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City of Orono Zoning Permit Application ® Mailing Address: Permit number: PO Box 66 Q Crystal Bay, MN 55323-0066 Date received: -L - Escrow#and Street Address: amount: 2750 Kelley Parkway yF ;� Orono, MN 55356 Permit Fee: 4e ES HO �G Fax: 952-249-4616 Approved by: Main: 952-249-4600 Notes: www.ci.orono.mn.us This application form must be completed in full and all required information must be submitted. (Please print.) Job Site Address: 14 vA �O-?�L� 67 I I CONTRACTOR/APPLICANT INFORMATION: Name: ✓ e- o c, c( Phone: - 7 Fax: Gw. Address: f- L{ Ci ; ZIP. S - Contact Person: f Contact's pho7�Wntro er S - -1 T3 Email moo✓ e w�,u� �� 40/, Applicant is: actor Homeowner (Circle One) PROPERTY OWNER INFORMATION: Name: FL)V f e(f Q,)Ik e Phone(day): Mailing Address: 3!20 Leu ' J /ca-e D J-- ZIP: -�C- 3 � i Email and/or Fax - Overall Project Description: R e VK p Gt/�� `f✓� Us 4o Check TYPE OF PERMIT �� 2 FEE Box collected when ermit is issued Dock,Commercial $50+engineering review costs Escrow for erosion control and engineering review costs $2,000 Dock, Residential - Permanent dock on any lake or initial seasonal dock not on Lake $50+engineering review costs Minnetonka(permanent dock requires CUP Hardcover Permit: Driveway, Patio,Sidewalk,etc.(New or Replacement) No charge Also requires is a Minor or Major Land Alteration Permit Land Alteration,Major(grading,filling,or excavating)of more than 500 cubic yards beyond $50 the lakeshore setback OR more than 50 cubic yards within the lakeshore setback (also requires Conditional Use Permit) !Reference: City Code Sections 78-967. 78-1247 and 78-12861 Escrow for erosion control and engineering review costs As determined by CUP Land Alteration, Minor(grading,filling or excavating)of 51 to 500 cubic yards beyond the $50+engineering review costs lakeshore setback OR 50 cubic yards or less within the lakeshore setback (Reference: City Code Sections 78-967.78-1247 and 78-12861 Escrow for erosion control and engineering review costs $2,000 Retaining Walls which exceed two feet in height above existing grade; or result in more $50+engineering review costs than 20 cubic yards of imported fill;or are located less than five feet from the property line. Escrow for erosion control and engineering review costs $2,500 !Reference: City Code Section 78-1405(5.1)1 Retaining Walls which measure more than four feet(from bottom of footings to top of wall) require a building permit.Tiered retaining walls are considered one wall unless the walls are separated by twice the height of the lower wall. Stairway or Lifts to Lake(New or Replacement) !Reference: City Code Sections 78-12821 $50+engineering review costs Escrow for erosion control and engineering review costs $2,000 Structure Permit for other structures 200 sf or less not requiring a building permit but $50+engineering review costs regulated by the zoning code!Reference: City Code Section 86-661 Escrow for erosion control and engineering review costs $2,500 Tree Removal or other vegetation removal within 75 feet of lakes No charge. Reference: Citv Code Section 78-1285 Pre-inspection required. Temporary Construction Office/Trailer(associated with building permit) $30 Of I (�� C�� C( f pct c, I� r1 �� q►- �( Updated: January 2017 111 �� T 10 of �� S v V i Q �/�