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, City of Orono Zoning Permit Application Mailing Address: Permit number: o20/0-0/039 O -- �.1 Crystal 66 Cstal Bay, MN 55323-0066 Date received: /020//0 l\\41" Street Address:"11, Escrow amount: �ti 2750 Kelley Parkway Permit Fee: 41 770-011 .t9x 4Orono, MN 55356 ESHO 100,Z4`-- wReceived by: Main: 952-249-4600 Fax: 952-249-4616 www.ci.orono.mn.us (A, j Lip () This application form must be completed in full and all required information must be submitted. (Pleas print.) GENERAL INFORMATION: Job Site Address: L.(w \,4J( - t,eCLGi2A-- _ blvd . w4/Zu1?7,L4-7, bill CONTRACTOR I APPLICANT INFORMATION: Name: -4147k C4414 e/tbc-b Phone: (AL-s0 I-5SC 3 Fax: CI 92_-40q-,953a- Address: go b + t e3(✓� City: Ln/'jZ-74z., i S ZIP: mit/ Contact Person: ✓-p i�C1V�- �3 -f Contact's phone number (p/Z_-S-0/-5S03 Email Applicant is: Contractor Homeowner (Circle One) PROPERTY OWNERICOR TION: Name: CyGLIA e.--11.4/0 Phone (day): 6102- -1 3 n �p Mailing Address: p,(;1; L4)-- + V a -cdi Fj I v . Bila r-r 7d--/A MAI ZIP: c,2-6oi/ Email and/or Fax G(rat N 1�- GIL ro,,r-1 .ci j-69 W ? c- .C IJ Overall Project Description: Check TYPE OF PERMIT COST Box Residential Dock- Permanent dock on any lake or initial seasonal dock not on $30 + engineering review Lake Minnetonka(permanent dock requires CUP) costs Commercial Dock $50+ engineering review costs Escrow for erosion control and engineering review costs $2,000 Minor Land Alteration (grading, filling or excavating)-500 or less cubic yards $50+ engineering review outside of lakeshore setback or less than 10 yards in lakeshore setback costs Escrow for erosion control and engineering review costs $2,000 Major Land Alteration (grading, filling, or excavating) more 500 cubic yards or $30 more than 10 cubic yards in lakeshore setback (also requires CUP) Escrow for erosion control and engineering review costs As determined by CUP Stairway to Lake $50+ engineering review costs Escrow for erosion control and engineering review costs $2,000 Retaining Wall not requiring a building permit(A building permit is required for any $50+ engineering review retaining wall that measures more than four feet from bottom of footings to top of costs wall. Tiered retaining walls are considered one wall unless the walls are separated by twice the height of the lower wall.) Escrow for erosion control and engineering review costs $2,500 Tree Removal or intensive vegetation removal in 0 to 75 foot zone No charge. Structure Permit for other structures not requiring a building permit but regulated $50+ engineering review by the zoning code (including, but not limited to accessory building of less than 120 costs square feet, detached deck or platform and sport court) Escrow for erosion control and engineering review costs -.dd#5sEte-- /0/4- /4(---j (over)