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; �� City of Orono
<br /> Zoning Permit A lication
<br /> Mailing Address: Permit number: / —� l�/3
<br /> '��O PO Box 66 Date received: �"�— /�
<br /> Crystal Bay, MN 55323-0066
<br /> Escrow#and
<br /> Street Address: amount:
<br /> � � 2750 Kelley Parkwa Permit Fee:
<br /> ♦ Orono, MN 5535
<br /> ���k�a�o♦�� �., Approved by: ��r
<br /> Fax: 952-249-4616 � Notes:
<br /> Main: 952-249-4600 `��ci.orono.mn.us
<br /> This application form must be completed in full and all required information must be submitted. (P/ease print.)
<br /> Job Site Address: �'ZS C��v� I �9 (�� vV
<br /> CONTRACTOR/APPLICANT INFORMATION:
<br /> Name: �p��(r 1�-�� �;Ch,i= � � ✓
<br /> Phone: Fax: 2 - 13�- 33 I
<br /> Address: °"jZs [�.._c� �� City: (N��,/y-T-p► ZIP: �3g ,
<br /> Contact Person: —�'�,,,` Jo�.iSn,..� ContacYs phone number _ — �
<br /> Email .�.�,,.��@ s p�,.,.�,��,�ti�� a�, �,,hApplicant is: Contractor omeowner (Circle One)
<br /> PROPERTY OWNER INFORMATION:
<br /> Name: � ��-L,.a�.-�l,L�'��f� �1�1Z
<br /> Phone(day): �S'Z _¢'1 b — q�-�7�
<br /> Mailing Address: �� Cp�n�Yt '120� �� ln�f�{ZA-r� ZIP: �"��'j. (
<br /> Email and/or Fax -+-1� �� S�,r-�n�h�►1 a c• C�w-�
<br /> v J � �1°sl.t� �A S�'�-+��++r�c-rL
<br /> Overall Project Description: �2,�,�� -��, ��;���,_����,,,�
<br /> �viw � Sos��A
<br /> Check TYpE OF PERMIT
<br /> Box COST*
<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 $50 +engineering review costs
<br /> on Lake 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
<br /> Land Alteration Permit
<br /> Land Alteration, Major(grading,filling, or excavating) more 500 cubic yards $50
<br /> or 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 /> ` ,� Land Alteration, Minor(grading,filling or excavating)—500 or less cubic $50+engineering review costs
<br /> X� yards outside of lakeshore setback or less than 10 yards in lakeshore setback
<br /> � Escrow for erosion control and en ineerin review costs $2,000
<br /> Retaining Wall measuring under four feet require a zoning permit. $50+engineering review costs
<br /> Retaining walls measuring more than four feet(from bottom of footings to top
<br /> of wall)require a building permit. (Tiered retaining walls are considered one
<br /> wall unless the walls are separated by twice the height of the lower wall.)
<br /> Escrow for erosion control and en ineerin review costs $2,500
<br /> Stairway or Lifts to Lake(New or Replacement) $50+engineering review costs
<br /> Escrow for erosion control and engineering review costs $2,000
<br /> Structure Permit for other structures not requiring a building permit but $50+engineering review costs
<br /> regulated by the zoning code(including, but not limited to accessory building
<br /> of less than 120 square feet, detached deck or platform and sport court)
<br /> Escrow for erosion control and en ineerin review costs $2,500
<br /> Tree Removal or other ve etation removal in 0 to 75 foot zone No char e. Pre-ins ection re uired.
<br /> Tem ora Construction Office/Trailer associated with buildin ermit $30
<br /> (over)
<br /> *Permit fee will be collected when the permit is issued.
<br /> Updated: January 2014
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