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"" ' � City of Orono <br /> � ' � r � Zoning Permit Application <br /> Mailing Address: Permit number: '� <br /> '�Q�O PO Box 66 ���/ <br /> Crystal Bay, MN 55323-0066 Date received: <br /> Escrow#and <br /> Street Address: amount: <br /> ,� � 2750 Kelley Parkway <br /> y � Orono, MN 55356 Permit Fee: <br /> � G <br /> I�kESH��� Fax: 952-249-4616 Approved by: <br /> Main: 952-249-4600 Notes: <br /> www�.ci.orono.mn.us <br /> This application form must be completed in full and all required information must be submitted. (Please print.) <br /> Job Site Address: �}�3p ��',/� � <br /> �Q Y_��L (./�r��,, M ni ��j l � <br /> CONTRACTOR/APPLICANT I FORMATION: <br /> Name: �1�, � ' z <br /> Phone: T - - � _ �- �' Fax: <br /> Address: � a rr � py,� Cit : p/� ZIP: j� <br /> Contact Per n: � ContacYs phone number - �� <br /> Email /tie; „`� hZ,k,� C-�licant is: Contractor Homeowner Circle ne) <br /> PROPERTY O ER INFORMATION: <br /> Name: <br /> Phone (day): <br /> Mailing Address: ZIP: <br /> Email and/or Fax <br /> Overall Project Description: <br /> Check TYPE OF PERMIT FEE <br /> B�X co/lected when 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 /> Also 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 /> [Reference: 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 Sections 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�Reference: Citv Code Section 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: Cit Code Section 78-1285 P�e-inspeCtion �equired. <br /> Tempora Construction Office/Trailer associated with buildin permit $30 <br /> Updated: May 2015 <br />