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Council <br /> Exhibit A <br /> City of Orono <br /> Zoning Permit Application /-�t.� <br /> Mailing Address: Permit number: o v V �fe::> <br /> PO Box 66 Date received: <br /> 0 Crystal Bay, MN 55323-0066 <br /> Escrow#and �� ,,.. <br /> Street Address: amount: <br /> a > 2750 Kelley Parkway Permit Fee:AI <br /> ' <br /> F Orono, MN 55356 <br /> Approved by: <br /> �kFSHD�Lk' Fax: 952-249-4616 Notes: <br /> Main: 952-249-4600 www_ci_orono_mn_us <br /> i <br /> This application form must be completed in full and all required information must be submitted. (Please print.) <br /> Job Site Address: �/�i� <br /> CONTRACTOR/APPLICANT INFORMATION: <br /> Name: , x,11 wf c i, <br /> Phone: _(�,/2_ )c),S 7 tf 9 Z Fax: <br /> Address: 3i-cr_- Cr CitZIP: <br /> Contact Person: ,ie+< CV, t^ Contact's phone number V KZ <br /> Email nt'�l�l..r mom; jv7 Applicant is: Contractor omeown (Circle One) <br /> PROPERTY OWNER INFORMATION: <br /> Name: -4, <br /> Phone(day): 7 V <br /> Mailing Address: Col-75- J+-=.•w_ 01 1�1de ceicJ-t.tet z ZIP: <br /> Email and/or Fax Cc, (0-I <br /> Overall Project Description: 1?P�ojccc�. c�r�V 'tv G l4 rc j s;cl�.,,� (c Cin, '►} <br /> Check TYPE OF PERMIT COSTBox * <br /> Dock, Residential- Permanent dock on any lake or initial seasonal dock not on $50 + engineering review costs <br /> Lake Minnetonka (permanent dock requires CUP <br /> Dock, Commercial $50+ engineering review costs <br /> Escrow for erosion control and engineering review costs $2,000 <br /> Hardcover Permit: Driveway, Patio, Sidewalk, Etc. (New or Replacement) No charge <br /> Also required is a Minor or Major Land Alteration Permit <br /> Land Alteration, Major(grading, filling, or excavating) more 500 cubic yards or $50 <br /> more than 10 cubic yards in lakeshore setback(also requires CUP) <br /> Escrow for erosion control and engineering review costs As determined by CUP <br /> Land Alteration, Minor(grading, filling or excavating)-500 or less cubic yards $50+ engineering review costs <br /> Xoutside of lakeshore setback or less than 10 yards in lakeshore setback <br /> Escrow for erosion control and engineering review costs $2,000 <br /> Retaining Wall measuring under four feet require a zoning permit. $50+ engineering review costs <br /> Retaining walls measuring more than four feet(from bottom of footings to top of <br /> wall) require a building permit. (Tiered retaining walls are considered one wall <br /> unless the walls are separated by twice the height of the lower wall.) <br /> Escrow for erosion control and engineering review costs $2,500 <br /> Stairway to Lake(New or Replacement) $50+ engineering review costs <br /> Escrow for erosion control and engineering review costs $2,000 <br /> Structure Permit for other structures not requiring a building permit but $50+ engineering review costs <br /> regulated by the zoning code(including, but not limited to accessory building of <br /> less than 120 square feet, detached deck or platform and sport court) <br /> Escrow for erosion control and engineering review costs $2,500 <br /> Tree Removal or other vegetation removal in 0 to 75 foot zone No charge. <br /> Temporary Construction Office/Trailer associated with building permit $30 <br /> (over) <br /> *Permit fee will be collected when the permit is issued. <br /> Updated: November 30,2012 <br />