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, � r � PC EXhlblt A <br /> City of Orono <br /> Conditional Use Permit or <br /> Other Land Use Permit Application <br /> StreetAddress: Application# �Z '�j��(.Q <br /> 2750 Kelley Parkway Date Received: Z— <br /> �0� Orono,MN 55356 � <br /> O O Staff: �/(���/� <br /> Main: 952-249-4600 <br /> fax: 952-249-4616 Fee: '7�j�� <br /> �� � Mailing Address: Escrow#&$ '7 Q]�'� <br /> ti P.O.Box 66 <br /> � �G~ Crystal Bay,MN 55323-0666 Permit Fee <br /> '��Hp'f� . Notes: <br /> This application form must be completed in full. Applicant will be notified within 15 days as to the status of the <br /> application. Incomplete applications will not be placed on Planning Commission Agendas. <br /> Job Site Address: ���� �CL� � �?C� <br /> �1�Y� CONTRACTOR/APPLICANTINF�RMATION: _ ����� <br /> Name: - � < < ^ �I����GG �iliG` <br /> Phone: ���L> �,c,i- c�-�-��1 Fax: <br /> Address: � �U��! i's'�✓n. Cit : /�-�U�-+- ZIP: SS �� <br /> Contact Person: �� l��-=�-S Contact's phone number Lz � • -�,-r7 <br /> Email S��✓o`i B���� e r� .•-���� Applicant is: Contractor _Homeowner_?(Circle One) C✓. <br /> �V�v� �. <br /> PROPERTY OWNER INFORMATION: <br /> Name: � �--�_3 � �-r����Y <br /> Phone(day): <br /> Mailing Address: ZIP: <br /> Email and/or Fax <br /> Overall Project Description: <br /> Check Box TYPE OF CONDITIONAL USE PERMIT Application Fee Escrow <br /> After-the-Fact Double <br /> Amend Existing CUP $700 N/A <br /> Commercial/Industrial Use $700* $700 <br /> Duplex Credit(per building) $700* $700 <br /> Gradin and Filling-501 cu. d.or more $700*+Permit Fee $700 <br /> Grading and filling—within 75'of OHWL(includes seawalls&retaining walls) $700"+Permit Fee $700 <br /> Grading and filling—wetland and floodplain $700*+Permit Fee $700 <br /> Guest House/Guest A artment $700" $700 <br /> Industrial(church,school,etc.) $700'` $700 <br /> Renewal, IF no chan e to ori inal lan $350 NA <br /> Residential Accesso Structure $700* $700 <br /> Check Box OTHER LAND USE APPLICATIONS A lication Fee Escrow <br /> Appeal of Administrative Decision $100 NA <br /> Commercial Site Plan Review $700* $10,000(minimum) <br /> Com rehensive Plan Amendment $700 NA <br /> Easement/Right-of-Wa RO Vacation,with Subdivision $200* NA <br /> Easement/Ri ht-of Wa ROW Vacation,without Subdivision $700* NA <br /> Rezonin $700 NA <br /> PID 5 acre minimum er code $200/acre minimum$1,000 $10,000(minimum) <br /> PUD Rezonin H 12 Corridor Onl —Residential $700+$40 er dwellin unit $10,000(minimum) <br /> PUD Rezonin H 12 Corridor Onl —Commercial/Industrial $200/acre minimum$875 $10,000(minimum) <br /> RECEIVED "p�us,Engineering&Legal Review Costs <br /> CUP&Other Land Use Applications <br /> Updated: January 31,2012 FFR �? ?^'? -13- <br /> CITY Q�eR�NO . �:s <br />