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• � <br /> City of Orono <br /> Zoning Permit A plication <br /> �---� Mailing Address: Permit number: a0 /D -d /���P <br /> /�Q \ PO Box 66 <br /> �\� Crystal Bay, MN 55323-0066 Date received: ll '"/ � -/O <br /> ,' � ; ��'j E�scrowamount: �ZsUd,� <br /> �� ���' ' <br /> Street Address: s cra v`i <br /> � '� ��'�� `�y ti�� 2750 Kelley Parkway �Fee: oZ0 /O-O l// 7 <br /> ������'�,,��,� Orono, MN 55356 ApProved bY: � �� � � <br /> �kESH�4� Notes: G � <br /> �=—= Fax: 952-249-4616 � � e � r �/�-� <br /> Main: 952-249-4600 `N`N`N.ci.orono.mn.us <br /> This application form must be completed in full and all required information must be submitted. (P/ease print.) <br /> GENERAL INFORMATION: <br /> Job Site Address:_____.� Z��: �" )Mj� �: ���, �✓� � i�-�J � �(��'r%� <br /> CONTRACTO APPLICAN FORMATION: <br /> Name: . " �5;;:��� -�� �"k'1,�`� <br /> Phone: `j'S � - `i 3 3 4 <L- > Fax: <br /> Address: S�=%- f��`L�'�� City: ZIP: <br /> Contact Person: ContacYs phone number <br /> Email i ' ,_ , ,, ; �, �, Applicant is: Contractor �Ho,meowner (Circle One) <br /> PROPERTY OWNER INFORMATION: <br /> Name: -1 ��.����_�� •i �I�1 L�Y'�" �%l Z� �-��' "�`'S�l �KI'�CL''«� <br /> Phone (day): � '� 1 � { � _ - �S'y - t/_ -55�5' -TT Ce�.c <br /> Mailing Address: � � p C,r{, (La �,P : ZIP: �s- <br /> Email and/or Fax ��_��,, 3 ��'� iA y�q v1 , ���.c . IC� rv,a i` ���r ti C -�� �: ! , 4;�, <br /> Overall Project Description: r L i�'�-p�t� k/{�l(J��}i� Ti�` ic�,��i a✓;,1/W- k1,�t�q W,rnS�j�� � ���/�y_�i <br /> �,—./� <br /> I S C" Y L-a.�� �il,l�e'i�[:�� „��.?�l� Lv� �.l �'�/�'l��-�! <br /> Check TYPE OF PERMIT COST <br /> Box <br /> Residential Dock-Permanent dock on any lake or initial seasonal dock not on $30+engineering review <br /> Lake Minnetonka ermanent dock re uires CUP costs <br /> Commercial Dock $50+engineering review <br /> costs <br /> Escrow for erosion control and en ineerin review costs $2,000 <br /> Minor Land Alteration (grading, filling or excavating)-500 or less cubic yards $50+engineering review <br /> outside of lakeshore setback or less than 10 yards in lakeshore setback costs <br /> Escrow for erosion control and en ineerin review costs $2,000 <br /> Major Land Alteration (grading, filling, or excavating) more 500 cubic yards or $30 <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 /> Stairway to Lake $50+engineering review <br /> costs <br /> Escrow for erosion control and en ineerin review costs $2,000 <br /> Retaining Wall not requiring a building permit(A building permit is required for any $50+engineering review <br /> / retaining wall that measures more than four feet from bottom of footings to top of costs <br /> '✓ wall. Tiered retaining walls are considered one wall unless the walls are separated <br /> by twice the height of the lower wall.) <br /> Escrow for erosion control and en ineerin review costs $2,500 <br /> Tree Removal or intensive ve etation removal in 0 to 75 foot zone No char e. <br /> Structure Permit for other structures not requiring a building permit but regulated $50+ engineering review <br /> by the zoning code (including, but not limited to accessory building of less than 120 costs <br /> square feet, detached deck or platform and sport court) <br /> Escrow for erosion control and en ineerin review costs $2,500 <br /> (over) <br />