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City of Orono <br /> Zoning Permit Application <br /> • Mailing Address: Permit number: / DLJ fid/ <br /> PO Box 66Date received: a <br /> Crystal Bay, MN 55323-0066 <br /> Escrow#and �y r <br /> Street Address: amount: 1�1j <br /> 2750 Kelley Parkway <br /> Orono, MN 55356 Permit Fee. <br /> Approved by: <br /> Fax: 952-249-4616 <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: I.2j j cj \\)0 CIA til - <br /> CONTRACTOR/APPLICANT INFORMATION: <br /> Name: <br /> Phone: �j "g' Z, 9 - '{ t.( Fax: <br /> Address: . .t�7 \\la°a�In�\ i ' • City: & a1-+4_ ZIP: C35" <br /> Contact Person: v__12_, Contact's phone number C6? - 47 3�y(Flap <br /> Email y,n t t Q ��C yh ,i b Applicant is: Contractor elek7ML5trxtne3 (Circle One) <br /> PROPERTY OWNER INFORMATION: <br /> Name: vyN-C - GLS <br /> Phone (day): <br /> Mailing Address: �' ZIP: <br /> Email and/or Fax c lT <br /> Overall Project Description: d��RO K�(� Q(ae-,, 'r.e,rri-- /o 1( i Q <br /> Check <br /> FEE <br /> TYPE OF PERMIT <br /> Boxcollected 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: May2015 RECEIVED <br /> 1\v��'I � JUL 1 i,. <br /> oG r <br /> CITY OF ORONO <br />