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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 />