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' � City of Orono <br /> Zoning Permit Application <br /> O Mailing Address: Permit number: G J ' O � <br /> � �O PO Box 66 Date received: '�%"-1 <br /> Crystal Bay, MN 55323-0066 <br /> Escrow#and , 1 � i�. <br /> Street Address: amount: N tS <br /> 2750 Kelley Parkway � <br /> y � Orono, MN 55356 Permit Fee: <br /> � G <br /> `�kESH�4� Fax: 952-249-4616 Approved by: 'v <br /> Main: 952-249-4600 Notes: <br /> www.ci.orono.mn.us <br /> This application form must be Gompleted in full and all required information must be submitted. (Please print.) <br /> �J � / � " ,Gz L'� �"1 /�� <br /> Job Site Address: ' (,"�7�� � (, p� (��j�({ �. J� �V(�(,{ Z � <br /> CONTRACTOR/APPLICANT INFORMATION: 'J <br /> Name: �](��fl�7'1 "�'Y�r% � M(d 71" f e�t'�'1 i'1'1�i!Z) <br /> Phone: � cc��2) `�j I - iU� I Fax: <br /> Address: Ciry: ZIP: <br /> Contact Person: ContacYs phone number <br /> Email Applicant is: Contractor Homeowner (Circle One) <br /> PROPERTY OWNER INF�MATION: <br /> Name: I FM � ��.' �'� 1 �' <br /> Phone(day): � <br /> Mailing Address: I � 5� OV1 ��c IG� G V '�Z h-( ZIP: 5 � <br /> Email and/or Fax ( 1 w (` � S 1= . : c' ' <br /> Overall Project Description: j � YYl ' VV � ,�� W 0� !'� ' <br /> CBoxk TYPE OF PERMIT col/ected whenE 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 /> Afso 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 /> IReference: 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 /> 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 /> [Reference: 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 Secrions 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 fReference: Ciri Code Secfion 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: Ci Code Section 78-1285 Pre-inspection re uired. <br /> Tem ora Construction Office/Trailer associated with buildin ermit $30 <br /> Updated: May 2015 <br />