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t � , <br /> . � ' • City of Orono <br /> Zoning Permit Application <br /> Mailing Address: Permit number: � —�d <br /> �Q �1� PO Box 66 <br /> �`V Crystal Bay, MN 55323-0066 Date received: � <br /> � .�,� � � Escrow amount: �� . � w� �� <br /> a,�� Street Address: � �� � rV�- <br /> a � "�'� �" 2750 Kelley Parkway Permit Fee: <br /> �- �, <br /> ��L f p� �p'�' Orono, MN 55356 Approved by: � <br /> 9kESH04 Fax: 952-249-4616 Notes: <br /> Main: 952-249-4600 W�•ci.orono.mn.us <br /> This application form must be completed in full and all required information must be submitted. (Please print.) <br /> GENERAL INFORMATION: <br /> Job Site Address: �j7�'-j ='�� ��N� �.��_ (�{1�U, ���. �3�� <br /> CONTRACTOR/APPLICANT INFORMATION: <br /> Name: � � � �.� � <br /> Phone: - - Fax: � - - 3 <br /> Address: s jy Cit : , Z ZIP: ��39 <br /> Contact Person: p, � (? �� Contact's phone number Ge� : (z-�� -� a(o <br /> Email e����y, p�c'c,C��.y�ec�iQ��,1,�,.h�'�pplicant is: ontra tc o� eowner Circle One) <br /> �bfi�f OW��'-- �: <br /> PROPERTY OWNER INFORMATION: � <br /> ►vame: �G�'l7 51-��k�D �_� GHU I� <br /> Phone (day): �c,� ;Z- � - ��` " <br /> Mailing Address: ��/ Z,As'�"� ZIP: <br /> Email and/o Fa �� �2 - -� 3 <br /> Overall Project Description: (���:�p.� p{ (���-�j�j�.,"j���r�'�{� '�G (���U� �,;75��`�•(�i,�� <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 /> OC� outside of lakeshore setback or less than 10 yards in lakeshore setback costs <br /> Escrow for erosion control and en ineerin review costs $�-6����. ��c- <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 sJ'r�;��- ��� <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 />