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i � � �. City of Orono Zoning Perrr�it A lication Mailing Address: Permit number: G.-v��`- C�G9 �Q PO Box 66 �Q Crystal Bay, MN 55323-0066 Date received: � Z/ l S Escrow#and / �t Street Address: amount: ` r� � 2750 Kelley Parkway y `� Orono, MN 55356 Permit Fee: en �, t�kESH04� Fax: 952-249-4616 APProved by: Main: 952-249-4600 Notes: www.ci.orono.mn.us This application form must be completed in full and all required information must be submitted. (P/ease print.) Job Site Address: 3� Z �p C AS Cb 1�01 NT lZD 0 Rb N C) M N 5S?j� � /APPLICANT INFORMATION: ►vame: A�T�oNY ! 'f'R1 N R �D TERMA N Phone: �{ Fax: Address: 2n2(� CAS�O Aoi1�i" 'iZD Ciry• ORbNO ZIP' .rjS�q Contact Person: '(R,l N A Contact's phone number �52 3q 3 2(��.�-} Email �-G�{C3(oQS� �w►�t.i 1. , C O Wl Applicant is: Contractor omeowner (Circle One) PROPERTY OWNER INFORMATION: Name: l�.1•I'TH-oNV ITRWA l7�TGRMIkN Phone(day): qC�2� �q�. 7� y�} MailingAddress: �Q�(Q (ASCo 1�DiNT fZp ZIP• SC�Q � Email and/or Fax .�-�k�V�@ Gmai L. r d rv� Overall Project Description: r—�"'ro�M 0 N 1 F3.)b l.l 5 TO'��FQ '1Tt�,S W/ fN 7$� �F S�I�E Check TYpE OF PERMIT FEE Box collected when ermit is issued Dock, Commercial $50+engineering review costs Escrow for erosion control and en ineerin review costs $2,000 Dock, Residential - Permanent dock on any lake or initial seasonal dock not on Lake $50+engineering review costs Minnetonka ermanent dock re uires CUP Hardcover Permit: Driveway, Patio, Sidewalk,etc. (New or Replacement) No charge Also re uires is a Minor or Ma or Land Alteratlon Permit Land Alteration, Major (grading, filling, or excavating) of more than 500 cubic yards $50 beyond the lakeshore setback OR more than 50 cubic yards within the lakeshore setback (also requires Conditional Use Permit) [Reference: Citv Code Sections 78-967. 78-1247 and 78-12861 Escrow for erosion control and engineering review costs As determined b CUP Land Alteration, Minor(grading,filling or excavating)of 51 to 500 cubic yards beyond the $50+engineering review costs lakeshore setback OR 50 cubic yards or less within the lakeshore setback fReference: Citv Code Sections 78-967. 78-1247 and 78-12861 Escrow for erosion control and engineering review costs $2,000 Retaining Walls which exceed two feet in height above existing grade; or result in more $50+engineering review costs than 20 cubic yards of imported fill; or are located less than five feet from the property line. Escrow for erosion control and engineering review costs $2,500 lReference: Ciri Code Section 78-1405(5.1)1 Retaining Walls which measure more than four feet(from bottom of footings to top of wall) require a building permit. Tiered retaining walls are considered one wall unless the walls are se arated b twice the hei ht of the lower wall. Stairway or Lifts to Lake(New or Replacement) lReference: C/tv Code Sectfons 78-128� $50+engineering review cosCs Escrow for erosion control and engineering review costs $2,000 Structure Permit for other structures 200 sf or less not requiring a building permit but $50+engineering review costs regulated by the zoning code IReference: Citv Code Section 86-661 Escrow for erosion control and en ineerin review costs $2,500 / Tree Removal or other vegetation removal within 75 feet of lakes No charge. �/ elerence: Ci Code Section 78-1285 Pre-ins ection re uired. Tem ora Construction Office/Trailer associated with buildin nnit $30 .d,-ovE�-- Updated: May 2015