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1��� <br /> , . r ���►.�� . �"� �,�\ <br /> . ' City of Orono �a��, ti " <br /> � <br /> Zoning Permit Application �� <br /> �,,—� Mailing Address: Permit number: o� d �� � Q 1 �C� <br /> � PO Box 66 <br /> r�O� �O Crystal Bay, MN 55323-0066 Date received: 2„ -Z3- /� <br /> ,, <br /> i; �; Escrow amount: --� <br /> I , �,�- .a Street Address: d � <br /> �'��'� � � e'� ti 2750 Kelley Parkway Permit Fee: �Q� -rj� � ,� '�'� �j�- <br /> `�t� � � ' p"� Orono, MN 55356 ( <br /> \. .� �� Approved by: � � � � �, � � '7-/ <br /> ��kESH�4 <br /> ��— Fax: 952-249-4616 Notes: �v <br /> Main: 952-249-4600 �W ci.orono.mn.us <br /> �J s r — ,v Ati. <br /> This application form must be completed in full and all required information must be submitted. (Please print.) <br /> GENERAL INFORMATION: _ � __ , � yL�� j j"3 4 � <br /> Job Site Address: �5 5 S �'�� � '� , � � �� � <br /> CONTRACTOR I APPL�ANT INFO MATIO : � <br /> Name: � c ��r �4{� � <br /> Phone: �s-L � - i► y S` Fax: ��s-z S�E S�`�� � <br /> Address: ' S 3 5� �v • Cit : U �u�u ZIP: ����� 3�� � <br /> Contact Person: '��, I-� ���; �, Contact's phone number S�"t - i-{"f i - j �`1 S- <br /> Email r�h,; �; I (y e Applicant is: Contractor Homeowner (Circle One) <br /> PROPERTY OWNER INFORMATI N: <br /> Name: i� 1-� �' `��?� � <br /> Phone (day): g�t - �� � - i i H S� <br /> Mailing Address: �,S" 3S ��...� I � �,i-��� ��r� S � '�`i � ZIP: ��s"'�� � <br /> Email and/or Fax ,�h�. {, � (� c��,.r.t-�, 1;•�k- ►�k/' � <br /> Overall Project Description: <br /> Check TYPE OF PERMIT COST <br /> Box <br /> Residential Dock- Permanent dock on any lake or initial seasonal dock not on $30 + engineering review <br /> Lake Minnetonka ermanent dock re uires CUP costs <br /> Commercial Dock $50+ engineering review <br /> costs <br /> Escrow for erosion control and en ineerin review costs $2,000 <br /> Minor Land Alteration (grading, filling or excavating)-500 or less cubic yards $50+ engineering review <br /> outside of lakeshore setback or less than 10 yards in lakeshore setback costs <br /> Escrow for erosion control and en ineerin review costs $2,000 <br /> Major Land Alteration (grading, filling, or excavating) more 500 cubic yards or $30 <br /> more than 10 cubic yards in lakeshore setback (also requires CUP) <br /> scrow for erosion control and en ineerin review costs As determined b CUP <br /> Stairway to Lake $50+ engineering review <br /> costs <br /> Escrow for erosion control and en ineerin review costs $2,000 <br /> Retaining Wall not requiring a building permit(A building permit is required for any $50+ engineering review <br /> retaining wall that measures more than four feet from bottom of footings to top of costs <br /> wall. Tiered retaining walls are considered one wall unless the walls are separated <br /> by twice the height of the lower wall.) <br /> Escrow for erosion control and en ineerin review costs $2,500 <br /> Tree Removal or intensive ve etation removal in 0 to 75 foot zone No char e. <br /> Structure Permit for other structures not requiring a building permit but regulated $50+ engineering review <br /> by the zoning code (including, but not limited to accessory building of less than 120 costs <br /> square feet, detached deck or platform and sport court) <br /> Escrow for erosion control and en ineerin review costs $2,500 <br /> (over) <br />