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� � City of Orono f���l� T�� ��T
<br /> � � Zoning Permit Application
<br /> ,
<br /> � � �\ Permit number: o?���-� d �3 �3
<br /> Mailing Address:
<br /> .Q,Q_J�,, PO Box 66 Date received: �d' 7— ��
<br /> QY `r Crystal Bay, MN 55323-0066
<br /> ��� Q Escrow#and � ��,� �-,�
<br /> �_`°" Street Address: amount: �LJ
<br /> '� '� ;�� � � 2750 Kelle Parkwa �
<br /> Y Y Permit Fee:
<br /> �c� � p� Orono, MN 55356
<br /> '�y w Approved by:
<br /> kEsB��' Fax: 952-249-4616
<br /> 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. (Please print.)
<br /> GENERAL INFORMATION:
<br /> Job Site Address: ���� ��� �.,- < ��,�,
<br /> CONTRACTOR/APPLICANT INFORMATION: '
<br /> Name: �� �� � �
<br /> Phone: (n i Z - 2 j- �1I� �'7 Fax:
<br /> Address: y 5J� S�C s;,ti�,�_ w��, CitY:/�.k,�-,�t }D��,,;,` ZI P: �S3 S�
<br /> Contact Person: !-'�, �,�,��,� �� ContacYs phone number � �— t
<br /> Email Applicant is: Contractor ; Homeowner (Circle One)
<br /> �.�--.
<br /> PROPERTY OWNER INFORMATION:
<br /> Name: ���< � �r�z:�- �
<br /> Phone (daY): �;��- �I -� �/Gi�7
<br /> Mailing Address: y S�J SIDYWC,< �.v�,, ,/'I� ��� �'l��_,-,� ZIP: �"� ���
<br /> Email and/or Fax
<br /> Overall Project Description: �,� (� � ; ��" — I �.v R.� ;�-,.c,t h�x��., 1� y�� -�.
<br /> Check TYPE OF PERMIT
<br /> Box COST*
<br /> Dock, Residential— Permanent dock on any lake or initial seasonal dock not on $30 + engineering review costs
<br /> Lake Minnetonka ermanent dock re uires CUP
<br /> Dock, Commercial $50+ engineering review costs
<br /> Escrow for erosion control and en ineerin review costs $2,000
<br /> Driveway Permit(New or Replacement) No charge
<br /> Also re uired is a Minor or Ma or Land Alteration Permit
<br /> Land Alteration, Major(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 /> Land Alteration, Minor(grading, filling or excavating)—500 or less cubic yards $50+ engineering review costs
<br /> � 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 of
<br /> wall) require a building permit. (Tiered retaining walls are considered one wall
<br /> 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 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 of
<br /> 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 intensive ve etation removal in 0 to 75 foot zone No char e.
<br /> (over)
<br /> *Permit fee will be collected at
<br /> the time the permit is issued.
<br />
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