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City of Orono <br /> Zoning Permit Application <br /> O Mailing Address: Permit number: d•�C.7/0, -i0/03 4,3 <br /> PO Box 66 Date received: /0- ye—/.h <br /> Crystal Bay,MN 55323-0066 <br /> Escrow#and f) <br /> Street Address: amount: `'�`"' <br /> 2750 Kelley Parkway <br /> tgr:-/-• Orono,MN 55356 PermitFee. 150 <br /> ,,,.,�1kEsrlO$� Fax: 952-249-4616 Approved by: m �WIAr� �' <br /> Main: 952-249-4600 Notes: <br /> www.ci.orono.mn.us <br /> This application form must be completed in full and all required information must be submitted. (Please print.) <br /> Job Site Address: 5;U /i d /5 i4A.,/) ed,f t7 L'C%1 n1 A" <br /> CONTRACTOR/APPLICANT 1 FORMATION: <br /> Name: -FP Al 6y etc e c i Sea <br /> Phone: t 7 Ll-`l / `/ n _, Fax: fS?.- //7 V-( 2/ 2 <br /> Address: 23 V6O 6 p.� a k rcn-v- QtJ City: XC-Z ± ( ZIP: SS-Ill i <br /> Contact Person: TO Vv1 Ab C e t/w\. Contact's phone n mber 3 c,to-ti-C- <br /> Email /I)'i ® 4\IA/tAC. K e' ntra <br /> Applicant is: Coctor Homeowner (Circle One) <br /> PROPERTY OWNER INFORMATION: p <br /> Name: /M ./ AU i7/� - 74'..-- 6 i /th.-// 'Xi<: <br /> Phone(day): 4 5 - 7 ?/-- JO 7 i <br /> Mailing Address: U 5-� /I J U ST-/& ,ALZA V Sl`/e)1z,/V'7/I M A./ ZIP: 5-5-3.7/ <br /> Email and/or Fax ot6 Arilf ix 3"7-7../ & cep.e• ,j <br /> Overall Project Description: <br /> BoxCheck FEE <br /> TYPE OF PERMIT collected when permit is issued <br /> Dock,Commercial $50+engineering review costs <br /> Escrow for erosion control and engineering review costs $2,000 <br /> Dock, Residential - Permanent dock on any lake or initial seasonal dock not on Lake $50+engineering review costs <br /> Minnetonka(permanent dock requires CUP) <br /> Hardcover Permit:Driveway,Patio,Sidewalk,etc.(New or Replacement) No charge <br /> Also requires is a Minor or Major Land Alteration Permit <br /> Land Alteration, Major (grading, filling, or excavating) of more than 500 cubic yards $50 <br /> beyond the lakeshore setback OR more than 50 cubic yards within the lakeshore setback <br /> (also requires Conditional Use Permit) <br /> (Reference: City Code Sections 78-967.78-1247 and 78-12861 <br /> Escrow for erosion control and engineering review costs As determined by CUP <br /> Land Alteration,Minor(grading,filling or excavating)of 51 to 500 cubic yards beyond the $50+engineering review costs <br /> lakeshore setback OR 50 cubic yards or less within the lakeshore setback <br /> (Reference: City Code Sections 78-967.78-1247 and 78-12861 <br /> Escrow for erosion control and engineering review costs $2,000 <br /> Retaining Walls which exceed two feet in height above existing grade; or result 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 /> (Reference: City Code Section 78-1405(5.1)1 <br /> Retaining Walls which measure more than four feet(from bottom of footings to top of wall) <br /> require a building permit. Tiered retaining walls are considered one wall unless the walls <br /> are separated by twice the height of the lower wall. <br /> Stairway or Lifts to Lake(New or Replacement) (Reference: City Code Sections 78-12821 $50+engineering review costs <br /> Escrow for erosion control and engineering review costs $2,000 <br /> Structure Permit for other structures 200 sf or less not requiring a building permit but $50+engineering review costs <br /> regulated by the zoning code(Reference: City Code Section 86-661 <br /> Escrow for erosion control and engineering review costs $2,500 <br /> Tree Removal or other vegetation removal within 75 feet of lakes No charge. <br /> (Reference: City Code Section 78-12851 Pre-inspection required. <br /> Temporary Construction Office/Trailer(associated with building permit) $30 <br /> Updated: May 2015 <br />