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<br /> City of Orono
<br /> � Zoning Permit Application
<br /> Mailing Address: Permit number: � (`�� --
<br /> �D�O PO Box 66 Date received: �J"��'1
<br /> Crystal Bay, MN 55323-0066
<br /> Escrow#and N�,�Y� ^1
<br /> Street Address: amount:
<br /> y � 2750 Kelley Parkway Permit Fee:
<br /> �, G� Orono, MN 55356 ^,._
<br /> � Approved by: v�r�n
<br /> �kFSH��� Fax: 952-249-4616 Notes:
<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 /> Job Site Address: ����' ��l� �7,/!�''j
<br /> CONTRACTOR/APPLICANT INFORMATION: ,
<br /> Name: ��l'�,�� 2� �s� �
<br /> Phone: `r"'S'� `f � �'7G� Fax: r� � �'Jc3
<br /> Address: i? �t, �����'% City: �XGt1S`i•� ZIP: SS��f
<br /> Contact Person: /ti � K� ��1/�j�/ ContacYs phone n er ��/Z �'G�3��7
<br /> Email M,r���„�;,;,��Applicant is: ontract Homeowner (CircleOne)
<br /> �
<br /> PROPERTY OWNER INF�R,,4�ATION:
<br /> Name: U�r1,�UC' �Jr�G S
<br /> Phone (day): (o�Z � L �� ',G 7/i�d _
<br /> MailingAddress: SU �✓ (�,�, +�G�I � ��b
<br /> Email and/or Fax `� 7�
<br /> Overall Project Description: �� ��.�J (,n.�.j�"'.c1L. / � �-'�� �[�( _
<br /> / .J
<br /> Check TYPE OF PERMIT
<br /> Box /�
<br /> Dock, Commercial �� ] �—j
<br /> Escrow for erosion control and en ineerin review costs �
<br /> Dock, Residential — Permanent dock on any lake or initial seasc
<br /> on Lake Minnetonka ermanent dock re uires CUP
<br /> Hardcover Permit: Driveway, Patio, Sidewalk, Etc. (New or f �50 ��S�"
<br /> �
<br /> Land Alteration, Major(grading, filling, or excavating) more 50 /'au (��^'—•- —
<br /> or more than 10 cubic yards in lakeshore setback (also requires y � r
<br /> Escrow for erosion control and en ineerin review costs
<br /> � Land Alteration, Minor(grading, filling or excavating)—500 or I��� „u.,,., w,,.,� .,��y�,,.,....,.� .__._.. ___._
<br /> yards 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
<br /> of wall) require a building permit. (Tiered retaining walls are considered one
<br /> wall 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 or Lifts 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 limited to accessory building
<br /> of 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 other ve etation removal in 0 to 75 foot zone No char e. Pre-inspection required.
<br /> Temporar Construction Office/Trailer associated with buildin permit) $30
<br /> (over)
<br /> *Permit fee will be collected when the permit is issued.
<br /> Updated: January 2014
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