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City of Orono coun���
<br /> Zoning Permit Application ExhibitA
<br /> Mailing Address:
<br /> Permit number: ��� �l� �O�
<br /> �Q J�,. PO Box 66 Date received: ����S�
<br /> �r Crystal Bay, MN 55323-0066 /�[j
<br /> 0 ;t� � Escrow#and �D/� ,O"� � ��'� «
<br /> ��_::.,�m� amount: / 3/7
<br /> � ,������' J � Street Address:
<br /> ,� A� ti 2750 Kelley Parkway Permit Fee: � � G�
<br /> ��'�'��7G���y p� Orono, MN 55356
<br /> �kESIi��'� Approved by:
<br /> Fax: 952-249-4616 Notes:
<br /> Main: 952-249-4600 -`;'�'� :=4:����r���_mn.�_��
<br /> This application form must be completed in full and all required information must be submitted. (Please print.)
<br /> Job Site Address: �"�� c,)"�' �u�c-�� �� :A-i �v ,c���
<br /> CONTRACTOR/APPLICANT INFORMATION: . �
<br /> Name: �1� r, ,,, � �X � �-� ��.� 7��.= p �•� � /`��v�'n�� ��,
<br /> Phone: 3 z v 9 � -�f` � Fax: _. �Z �, , c, �. �1—� J C-
<br /> Address: f: U� J � v Cit : �::,,•. c- ZIP: SS�3,3 ,
<br /> Contact Person: �p;,,.�; /rlo� U�;,� Contact's phone number z, i� - ' -� J�%lZ:
<br /> �
<br /> Email Applicant is: Contractor omeowne (Circle One)
<br /> PROPERTY OWNER INFOI�VIATION�: /-�
<br /> Name: U c )c c T U��'rti���' �
<br /> Phone (day): 1a /� "• L yp � �, ) /`j
<br /> Mailing Address: sj �+ � �'- (,'�� S� a f' D� .,,T �n n r� ZI P: �S'�,f"�i/
<br /> Email and/or Fax _ �-f-� ,.., ,./,c, c./�/n � (�-h�., : /, C � i�-?
<br /> Overall Project,Description: 1nn l7 �/ � (� �( f 7-'�,v c� �� t't � r ��ti/ �» � r (t, �✓rc,Y�
<br /> l� Y ! ✓G �o� � -• �y/ �r, c y�
<br /> Check TypE OF PERMIT
<br /> Box COST*
<br /> Dock, Residential - Permanent dock on any lake or initial seasonal dock not on $50 + engineering review costs
<br /> Lake Minnetonka permanent dock requires CUP
<br /> Dock, Commercial $50+ engineering review costs
<br /> Escrow for erosion control and engineerin review costs $2,000
<br /> / Driveway Permit (New or Replacement) No charge
<br /> '✓ Also re uired is a Minor or Ma�or Land Alteration Permit
<br /> Land Alteration, Major(grading, filling, or excavating) more 500 cubic yards or $50
<br /> more than 10 cubic yards in lakeshore setback(also requires CUP)
<br /> Escrow for erosion control and engineerin review costs As determined b CUP
<br /> � Land Alteration, Minor(grading, filling or excavating)-500 or less cubic yards $50+ engineering review costs
<br /> outside of lakeshore setback or less than 10 yards in lakeshore setback
<br /> Escrow for erosion control and en ineering review costs $2,000
<br /> Retaining Wall measuring under four feet require a zoning permit. $50+ engineering review costs
<br /> Retaining walls measuring more than four feet (from bottom of footings to top of
<br /> wall) require a building permit. (Tiered retaining walls are considered one wall
<br /> unless the walls are separated by twice the height of the lower wall.)
<br /> Escrow for erosion control and engineerin review costs $2,500
<br /> Stairway to Lake (New or Replacement) $50+ engineering review costs
<br /> Escrow for erosion control and engineering review costs $2,000
<br /> Structure Permit for other structures not requiring a building permit but $50+ engineering review costs
<br /> regulated by the zoning code (including, but not limited to accessory building of
<br /> less than 120 square feet, detached deck or platform and sport court}
<br /> Escrow for erosion control and en ineerin review costs $2,500
<br /> Tree Removal or other vegetation removal in 0 to 75 foot zone No char e.
<br /> (over)
<br /> *Permit fee will be collected at
<br /> the time the permit is issued.
<br /> Updated: December 30, 2011
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