2011 - 00744 - land alteration - Laserfiche WebLink

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ii( City of Orono OK-4-4 , 040 b 40 ' oning Permit Application tt// Mailing Address: Permit number: v?D LJ— O '7, Y PO Box 66 Date received: 7/43 7//l/— � 0Crystal Bay, MN 55323-0066 _x"0 0 Escrow#and y 1 Street Address: amount: ��' , � � N, 2750 Kelley Parkway :::e:: �' j. it rjQ� �� )�s'�ilC.' G~ Orono, 9- 5535 I 151) l �, 95 - Fax: 952-249-4616 Notes: S!�G I ` Main: 952-249-4600 www.ci.orono.mn.us v t This application form must be completed in full and all required information must be submitted. (Please print.) GENERAL INFORMATION: rr �U // Job Site Address: �Dl19 Lake rt `e -De pi. 3 `O W,//Ow N 0rc 0, pm/ S 536-6 CONTRACTOR/APPLICANT INFORMATION: Name: C /'I Q �e.het ("SSvc/a vr1 Phone: cf C.::''Y 7-3 ` 8 �8 Fax: Address: C L ),/IO c, N City: (D cON[) ZIP: 55-33 6 Contact Person: 1�_"Mei eider_ I Contact's phone number quoZ , 'Z/7 -8?-d`� Email j+W) e 1de c 19 s® a;/, AApplicant is: Contractor Homeowner (Circle One) PROPERTY OWNER INFOR A ION:r i� ) Name: Gl 'ak (-ire Dep81-T wteult -- Phone (day): �j�' ' /-I/ -9 t4./ Mailing Address: 34/ UJ ;(I ) r) 4Jrive_ N. 0 cc. in ZIP: 6J`'-35"6 Email and/or Fax : <f -5_ilir= Overall Project Description: J•iC:1.1 Gi ,v)e i, f-" � c., i ' tt_-e-,73:,-;rd i``-d`,d t I- 1 r a , ,`s-,,A a CheckTYPE OF PERMITBox COST* Dock, Residential—Permanent dock on any lake or initial seasonal dock not on $30 + engineering review costs Lake Minnetonka (permanent dock requires CUP) Dock, Commercial $50+ engineering review costs Escrow for erosion control and engineering review costs $2,000 Driveway Permit(New or Replacement) No charge Also required is a Minor or Major Land Alteration Permit Land Alteration, Major(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 Land Alteration, Minor(grading, filling or excavating) —500 or less cubic yards $50+ engineering review costs )( 'outside of lakeshore setback or less than 10 yards in lakeshore setback Escrow for erosion control and engineering review costs $2,000 14 Retaining Wall measuring under four feet require a zoning permit. $50+ engineering review costs XRetaining walls measuring more than four feet (from bottom of footings to top of AA,emayim wall) require a building permit. (Tiered retaining walls are considered one wall ItvA«s unless the walls are separated by twice the height of the lower wall.) ' Escrow for erosion control and engineering review costs $2,500 Stairway to Lake (New or Replacement) $50+engineering review costs Escrow for erosion control and engineering review costs $2,000 Structure Permit for other structures not requiring a building permit but $50+engineering review costs regulated by the zoning code(including, but not limited to accessory building of less than 120 square feet, detached deck or platform and sport court) Escrow for erosion control and engineering review costs $2,500 Tree Removal or intensive vegetation removal in 0 to 75 foot zone No charge. (over) *Permit fee will be collected at the time the permit is issued.