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, City of Orono <br /> � Zoning Permit Application <br /> Mailing Address: Permit number: o��/,J" �� � <br /> �Q�O PO Box 66 Date received: �-�� "" <br /> Crystal Bay, MN 55323-0066 <br /> Escrow#and <br /> Street Address: amount: 'h 11'Iff" � �J' '� <br /> 2750 Kelley Parkway <br /> y � Orono, MN 55356 Permit Fee: <br /> F �, <br /> A roved b Urn <br /> 1�kE S N O�� Fax: 952-249-4616 pp Y' J• f n��`r + <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: a �� d � �,�{-5CD OJ�r�7- ��- I� y �20�tJD �1i1/ S`J�J `rl / <br /> CONTRACTOR/APPLICANT INFORMATION: <br /> Name: M�}�.K= F-N�v(Q2 "' M H3 IJE SCl�/ !�a f� �c..C. <br /> Phone: �l(o3��E27-3q�/y Fax: -----. <br /> Address: � � ��Gf-1+�- .¢�E � City: �r�l��L�Q��I P: $S'y`�,( <br /> Contact Person: /v�iq-,�,k �-u�t' ContacYs phone numb r (05`l-`5�3� (e.S$Sr <br /> Email �v�,��k,�wek3o�cs� ���/�.<a,.,Applicantis: Contractor Homeowner (CircleOne) <br /> PROPERTY OWNER INFORMATION: <br /> Name: �2,�c ��o�5�-c9'wt. <br /> Phone (day): [L/} - �SO- 9SO0 <br /> Mailing Address: �!t i Q Gf+sc p Od�,/r- /Z.,�� d��� � �-r��/ .�-x^ ZIP: 5 j3a! <br /> Email and/or Fax Q ;� � � �,`�,-,,. � <br /> Overall Project Description: ,�rJ��,��r(% �v`�GC.S ��aS C�R�3�� , ax/� t�r��J�C/4r�� � <br /> Check TYPE OF PERMIT N�P�'�� b�E FEE <br /> Box '1�5'b !C, collected 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 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 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 /> X 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[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 /> (Reference: Citv Code Section 78-12851 Pre-inSpeCtion required. <br /> Temporar Construction Office/Trailer associated with buildin permit $30 <br /> Updated: May 2015 <br />