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City of Orono . Zoning Permit Application Mailing Address: Permit number: 0. 01 7- O 07 7 cQ�O PO Box 66 Crystal Bay, MN 55323-0066 Date received: 7 jp-)7 Escrow#and Street Address: amount: � CLOD V U 2750 Kelley Parkway / y Orono, MN 55356 Permit Fee: 50 V e,1 Approved by: kES H OR Fax: 952-249-4616 Main: 952-249-4600 Notes: This application form must be completed in full and all required information must be submitted. (Please print.) Job Site Address: a.L C. "'LL Ci „ &Li (( P.k, CONTRACTOR/AP LIC NT IN.EORMATION: Name: k1# �1� 4�&.iZt�LS .. �W a> • C � .., P.-W.-42- -3 0•-. 1c= . t.& Itv Phone: 6 ( . - .?e .. -. 0 Fax: 5`.s`.1. _c/ r_jff 0J j - / ! I Address: . G Co t.),.'•t '•Jr„�t.; I( i<:C.?c.i,t City: L' A 7 Ze4.-k-C3_ ZIP: 5M-35' I Contact Person: 44..-.r c.� , I ila C 0 , .z Contact's phone number Email e„. k(Z424.4tid— , 4: Applicant is: Contractor (H---q-meowne� (Circle One) e..9,ty. (lc -- PC PROPERTY OWNER INFORMATION: ff ` t RC�1e s` ` - •, Name: - 'c.Glir�..\t :. as ..., k f_I C /J - ,C. c ,- t R ti� 11 s.• .✓ Phone(day): f. ( '1.-.��c' - :i-' Yl 6 Mailing Address: a c,c 0 0 l.,; (t RC, ZIP: Y 5-3 y / Email and/or Fax a_ .. it4&,«.og_. A. vn.si:. CC,v. ct-5 1 - /7 3.- C !/j Overall Project Description: L c�i l& �; _;,` 17 L Cis 1._k l ' Check TYPE OF PERMIT FEE Box collected when permit 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!5.111 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: City Code Section 78-12853 Pre-inspection required. Temporary Construction Office/Trailer(associated with building permit) $30 RECEIVED JUL 0 6 201i Updated: January 2017 CITY OF ORONO