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City of Orono <br /> Zoning Permit A lication <br /> Mailrng Address: ! Permit number. 2�l S ` � � � � <br /> �Q/�l PO Box 66 ���Date received: -� - L <br /> + �O Crystal Bay,MN 55323-0066 � �G C{ <br /> � Escrow#and � i�Q <br /> Street Address: amourit: �� '"����� �� ! $� <br /> 2750 Kelley Parkway <br /> \y ` Orono,MN 55356 � e�� . Qo d � � � <br /> �! � �,�' Approved by: I <br /> �xESH�� Fax: 952-249-4616 <br /> Main: 952-249-4600 Notes: � <br /> www.ci.orono.mn.us <br /> I - -- -- -- <br /> This application form must be completed in full and all required information must be submitted. (Please print.) <br /> Job Site Address: �l�'� � /`*�m IV12i✓d �/ZONl� MN <br /> CONTRACTOR/APPLICANT INFORMATION: <br /> Name: N� 2 0 �i�i�S <br /> Phone: �"52- 9�S - 2955- Fax: 2- 955-3 � <br /> Address: ��(7 (;9. %Ze( 2l City: /1/)p��� ZiP: 53(oD <br /> Contact Person: �e�h,�t M��1/B2 ContacYs phor�um �- <br /> Email /Ce,,%„� Nvenccmc�n��tCvf1�PP���nt is: ��G tQrtractor Homeowner (Circle One) <br /> PROPERTY OWNER INFORMATION: <br /> Name: - Q L 'f' <br /> Phone(day): __7_(�_ - � 0 _ <br /> Mailing Address: 2/S - /� , � fl� ZIP: 4 <br /> Email and/or Fax @ S <br /> Overall Project Description: �er2 ' �l�k� <br /> � CBoXk TYPE OF PERMIT collecfed whenE ermif is issued � <br /> j Dock,Commeroial S50+engineering review costs <br /> � Escrow for erosion control and en ineerin review costs $2 000 <br /> ; Dock, Residential - Permanent dock on any lake or initial seasonal dock not on Lake $50+engineering review costs <br /> � Minnetonka ermanent dock re wres CUP' <br /> ; Hardcover Permit:Driveway,Patio,Sidewalk,etc.(New or Replacement) No charge <br /> ' Also re uires is a Minor or Ma'or land Alteration Pertnit <br /> ; Land Alteration, Major (grading, fillirg, or excavating) of more than 500 cubic yards $50 <br /> � � beyond the lakeshore setback OR more than 50 cubic yards within the lakeshore setback p � <br /> (also requires Conditional Use Permitl �, 2Q� Q�(� c,SG�Z <br /> (Reference: Cifv Code Sectfons 78-967.78-1247 and 78-12861 �� <br /> Escrow for erosion control and engineering reviev��costs As detemined b CUP � � "' <br /> Land Alteration,Minor�grading, filling or excavating}of 51 to 500 cubic yards beyond tfie $50+engineenng review costs <br /> i lakeshore setback OR 50 cubic yards or less within the lakesho�e setback <br /> fReference: CNv Code Sections 75-967.78-1247 and 78-12861 � <br /> Escrow for eroslon control and engineering review costs � $2,ppp <br /> j Retaining Walls which exceed two feet in height above existing grade; or result in more $50+engineering review costs <br /> than 20 cubic yards of imported frll; or are located less!han five feet from the property line <br /> Escrow for erosion control and engineering review costs $2,500 <br /> [Re�erence: Cifv Code Section 78-1405(5.1)1 <br /> Retaining Walls which measure mora than four feet(from bottom of footings to top of wall) <br /> require a buildirg perznit. Tiered retaining walls are considered one wall unless the walls <br /> are se arated b hv�ce the hei ht of the lower wall. <br /> ' Stairway or Lifts to Lake{New or Replacement) !Re%rence: Ciiv Code Secfions 78-12821 $50+engineering review costs <br /> � Escrow for erosion controi and engineering review costs $2,040 <br /> ! Structure Permit for other strucfures 200 sf or less not requiring a building permit but $50+engineering review casts <br /> i regulated by the zoning code Leference: Citv Code Section a&ss1 <br /> � Escrow for erosion conVol and en ineerin review costs $2,500 <br /> i Tree Removal o�other vegetation removal within 75 feet of lakes No charge. <br /> ' R nce: C Code SecSo�78-1285 Pre-ins ecUon re uired. <br /> ° Tem ora Construction OfficelTrailer;associated with buildin rmit $30 <br /> Updated: May 2015 <br />