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<br /> � � Zoning Permit Application
<br /> � Permitnumber: p24 � d`-��J�aZ
<br /> Mailing Address: (
<br /> .Q.�� PO Box 66 Date received:
<br /> �j' Crystal Bay, MN 55323-0066
<br /> � O Escrow#and •
<br /> ` Street Address: amount: � (,�
<br /> � 2750 Kelley Parkway Permit Fee: �'�
<br /> ��� +. �G�F Orono, MN 55356
<br /> •9,k.ESH04, Approved by: �
<br /> Fax: 952-249-4616 Notes: c� „� QJ..vo
<br /> Main: 952-249-4600 �•ci.orono.mn.us ����
<br /> This application form must be completed in full and all required information must be submitted. (Please print.)
<br /> GENERAL INFORMATION:- ��� � - � • - � •
<br /> Job Site Address: ��� �j o.��,,,,�.. � (�ro+no: V�IAJ �53 St�
<br /> CONTRACTOR/APPLICANT INFORMATION:
<br /> Name: C�-.�t.rsfi„•-,P 1,..01.. _„��.
<br /> Phone: .•� _zZ _ �3 � Fax:
<br /> Address: o o x 3`7�t � City: C,��.c_ls��,� ZIP: >5 33 r
<br /> � Contact Person: i,,,,, L�vc-tF Contact's phone p.u.mber �,�y.zzr� s53�+�
<br /> Email �g�� �,;_.,,��+,t�p;,nq� c�c...�noo, Applicant is:�ontracto , Homeowner (Circle One)
<br /> 4,•�
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<br /> PROPERTY OWNER INFORMATION: � �.��
<br /> Name: 1���� S�I.��,,.+e.�
<br /> Phone (day): �iZ-�;i -,�4 i S
<br /> Mailing Address: �1�5 '�w��kd. ,c�rouo. „u,N ZIP: y�'S�7lo
<br /> Email and/or Fax
<br /> Overall Project Description: (Z�.N•G••=.-1 o-F la-N�`�LC��� ,- ,��.p►au�«� �-� !��(.�<<.�,p e c�L��l y .,
<br /> Check TYPE OF PERMIT
<br /> Box COST*
<br /> Dock, Residential— Permanent dock on any lake or initial seasonal dock not on $30 + 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 /> B�ay Permit (New or Replacement) � " No charge
<br /> Also re uired is a Minor or Ma'or Land Alteratio � ermi
<br /> Land Alteration, Major(grading, filling, or excavating) more 500 cubic yards or $30
<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 feet(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 $50+engineering review costs
<br /> regulated by the zoning code (including, but not lirnited to accessory building of
<br /> less than 120 square feet, detached deck or platform and sport court)
<br /> Escrow for erosion control and en ineerin review costs $2,500
<br /> Tree Removal or intensive ve etation removal in 0 to 75 foot zone No char e.
<br /> (overy
<br /> *Permit fee will be collected at
<br /> the time the permit is issued.
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