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� City of Orono <br /> Zoning Permit A lication <br /> Mailing Address: PermR number: �-�[ �P - � � Q l � <br /> '�o�O PO Box 66 Date received: � <br /> Crystal 8ay,MN 55323-0066 <br /> Escrow#and /�' <br /> Street Address: amount: r'+� • <br /> �, � 2750 Keiley Parkway pc-, <br /> y� ,h Orono,MN 55356 Permft Fee � , �� , <br /> G <br /> t�'�ESHO�� Fax: 952-249-4616 Approved by <br /> Main: 952-249-4600 Notes � <br /> www.ci.orono.mn.us <br /> This application form must be completed in full and all required info���u�t,�����itted. (Please print.) <br /> �� <br /> Job Site Address: zsno s�n,ave rvau, <br /> CONTRACTOR/APPLICANT INFORMATION: <br /> Name: cnyanneane <br /> Phone: 7�-�7� Fax: <br /> Address: �os�c���mR�o2< City;M��a ZIP: 5sa+o <br /> Contact Person: �+r Fe��,crc����e� Contact's phone number ��'�-� <br /> Email dusty.finke�ci.medina.mn.us Applicant is: Contractor Homeowner (Circle One) <br /> PROPERTY OWNER INFORMATION: <br /> fVame: sc�e�ece��,:,,en�. <br /> Phone(day): aiz-sai-isza <br /> Mailing Address: so9 Tw�o�ce�o�,s�sza,w�,MN Z{p:ssss� <br /> Email andlor Fax �.�erw��-� <br /> Overall Project Descrlption: aratling work for consbuclion of public road,Deer Hf9 Road,to be consWcted by Ciy of Medna.CUP approved 6/Y3r207 B. <br /> cBo k TYPE OF PERMIT collected whenE ermit is issued <br /> Dock,Commercial $50+engineering review costs <br /> Escrow for erosion oontrol and en ineerin review cos#s $2 000 <br /> Dock, Residential - Permanen4 dock on any lake or initial seasonal dock no4 on Lake $50+engineering review costs <br /> Minnetonka rmanent dock ne uires CUP <br /> Hardcover Pennit:Driveway,Pa4io,Sidewalk,etc.(New or Replacement) No harge <br /> Also re uires 6s a Minor or Ma'or Lartd Alteration Permit <br /> Land Alteretion, Major (grading, filling, or excavating) of more than 5Q0 cubic yard $50 <br /> X beyond the lakeshore setback OR more than 50 cubic yards within the lakeshore setbac <br /> (also requires Conditional Use Permit) � <br /> IReference: Ciri Cods Sections 7&967.7&1247 and 78-928B1 �� ESC�b W Q��� . <br /> Escrow for erosion control and engineering review costs As detemtined b CUP <br /> Land Alteratlon,Minor(grading,filling or excavating)of 51 to 500 cubic yards beyond the $50+engineering review costs <br /> lakeshore setback QR 50 cubic yards or less within the lakeshore setback <br /> lReference: Citv Code Secbions 78-967.78-9Y47 and 78-128�j <br /> Escrow for erosion coretrol and engineering review wsts $2,000 <br /> Retaining Walls which exceed two feet in height above existing grade; or resuJt 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 /> fRef�erenee: Citv Code Ssction 78-1405l5.Ul <br /> Retaining Walls which measure more than four#eet(from bottom of footings to top of wall) <br /> require a building pertnit. Tiered retaining walls are considered one wall unless the walls <br /> are se arated b iwice the he ht of the lower wall. <br /> Stairway or Lifts to Lake(New or Replacement) LReference: Clri Code SecUons 78-i2821 $50+engineering review costs <br /> Escrow for erosion control and engineering review costs $2,000 ' <br /> Structure Permlt for other stnactures 200 sf or less not requiring a building permit but $50+engineering review costs <br /> regulated by the zoning code(ReRerence: Citv Code Sectlon 88-8� <br /> Escrow for erosion control and en ineerin review costs $2,500 <br /> Tree Removal or other vegetatlon removal within 75 feet of lakes No charge. <br /> Reference: Ci Code 6on - 285 Pre-ins ection uired. <br /> Tem ara Construction OtflcelTraifer associated with buildin rmit $30 <br /> Updated: May 2015 <br />