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° _. City af Orono <br /> . Zoning Permit i4 lication <br /> Mailing Address: Permit number: <br /> g,Q�O PO Box 66 Date received: — <br /> Crystal Bay, MN 55323-0066 � <br /> Escrow#and I ^ <br /> Street Address: amount: {-t�t <br /> ,� 2750 Kelley Parkway permit Fee: <br /> y `�' Orono, MN 55356 <br /> �' G <br /> �RXFSNO�'�' Fax: 952-249-4616 /�1Pproved by: <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: <br /> CONTRACTOR/APPLICANT INFORMATION: <br /> Name: <br /> Phone: Fax: <br /> Address: __ Ci : Z�p• <br /> Contact Person: Contact's phone number <br /> Email Applicant is: Contractor Homeowner (Circle One) <br /> PROPERTY OWNER INFORMATION: <br /> Name: f 1Z-{� L'G �:�iYZ��_-i <br /> Phone(daY)� � /.�- - �=;c; ����:�_�, <br /> Mailing Address: :,1.L i�', <��6.S: ._• c�,, �� ;_ �"-'�":��� ZIP• �,` 3=i I <br /> Email and/or Fax l-"rLtL c4 ���:�;�'ri�',..=� . � 4;,,-r <br /> Overall Project Description: <br /> Check TYpE OF PERMIT FEE <br /> Box collecfed when 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 Alteratlon 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 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 78-1286i <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: Cftv Code Section 78-1405f5.1)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 watl 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) IReference: Citv Code SectJons 78-1282I $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/Reference: Citv 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 /> eference: C' Code Section 78-1285 Pre-ins ection re uired. <br /> Tem ora Construction Office/Trailer associated with buildin rmit $30 <br /> Updated: May 2015 <br />