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� City of Orono <br /> Zoning Permit A lication <br /> Mailing Address: Permit number: ����Q <br /> - � � PO Box 66 _ � � <br /> ' � O Crystal Bay, MN 55323-0066 Date received: ��� <br /> Escrow#and ' v;�` <br /> Street Address: amount: `,�`` <br /> �, 2750 Kelley Parkway permit Fee: <br /> y � Orono, MN 55356 �,%� <br /> F � <br /> lqkESHO�� Fax: 952-249-4616 Approvedby: <br /> Main: 952-249-4600 Notes: <br /> �:vVJbN CI.orOnO ITlll US <br /> This application form must be completed in full and all required information must be subrnitted. (Please print.) <br /> Job Site Address: �+ �:. �J (,-1�ndal� LOVp La'1 , L7 v27nU � rY►/l.� ��3��v <br /> CONTRACTOR/APPLICANT INFORMATION: <br /> Name: �`(�v�� -1At,D�\G C c:uv���� �S L_i_-L <br /> Phone: (��„-������ Fax: <br /> Address: r� Ci : � ZIP: <br /> Contact Person: r ContacYs phone number �i L ���, _3y�_3 <br /> Email �,���Y� �;L a G.�1�4 Applicant is: Atr�"�o Homeowner �c�►���o�e� <br /> PROPERTY OWNER INFORMATION; . <br /> Name: ��t%�u��i� ���c�✓ <br /> Phone(day): �j5� - g.=/� -g,iy3 <br /> Mailing Address: Z3�5 ��ln�lu-ec (�✓e U'� �j����� �H,� ZIP: SS�S;6 <br /> Email and/or Fax �� �U � ,,u2 f�e..�C� �l r�a r�I , r v v►y' <br /> Overall Project Description: C vrt Lre �►-� �xr fr c��'� ��Q.G(.,� �G�,Q,Q <br /> CYlof �yc.cu:�� <br /> Check NpE OF PERMIT <br /> Box fJ <br /> Dock, Commercial v � sts <br /> Escrow for erosion control and en ineeri review costs �1� `�/�_���� <br /> Dock, Residential-Permanent dock on ny lake or initial seasonal dock nc osts <br /> on Lake Minnetonka ermanent dock re uires CUP <br /> Hardcover Permit: Driveway, Patio,Sidewalk, etc.(New or Replacement) No charge <br /> Also requires is a Mlnor or Major <br /> Land Alteration Permlt <br /> Land Alteration, Major(grading, filling, or excavating) more 500 cubic yards $50 <br /> or more than 10 cubic yards in lakeshore setback (also requires CUP) <br /> Escrow for erosion control and en ineerin review c�osts ' a determined b CUP <br /> Land Alteration, Minor(g�ding, f���^^ -- - ,0+ engineering review costs <br /> yards outside of lakeshore setbac Z�,IGJ <br /> Escrow for erosion control and ei 5 � ,000 <br /> Retaining Wall measuring under 1 O� �f,�l� �+ engineering review costs <br /> Retaining walls mea�uring more th ���,�/ � Gy <br /> of wall) require a b�ding permit. ( L �- <br /> wall unless the w s are separated ��/►��.��' .�t�'1�7 <br /> Escrow for ero on control and enc I '� i00 <br /> Stairway or L' to Lake(New or ,.,�/� + engineering review costs <br /> Escrow for osion control and eng ��Qu� �'�-�` ' i00 <br /> Structure ermit for other structur � _ ` � engineering review costs <br /> regulated by the zoning code(incluc � ���� <br /> of less than 120 square feet, detach v��� <br /> Escrow for erosion control and en i )0 <br /> Tres Removal or other ve etation iar e. Pre-inspection re uired. <br /> Tem ra Co»struction OtficeJTr: <br /> __ Y������e� when the permit is issued. <br /> ,_ _ . <br /> Updated: January 2015 <br />