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J, <br /> � City of Orono <br /> Zoning Permit Application <br /> MailingAddress: Permit number: ����— ��o3�J� <br /> ��J��, PO Box 66 <br /> �r Crystal Bay, MN 55323-0066 Date received: � // /� <br /> � � °��. � � Escrow amount: d,pU�• �� � �/d <br /> ��,-� a � Street Address: <br /> II'� � '� �" 2750 Kelley Parkway Permit Fee: � �� ,� 5� <br /> � <br /> �� a P� ��,�F Orono, MN 55356 Approved by: <br /> �`9k'ESHo4 Fax: 952-249-4616 Notes: -�-v l�� � - � <br /> Main: 952-249-4600 ��ci.orono.mn.us <br /> This application form must be completed in full and all required information must be submitted. (Please print.) <br /> GENERAL INFORMATION: <br /> Job Site Address: �fj j__�� �R,�. s� ��yp�o ,�.� <br /> CONTRACTOR/APPLICANT INFORMATION: <br /> Name: <br /> Phone: Fax: — <br /> Address: Cit : ZIP: <br /> Contact Person: �� �/�jn/ ContacYs phone number C� /(���� Z�c���.�ct <br /> Email �p����l�����pplicant is: Contractor �fome wner (Circle One) <br /> PROPERTY OWNER INFORMATION: • <br /> Name: �j�L�. �� <br /> Phone (day): .. <br /> Mailing Address: ZIP: <br /> Email and/or Fax ' �'j� <br /> Overall Project Description: _ _ <br /> ___.._.___�_- �-�- <br /> Check TYpE OF PERMIT COST <br /> Box <br /> Residential Dock—Permanent dock on any lake or initial seasonal dock not on $30 + engineering review <br /> Lake Minnetonka ermanent dock re uires CUP costs <br /> Commercial Dock $50+ engineering review <br /> costs <br /> Escrow for erosion control and en ineerin review costs $2,000 <br /> Minor Land Alteration (grading, filling or excavating) —500 or less cubic yards $50+ engineering review <br /> X outside of lakeshore setback or less than 10 yards in lakeshore setback costs <br /> Escrow for erosion control and en ineerin review costs $2,000 <br /> Major Land Alteration (grading, filling, or excavating) more 500 cubic yards or $30 <br /> more than 10 cubic yards in lakeshore setback (also requires CUP) <br /> Escrow for erosion control and en ineerin review costs As determined b CUP <br /> Stairway to Lake $50+ engineering review <br /> costs <br /> Escrow for erosion control and en ineerin review costs $2,000 <br /> Retaining Wall not requiring a building permit(A building permit is required for any $50+ engineering review <br /> retaining wall that measures more than four feet from bottom of footings to top of costs <br /> wall. Tiered retaining walls are considered one wall unless the walls are separated <br /> by twice the height of the lower wall.) <br /> Escrow for erosion control and en ineerin review costs $2,500 <br /> Tree Removal or intensive ve etation removal in 0 to 75 foot zone No char e. <br /> Structure Permit for other structures not requiring a building permit but regulated $50+ engineering review <br /> by the zoning code (including, but not limited to accessory building of less than 120 costs <br /> square feet, detached deck or platform and sport court) <br /> Escrow for erosion control and en ineerin review costs $2,500 <br /> (over) <br /> RECEIVED <br /> APR 1 1 2011 <br /> CITY OF ORONO <br />