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� City of Orono <br /> Zoning Permit A lication <br /> ;— — Mailing Address: Permit number: av� 'D`/�'� <br /> �Q � PO Box 66 Date received: � ��� � 2 <br /> � Crystal Bay, MN 55323-0066 <br /> ' V <br /> Q �� Q\\1 Escrow#and <br /> � � ��- _ �� StreetAddress: amount: <br /> '� � ,�'� ti 2750 Kelley Parkway Permit Fee: �� �'� <br /> �� i ' " G� Orono, MN 55356 <br /> ��kESH�4� Approved by: � <br /> �___ Fax: 952-249-4616 Notes: - ,.y, . <br /> Main: 952-249-4600 W�ci.orono.mn.us � ���'�' N� <br /> �D C�-GiLl�l <br /> This application form must be completed in full and all required information must be submitted. (Pfease print.) <br /> Job Site Address: g� ��1C. �Z�d c�c. Po,�,� �J r(�✓l � , � (�1 <br /> CONTRACTOR/APPLICANT INFORMA ION: � • <br /> Name: (—��YY1�'}I,LYI�, � -Q Pu,b l t sl��n �I�l�,. <br /> Phone: - 4 - l Fax: <br /> Address: �j Cit : ZIP: <br /> Contact Person: Y1 Contact's pho e nu ber - <br /> Email D�Oln n 5 On�, Applicant is: Contractor � Homeowner' (Circle One) <br /> h n m,c,-1-u1'�c�. Cn m <br /> PROPERTY OWNER INFORMATION: <br /> Name: 5 Qil'Y1�Q, (�) (,�,kj� 11UQ„ <br /> Phone (day): <br /> Mailing Address: ZIP: <br /> Email and/or Fax <br /> Overall ProjectDescription: W� 0�,�'�e,. �,�'-OYYI r Y� m�d�,t,�►� d��rl, <br /> O�� � �e,u-fi OU�+r �t S.�, -e,— Su, <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 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 /> 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 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 teet(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 + enginee � review costs <br /> regulated by the zoning code (including, but not timited to accessory buildinq of � �l �` <br /> less than 120 square feet, detached deck or platform and sport court) �� L-�.r <br /> Escrow for erosion control and en ineerin review costs $ , 0 <br /> Tree Removal or other ve etation 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: April 23,2012 <br />