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PC Exhibit A <br />City of Orono <br />Land Use & Conditional Use Permit <br />Application <br />Street Address: <br />2750 Kelley Parkway <br />Orono, MN 55356 <br />Main: 952-249-4600 <br />fax: 952-249-4616 <br />Mailing Address: <br />P.O. Box66 <br />Crystal Bay, MN 55323-0066 <br />Application# <br />Date Received: <br />Staff: <br />Fee: <br />Escrow#&$ <br />Permit Fee <br />Notes: <br />This application form must be completed in full. Applicant will be notified within 15 days as to the status of the <br />application. Incomplete applications will not be placed on Planning Commission Agendas. <br />Job Site Address: 'f'-/0 l!J13 J:s /046 <br />CONTRACTOR, APPLICANT INFORMATION: 0 . J , I., 11= <br />Name: _ S V r'\ c. cu+-D VJ I c{,..,er S -W 01(A.J 4vt.-[E.111&~ <br />Phone: ~~ 3 -!-/ ~q -,q--S-S~ Fax: 7~ ~ ~-.55""'5"CJ <br />Address: 57S-q~~ .£f~ f?ck '3$'2-cTtii, i ;n ZIP: !i"S.3£1 <br />Contact Person: ~ =;;-~ol-ith~ Contact's phone num er 7?,1-¥7?-S:S£'S <br />Email joh;:; w U.L .~Applicant is: anti-actor Homeowner (Circle One) <br />PROPERTY OWNER INFORMATION: II/ .I) <br />Name: O"'ohv1 a¥1.d M,(C-e,.., ,c,e,,,,,v1V1n <br />Phone (day): t; ( :z.. -'3 ~o -qS:o J le, t 2. -8'75;--£ 3 Z o <br />Mailing Address: Z I Cf S-7 fhinad-aaE¼ t3&J.. V4 :-t-J Z , E:>a,e,/t1°6r.l>1iVZIP: SS 3 3 I <br />Email and/a~ Fax jo~6 .' ce.-1 n,,11n r? @--ceJ,.,,,.sho-e..f. an-, ~r e, /~&e,., te.i 1:\14 Ill"\ @ 8m+t"1 / , WYvi • <br />Overall ProJect Description: Ccvuftu,f~ l"\e.v .$€4/ 0(14 I eqb,n f ce,-b,,n &•~ <fne.rfc.-f"'tt <br />Check Box LAND USE APPLICATIONS Application Fee Escrow <br />Appeal of Administrative Decision $50 NA <br />Commercial Site Plan Review $700* $10,000 (minimum) <br />Comprehensive Plan Amendment $700* $700 <br />Easement/ Right-of Wav (ROW) Vacation, without Subdivision $700* $700 <br />PID (5 acre minimum per code) $200/ acre (minimum $1,000)* $10,000 (minimum) <br />PUD Rezonina (Hwv 12 Corridor Only) -Residential $700 + $40 oer dwellino unit* $10,000 (minimum) <br />PUD Rezonina (Hwv 12 Corridor Only) -Commercial/Industrial $200/acre (minimum $875)* $10,000 (minimum) <br />RPUD or PRD, without Subdivision $50/dwelling (minimum $600) <br />Zoning Amendments includina Rezoning $700* $700 <br />~-AfF;;;/{ Va ri4r,,U ,,s -U.!.( -/-lv,v1, ~ ac.re.f. -hr _tfw.d--,;1/...,~ er efut-.tf u,b,;, eye,,kc/-,I t-ct'J/J < 'F <br />Check Box CONDITIONAL USE PERMlnCUP) y Application Fee Escrow <br />After-the-Fact CUP Double Fee <br />Amend Existing CUP $700* N/A <br />Commercial / Industrial Use $700* $700 <br />Duplex Credit (per building) $700* $700 <br />Gradina and Filling-501 cu. yd. or more $700*+Permit Fee $700 <br />Grading and filling-within 75' of OHWL (includes seawalls & retaining walls) $700*+Permit Fee $700 <br />Grading and filling-wetland and floodplain $700*+Permit Fee $700 <br />-· --Guest House / Guest Apartment $700* $700 _, --.. <br />Institutional -Type: $700* $700 <br />Renewal of CUP, IF no change to original plan $350 NA <br />X Residential Accessory Use -Tvpe: --$700* $700 <br />(;t,v_rY 'r't1~ _sel(ScJ/)C( I CJJbi)i\C\,t:IVt:U *plus, Engineering & Legal Review Costs <br />Packet Last Updated: 03/29/13 FEB 1 9 2013 <br />crfY2a~9 <br />0RONO #3658