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PC Exhibit A <br /> • � . <br /> City of Orono , <br /> Conditional Use Permit or <br /> Other Land Use Permit Application <br /> StreetAddress: Application# � _ <br /> 2750 Kelley Parkway <br /> O��.�0 Orono,MN 55356 Date Received: //- - <br /> Staff: �/ <br /> Main: 952-249-4600 <br /> fax: 952-249-4616 Fee: 7�d, <br /> � � Mailing Address: EsCrow#&$ <br /> ti P.O.Box 66 <br /> � G~ Crystal Bay,MN 55323-0066 Permit Fee <br /> ��kEsHOg'� 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 /> JobSiteAddress: �9�� ���S�-X I�'� a�'//�- a3 �3 /- � � <br /> CONTRACTOR/APPLICANT INFORMATION: � <br /> Name: W I p o Ko w��5 <br /> Phone: ��Z- ��t(o - Ca-1 Fax: 52- 3 - <br /> Address: ►Sta2"3 ►vo;� t.,.K,h� Cit : V"�i�hc, ZIP: 53HS <br /> Contact Person: �:�1 � p4• Contact's phone num er to�Z.- 3qc�- (�'7 ZS� <br /> Email b�\\�w i po�nv++�.c5 •C ow� Applicant is: ontractor Homeowner (Circle One) <br /> PROPERTY OWNER INFORMATION: <br /> Name: 5�Sa� .� S�. �-�� �•e.l� <br /> Phone(day): (012. - 0`l- °I Blo <br /> Mailing Address: �p ur ZIP: S S 3 s co <br /> Email and/or Fax S H s�h C �'r�d n��i -ww.i a c��^'� <br /> Overall Project Description: �Pu b� �.-�oA-�� � 2r^-a` � -p�s" � � , � "�� <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 ori inal plan $350 NA <br /> * <br /> Residential Accesso Structure .� �k �r ^ C � S 700 $700 <br /> Check Box OTHER LAND USE APPLICATIONS A lication Fee Escrow <br /> Appeal 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 (ROIII�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 H 12 Corridor OnI —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- .NC?� 16 2012 <br /> , f <br /> .. �!`G'C"`�r P'iC e'l��vR��-., � �=;;' . <br />