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<br /> � �� - � City of Orono
<br /> �,
<br /> ' Zoning Permit Application
<br /> ,
<br /> Mailing Address: Permit number: (��/��-l-� '�� /
<br /> �Q� PO Box 66
<br /> O C ry s t a l B a y, M N 5 5 3 2 3-0 0 6 6 Date received:
<br /> Escrow#and
<br /> Street Address: amount:
<br /> ,� y, 2750 Kelley Parkway
<br /> y � Orono, MN 55356 Permit Fee:
<br /> � G
<br /> I�kES}IO�� Fax: 952-249-4616 Approved by:
<br /> Main: 952-249-4600 Notes:
<br /> v�wv��.ci.orono.mn.us
<br /> This application form must be completed in full and all required information must be submitted. (Please prinf.)
<br /> Job Site Address:
<br /> CONTRACTOR/APPLICANT INFORMATION:
<br /> Name: �<���--� �k �7 �����2`7
<br /> Phone: q a-1- �r � 4 - S,� j j Fax:
<br /> Address: �S x Sl.{-il 2��,,�� � ;Z�.� e Citv: c� r'� �� � ZIP• S�'? �; t
<br /> Contact Person: f�u,r�;,� ContacYs phone number
<br /> Email
<br /> �-4= �,;,;., o� 3 �,a .��,ti� �., ���� Applicant is: Contractor ��FTomeown (Circle One)
<br /> �
<br /> PROPERTY OWNER INFORMATION:
<br /> Name: ) �5 � �� �a l L �2�� �l
<br /> Phone (day): `7 s' z - � � �r -j�j-�
<br /> Mailing Address: �,v�� � �-{-e rZ� L, ;� `; l i��v ,� ZIP� > > � �� �
<br /> Email and/or Fax �, c ,-,� U �0 3 C� �., t,,,, �,. . �
<br /> Overall Project Description: ���,-4 (,. ;-1 ; {,,,_,�
<br /> Check TYPE OF PERMtT FEE
<br /> BOX co/lected when 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 re uires is a Minor or Ma'or 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 /> lReference: Citv Code Sections 78-967. 78-1247 and 78-12861
<br /> Escrow for erosion control and engineering review costs As determined b 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: Citv 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 /> LReference: Citv Code Section 78-1405(5.1)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 contro�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: Citv Code Section 86-661
<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: Cit Code Section 78-1285 Pre-inspection required.
<br /> Tempora Construction Office/Trailer associated with buildin permit $30
<br /> Updated: May 2015
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