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. . . � Zoning Permit Ap lication � Mailing Address: Permit number: 02 0 I a' Od 9 �Q A�\\ PO Box 66 Date received: 9 �O /2i �� `V Crystal Bay,MN 55323-0066 �� Q ,� Q��',, Escrow#and i� § '�" `�'; StreetAddress: amount: '��'� � Z�,C,'��x~- �Ji 2750 Kelley Parkway Permit Fee: \\�,,��' ' �,�`y'��, p� Orono, MN 55356 \.�.�gH�g� Approved by: � ___ Fax: 952-249-4616 Notes: Main: 952-249-4600 '��'N.ci.orono.mn_us This application form must be completed in full and all required information must be submitted. (P/ease print.) Job Site Address: �05 1 �-1 �ah 1 c,c�d2 t�a�..Gl CONTRACTOR/APPUCANT INFORMAT(ON: Name: �.c n�znt l.�z�c,R ��.;.,� «�a Phone: �_- H �I� Fax: �i.�� H 7� H 1 I 4 Address: 3��3 c-,asT Lane.. City: Mo,. ��2 ZIP: ��-3Ly Contact Person: ,�;,n 7r,� � ContacYs phone number g5 a y 7�. .� �S� Email �h�,.,,.,��t��0;� ��' ' �.}��c Applicantis: Contractor Homeowner (CircleOne) m.`-t • �v�..-'t PROPERTY OWNER INFORMATION: Name: �, �� L�_3� Phone(day): - Mailing Address: .y CS � I--1 ,a h..,:,��._ c��,ti.o ZIP: _;5 3�y Email and/or Fax r c �-s c� i a a C-' �g�L . �:�,�� Overall Project Description: R2 Qk4„t�,�.n�� .s�tc�.rs -!n G.ak� —� Check TYpE OF PERMIT Box COST* � Dock, Residential—Permanent dock on any lake or initial seasonal dock not on $50 +engineering review costs Lake Minnetonka ermanent dock re uires CUP) Dock,Commerciaf $50+engineering review costs Escrow for erosion control and en ineerin review costs $2,000 Driveway Permit(New or Replacement) No charge Atso re uired is a Minor or Ma�or Land Alteration Permit Land A(teration, Major(grading, filling, or excavating)more 500 cubic yards or $50 more than 10 cubic yards in lakeshore setback(also requires CUP) i Escrow for erosion control and en ineerin review costs As determined b CUP Land Alteration, Minor(grading,filling or excavating)—500 or less cubic yards $50+engineering review costs outside of lakeshore setback or less than 10 yards in lakeshore setback Escrow for erosion control and engineerin review cosis $2,000 Retaining Wall measuring under four feet require a zoning permit. $50+engineering review costs Retaining walls measuring more than four feet(from bottom of footings to top of ! wall)require a building permit. (Tiered retaining walls are considered one wall unless the walls are separated by twice the height of the lower wall.) Escrow for erosion control and en ineerin review costs $2,500 XStairway to Lake(New or Replacement) $50+engineering review costs Escrow for erosion control and engineering review costs $2,000 � Structure Permit for other structures not requiring a building permit but $50+engineering review costs regulated by the zoning code(including, but not limited to accessory building of less than 120 square feet, detached deck or platform and sport cou�t} Escrow for erosion control and en ineerin review costs $2,500 Tree Removal or other ve etation removal in 0 to 75 foot zone No char e. (over) *Permit fee will be collected at the time the permit is issued. Updated: December 30.201 t