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� City of Orono <br /> � Zoning Permit A lication <br /> O Mailing Address: Permit number: ��� 5 -�!� d <br /> �, �O PO Box 66 <br /> Crystal Bay, MN 55323-0066 Date received: <br /> Escrow#and - n�� <br /> Street Address: / amount: �� <br /> � � 2750 Kelley Parkway l permit Fee: <br /> y G` Orono, MN 55356 ���� v <br /> F ^ <br /> !q �, ^ 1 Approved by: <br /> kf S�-►O� Fax: 952-249-4616 ,Q` <br /> Main: 952-249-4600 � Notes: <br /> ww,v.ci orono.mn.us <br /> This application form must be completed in full and all required information must be submitted. (Please print.) <br /> S� i <br /> Job Site Address: Z(� ►Sl� '1 S�l,� f' 'T f;''�,, � �j%�1�i:n t� <br /> T <br /> CONTRACTOR/APPLICANT INFORMATION: <br /> Name: .• � �,� r� <br /> Phone: � � I -/-2 "' Fax: <br /> Address: z 1 ;;z', . • ,,,✓� Cit : �,,.��f ZIP• --rJ'� <br /> Contact Person: �v1i K�_ �1;.-►�; ContacYs phone number ��_s��s� �ILx1� <br /> Email ���Kr'�iG,.�/X� -�a�i)��►+.f=d Nlr'7�c�>.;� Applicant is: �ontra�tac Homeowner (Circle One) <br /> � �_.._.W._..,..._ .. <br /> PROPERTY OWNER INFORMATION: <br /> Name: !�-iJ►�►'/e�, �/�>ov,r�S <br /> Phone (day): / _ �' > -,r � �,� �- <br /> Mailing Address: i:•1 C>I C�%S c'-� �2r.•�� t-;�/ !/�� �.._.�. �Y -G-v� ��Y ZIP:S;,j'�zZ <br /> Email and/or Fax �fti�.n [�k,�,...,yc�;c�-.� il��,.rs �[iT:� <br /> Overall Project Description: h�S�C. 1.15�_:;�� -- �S�fSy E�G�y. ���_ ry►u�� �� _`� ��•SS ' �' ' '� =� <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 re uires is a Minor or Ma'or Land Alteration Pertnit <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 /> fReference: Citv 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: Citv 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 /> lReference: Citv 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 se arated b twice the hei ht of the lower wall. <br /> Stairway or Lifts to Lake(New or Replacement) lReference: Citv 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 lReference: Citv Code Section 8&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: Cit Code Section 78-1285 Pre-ins ection re uired. <br /> Tem ora Construction Office/Trailer associated with buildin ermit $30 <br /> Updated: May 2015 <br />