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1 '� � City of Orono <br /> ` 4 � <br /> � • Zoning Permit Application <br /> Mailing Address: Permit number: �� � S ' � � ��� <br /> �Q� PO Box 66 Date received: �O `1 Z�� <br /> O Crystal Bay,MN 55323-0066 <br /> Escrow#and � / � <br /> Streef Address: amount: <br /> � 2750 Kelley Parkway <br /> y `�' Orono, MN 55356 Permit Fee: <br /> �l �' Approved b : <br /> qkESH��� Fax: 952-249-4616 y <br /> Main: 952-249-4600 Notes: <br /> www.ci.orono.mn.us � <br /> This application form must be completed in full and all,�equired information m st be submitted. (P/ease print) <br /> Job Site Address: � �,.\� .r <br /> CONTRACTOR/APP ANTI OR . <br /> Name: <br /> Phone: . Fax: <br /> Address: Ci : ZIP: <br /> Contact Person: Contact's phone number <br /> Email Applicant is: Contractor ome (Circle One) <br /> G9'W►E ,11��, <br /> PROPERTY OWNER INFORMATION: <br /> Name: �i,�.._ .. <br /> Phone(day): __ __ <br /> Mailing Address: ZIP: _ <br /> Email and/or Fax <br /> Overall Project Description: . <br /> CBoXk TYPE OF PERMIT collected whenE ermit is issued <br /> Dock,Commercial $50+engineering review costs <br /> Escrow for erosion control and en ineerin 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 ermanent dock re uires CUP <br /> Hardcover Permit: Driveway, Patio,Sidewalk,etc.(New or Replacement) No charge <br /> Also requires is a Minor or Ma or 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 /> lReference: Cftv Code Sections 78-967.78-1247 and 78-12861 <br /> Escrow for erosion control and engineering review costs As determined b 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 /> lReference: Ciri Code Sectlons 78-967,78-1247 and 78-12861 <br /> Escrow for erosion control and engineering review costs $2,000 <br /> Retaintng 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 /> fReierence: Cltv Code Section 78-1405(5.1)1 <br /> Retalning 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 se arated b twice the hei ht of the lower wall. <br /> Stalrway or Lifts to Lake(New or Replacement) lReference: C►tv 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!lteference: Cftv Code Section 86-661 <br /> Escrow for erosion control and en ineerin review costs $2,500 <br /> Tree Removal or other vegetation removal within 75 feet of lakes No charge. <br /> Reference: C' Code Sectfon 78-1285 Pre-inspection required. <br /> Tem ora Construction Office/Trailer associated with buildin ermit $30 <br /> +` � . <br /> i rti:F� � . <br /> � <br /> Updated: May 2015 <br />