTY OWNER INF MATION: <br /> Name: bt� �� Q <br /> Phone (day): 33 � C� <br /> Mailing Address: -�j .�- /�I ZIP: 3 <br /> Email and/or Fax Sc ( �-f-Q � c._ �-��, i�, r <br /> Overall Project Description: � �G: Q S �a,Q•'� G�''��' <br /> CBoXk TYPE OF PERMIT collected whenE ermit is issued <br /> Dock, Commercial $50 +engineering review costs <br /> Escrow for erosion control and en ineerin 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 Major 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 78-1286] <br /> Escrow for erosion control and engineering review costs As determined by 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 /> (Reference: Ciiv 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 five feet from the property line. <br /> Escrow for erosion control and engineering review costs $2,500 <br /> (Reference: Citv Code Section 78-1405(5.1)) <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[Reference: City Code Section 86-66] <br /> Escrow for erosion control and en ineerin review costs $2,500 <br /> Tree Removal or other vegetation removal within 75 feet of lakes No charge. <br /> Reference: Ci Code secrion 78-1285 Pre-inspection required. <br /> Tem ora Construction Office/Trailer associated with buildin permit $30 <br /> Updated: May 2015 �[(v��� <br />