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City of Orono <br /> Zoning Permit Application <br /> Mailing Address: Permit number: �-" � � <br /> �Q�O PO Box 66 Date received: � , 'rj <br /> Crystal Bay, MN 55323-0 <br /> — Escrow#and . ' <br /> Street Address: (�����j��( amount: Z � � l �L��� ' <br /> 2750 Kelley Par�Cway -----------_____----- <br /> y : Orono, MN 55356 Permit Fee: C / <br /> F <br /> !q �,�' Approved by: <br /> kFs H O� Fax: 952-249-4616 <br /> Main: 952-249-4600 Notes: <br /> www.ci.orono.mn.us <br /> This application form must be completed in full and all required information must be submitted. (Please print.) <br /> Job Site Address: � � �� Q�,j �f'�T �-,� <br /> CONTRACTOR/APPLICANT INFORMATION: <br /> Name: f)T�C/'.l .l`�}:;',C`)5, ��,5�'�-`f /k-�!��j'�.;�:=.4 d�i�1�� `..°"�"::.� <br /> Phone: � Fax: �, <br /> Address: r? ?i�� (�l� `' 7'' 0,.�,1i�� 'r'-�r�r���u'::,�_� City: 1�j�1��� ZIP: �-s;>'s� <br /> Contact Person: -J ContacYs phone number �"���,_ ..�.,j� --,7�i��:� <br /> Email �,, ��°/,(�a���.t.� Applicantis: �Contracf Homeowner (CircleOne) <br /> '�r�s, Gd� <br /> PROPERTY OWNER INFORMATION: <br /> Name: ����`���� <br /> Phone(day): / ` <br /> ��'�'�L�—� � <br /> Mailing Address: �', Q� ���� �'/ry- sr;� ��,�. p�-� ZIP: _S`�5='-�'�� <br /> Email and/or Fax � � ,�— ' / � <br /> Overall Project Description: � ° � � � + 'a' ���-_ ' �;-,:�' <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 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: Citv Code Sections 78-967. 78-1247 and 75-12861 <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 /> fReference: 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 86-661 -�i��,i <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-inspeCtion required. <br /> Tem orar Construction Office/Trailer associated with buildin ermit $30 <br /> Updated: May 2015 <br />