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�� �, C�ty of �r�no <br /> , ; Zoning Permi� A�plication <br /> O Mailing Address: Permit number: 3 �'' � � 7 <br /> �- � PO Box 66 Date received: � -Z J ` �3 <br /> � Crystal Bay, MN 55323-0066 <br /> Escrow#and <br /> Street Address: amount: <br /> � �. 2750 Kelley Parkway Permit Fee: G�D� <br /> yF � Orono, MN 55356 <br /> ! �' Approved by: <br /> �kESH��� Fax: 952-249-4616 Notes: <br /> Mai n: 952-249-4600 <br /> This application form must be completed in full and all required information must be submitted. (Please print.J <br /> Job Site Address: /�2 O �c7�v►S �e �� �0 4 C� � �n m,v <br /> Na�me:�CTOR/APP�ICA��I�JNFOR�A�ION; <br /> 1.� �r �'� L'Lr�Q� <br /> Phone: �1 'L - �S�t - (-�5 3 l Fax: <br /> Address: Cit : ZIP: <br /> Contact Person: 1 �. c, Cu� Contact's phone number f - � --� <br /> Email Applicant is: Contractor Homeowner (Circle One) <br /> PROPERTY OWNER INFORMATIO� <br /> Name: c3�csZ. et <br /> Phone (day): )'Z - "13 O - Z3 O dZ, c�' a v�S a - - 7 <br /> Mailing Address: j y Zp "�vk,�S po l�.c� . �n�.r� ZIP: <br /> Email and/or Fax <br /> Overall Project Description: � � o,^ - �r,.6t � Son Nn�S - S ���.�, <br /> �G�-aCk '�lst. -� rn. a...r <br /> Check TYPE OF PERMlT <br /> Box COST* <br /> Dock, Residential-Permanent dock on any lake or initial seasonal dock not on $50 + engineering review costs <br /> Lake Minnetonka ermanent dock re uires CUP <br /> Dock, Commercial $50+engineering review costs <br /> Escrow for erosion control and en ineerin review costs $2,000 <br /> Hardcover Permit: Driveway, Patio, Sidewaik, Etc. (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 excavatinc�) more 500 cubic yards or $50 <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 /> 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 ineerin 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 en ineerin 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 ve etation removal in 0 to 75 foot zone No char e. <br /> Tem ora Construction Office/Trailer associated with buildin ermit $30 <br /> (over) <br /> *Permit fee will be collected when the permit is issued. <br /> Updated: November 30,2012 <br />