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, , ,' PC ExhibitA <br /> � • ' . � . RECEIV�� <br /> City of C�roi�o MAY292012 <br /> Canditional 11s►e F�ermit or ��T�aFORO�a <br /> Ott��r Land Use Peirmit Appiication <br /> StreetAddress: Application# f�_ 3 S(p C� . _A— <br /> 2750 Kelley Parkway -- <br /> ��� Orono,MN 55356 Date Received: 5-2�'-� a--� _^___ <br /> � � � Main: 952-249-4600 Staff: <br /> fax: 952-249-4616 Fee: Q(�, a p ����� <br /> r3 ; � <br /> � Mailing Address: Escrow#&$ 700. D D /� � <br /> �.� FY P.O.Box 66 �� �--� -' <br /> � G~ Crystal Bay, MN 55323-0066 Permit Fee <br /> �`�kESH�4'� Note:>: --- <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 appfications will not be ptaced on Planning Commission Agendas. <br /> Job Si�e Address: 3� ,���{l� 1'�1 �� �_ <br /> CONTRACTOR/APPLICANT INFORMATION: <br /> -;� <br /> Name: 5.,�� �-,���.�5�*+ Sk��t...t�oZ �L�.. ,. ------- <br /> Phone: q�i Z - ���- 5s w o Fax: ��z- 6q� - 55R I --- <br /> Address: ?�ta1 ��yz�-I�� t�,IvL City: rn�ly ZIP: 5SNz6 �_ <br /> Contact Person: Sv�c� l�kyf��e�N Contact's phone ��y- 2�'1` 2670 � • _ <br /> Email <,���, �,,i s.�,,,,�Z, �� Applicant i�: Contra r Homeowner (Circle One) � <br /> PROPE:RTY OWNER INFORMATION: <br /> Name: ,�n,-H� '$ O.t�n��. �c;ssat� ___ <br /> Phone (day): �,12- �,00 - 0�125 � __._. <br /> Mailing Address: �t�s S. �o's� S-a-�,-t v.1,�� c.�N ZIP: SSH oN _�__ <br /> Email and/or Fax <br /> Overall Project Description: ��Nd;-ro�a�.\ K c <c � 2�.- C��..� S','�'�c_ ___ <br /> Check Box TYPE OF CONDITIONAL USE PEIZMIT Application Fee Escrow � <br /> —^�— -•--I <br /> ✓' After-the-Fact Double ___.� <br /> Amend Existing CUP $700 N/A � <br /> Commercial/lndustrial Use $700* $700 � <br /> Duplex Credit(per building) $700* $700 -� <br /> ._ v' Gradi�and Filling�501 cu. d. or more $700*+Permit Fae $700 <br /> Grading and filfing-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 /> fndustrial (church, school, etc.) $700* _ $700 __ <br /> Renewal, IF no change to original pfan $350 NA ___�� <br /> _ Residential Accesso Structure $700* $700 <br /> Check Box OTHER LAND USE APPLICATIONS A lication Fee �scrow <br /> Ap eal of Administrative Decision $100 NA <br /> � � Commercial Site Plan Review $700' $10,OOO(minimumj <br /> Com rehensive Plan Amendment $700 NA ___ <br /> � � Easement/ Right-of-Way(ROW)Vacation,with Subdivision $200'` _ NA _ <br /> Easement/Ri ht-of Wa ROW Vacation,without Subdivision $700* NA <br /> Rezoning $700 NA _ <br /> PID (5 acre minimum er code $200/acre minimum $1,000 $10,000(minimum) <br /> PUD Rezonin Hwy 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 ri Le 1 Re ' w Costs <br /> CUP&Other Land Use Applications <br /> . UF�dated: January 31,2012 <br /> - 13 - <br />