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> <br /> ' R�CEI�f�D <br /> AUG 21 2012 <br /> C i#y of Oro n o CITY OF ORONO <br /> Conditional Use Perrnit or � PCExhibitA <br /> Other lLand Use Permit Application - � <br /> - StreetAddress: Application# �v � <br /> 2750 Kelley Parkway <br /> OQ���O Orono,MN 55356 Date Received: �Zi'IL <br /> r Staff: <br /> Main: 952-249-4600 <br /> ���. fax: 952-249-4616 Fee: $ � <br /> p` �'�` �' Mailing Address: <br /> ,� . �..x�. a. Esc�ow#&$ �Zn a <br /> �', ;� ;, ".` C,� P.O.Box 66 - <br /> 0 <br /> � ` , � G~ Crystal Bay,MN 55323-0066 Permit Fee (�v <br /> �9kES804"� 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: 1430 Cherry Lane, Orono, MN 55364 ._,,:�. <br /> CONTRACTOR/APPLICANT INFORMATION: � / <br /> Name: Gustafson Design, Inc � ���� �-°�� - �J 3 ` �`,� <br /> Phone: . 763-544-421 ' Fax: <br /> Address: 1845 Wisconsin Ave No city: Golden Vallev Z1P: 55427 <br /> Contact Person: Dale Gustafson � Contact's phone number <br /> Email dalequsC?earthlink.n Applicant is: Contractor Homeowner (Circle One) <br /> PROPERTY OWNER INFORM/Q�TION: <br /> Name: �'�n,vt,-s 90`'}-+t��-� <br /> Phone(day): � - --c� v • - <br /> Mailing Address: � c'7 c�-.e.�-r �• ��. G� ZIP: <br /> Email and/or Fax a -� o/. � <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 /> Grading 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 original lan $350 NA <br /> Residential Accessor Structure $700* $700 <br /> Check Box OTHER LAND USE APPLICATIONS .A lication Fee Escrow <br /> A eaf ot 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 ROW Vacation,with Subdivision $200* NA <br /> Easement/Right-of Way ROW Vacation,without Subdivision $700' NA <br /> Rezoning $700 NA <br /> PID 5 acre minimum per code $200/acre minimum$1,000 $10,000(minimum) <br /> PUD Rezoning(Hwy 12 Corridor Onl —Residential $700+$40 er dwellin unit $10,000(minimum) <br /> PUD Rezoning Hwy 12 Corridor Onl —Commercial/Industrial $200/acre minimum$875 $10,000(minimum) <br /> . • *plus, Engineering&Legal Review Costs <br />