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. PC Exhibit A ' <br /> r� '` REC����u <br /> � JUN 21 2012 . <br /> . , <br /> C ity of O ro n o clTl( OF ORONO <br /> � Conditional Use Permit or <br /> Other Land �Use Perm�it Application <br /> Street Address: Application# 5 <br /> 2750 Kelley Parkway <br /> ��..� Orono,MN 55356 Date Receivecl: - � <br /> O O Staff: /�G <br /> Main: 952-249-4600 <br /> fax: 952-249-4616 Fee: Q� � <br /> ,� , p„ Mailing Address: ESCrow#�&$ <br /> �,� .4 P.O.Box66 <br /> G~ Crystal Bay,MN 55323-0066 Permit Fee <br /> l`9.tfESHp4�' Notes: <br /> This application form must be completed in full. Applicant wilf 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: <br /> CONTRACTOR/AP�LICANT INFORMATION: -��~n <br /> Name: • , W,t� dl�l,V (J A�U c� — d � <br /> Phone: Z — Fax: � <br />. Address: Vt(p 121p Cit : . � ZIP: <br /> Contact Person: �S �1.,�1��2�J�-- Contact's phone number Z-- Z .. <br /> Email �6UVfLPO�`t�ca�'►CoC►���, itJ��Applicant is: Contractor omeown (Circle One) <br /> PROPERTY OWNER INFORMATION: <br /> : , Name: �'�C ��X�C)� . - <br /> Phone(day): <br /> Mailing Address ZIP: <br /> Email and/or Fax <br /> Overall Project Description: • " <br /> Check Box TYPE OF CONDITIONAL USE PERMIT ' Ap lication Fee Escrow <br /> After-the-Fact Double <br /> Amend Existing CUP $700 N/A <br /> Commercial/Industrial Use $700* $700 . <br /> Du ex Credit(per building) $700* $700 <br /> radin and Fillin —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 /> Ap eal of Administrative Decision $100 NA <br /> Commercial Site Plan Review $700* $10,000(minimum) <br /> Com rehensive Plan Amendment $700 NA <br /> Easement/Ri ht-of-Wa ROW 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 Hw 12 Corridor Onl —Residential $700+$40 er dwellin unit $10,000(minimum) <br /> PUD�Rezonin Hw 12 Corridor Onl —Commercial/Industrial $200/acre minimum$875 $10,000(minimum) <br /> `plus,Engineering &Legal Review Costs <br /> CUP&Other Land Use Applications <br /> Updated: January 31,2012 <br /> - 13- <br />