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City of Orono <br /> Zoning Permit Application <br /> O Mailing Address: Permit number: � "' L/� /�� <br /> A �O PO Box 66 Date received: 9—�f� <br /> 1' Crystal Bay, MN 55323-0066 <br /> Escrow#and `�?�"� �'�C� G��x '�-� ��� '"L'�� � <br /> Street Address: amount: <br /> 2750 Kelley Parkway <br /> y � Orono, MN 55356 Permit Fee: � � -�� ���� <br /> F <br /> � �,�' Approved by: ` .. <br /> �k�SHo� Fax: 952-249-4616 �"t 2�i1'`"n <br /> Main: 952-249-4600 Notes: <br /> www.ci.orono.mn.us ? �c��t c <br /> �� _ � � � � 11�" . � ��'�C-K � <br /> This application form must be completed in full and all required in rmation must be submitted. (Plea e print.) <br /> Job Site Address: ��'S �Gt.��/(tW Pa-r(G�.�1cz�ca <br /> CONTRACTOR/APPLICANT INFORMATION: <br /> Name: /�Or� �S �,,�...L <br /> Phone: -j Fax: (03- -�{ <br /> Address: a--� ^ -�r.� ,� Cit : ZIP: ,SSY <br /> Contact Person: � ����`.�� Contact's phone number /�-S�/C,�-q8� <br /> Email �j��'��ho,r-�y,�yn�S,��Applicant is: Contractor omeown r�(Circle One) <br /> � <br /> PROPERTY OWNER INFORMATION: � <br /> Name: /Ja��'c�. �ne�' L LG <br /> Phone (day): � <br /> Mailing Address: $T"'1- � /V cS' / ZIP: S$ '� <br /> Email and/or Fax W P . C <br /> Overall Project Description: � �/ - �c� <br /> CBoXk TYPE OF PERMIT collected whenE ermit is issued <br /> Dock, Commercial $50 +engineering review costs <br /> Escrow for erosion control and en ineering 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 (permanent dock requires CUP) <br /> Hardcover Permit: Driveway, Patio, Sidewalk, etc. (New or Replacement) No charge <br /> Also requires is a Minor or Major Land Alteration Permit <br /> Land Alteration, Major (grading, filling, or excavating) of more than 500 cubic yards $50 <br /> beyond the lakeshore setback OR more than 50 cubic yards within the lakeshore setback <br /> (also requires Conditional Use Permit) <br /> (Reference: Citv Code Sections 78-967, 78-1247 and 78-1286) <br /> Escrow for erosion control and engineering review costs As determined b CUP <br /> Land Alteration, Minor(grading, filling or excavating)of 51 to 500 cubic yards beyond the $50 +engineering review costs <br /> + � lakeshore setback OR 50 cubic yards or less within the lakeshore setback <br /> X (Reference: Ciry Code Sections 78-967, 78-1247 and 78-1286] <br /> Escrow for erosion control and engineering review costs $2,000 <br /> 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 fill; or are located less than five feet from the property line. <br /> Escrow for erosion control and engineering review costs $2,500 <br /> (Reference: Citv Code Section 78-1405(5.1)1 <br /> Retaining Walls which measure more than four feet(from bottom of footings to top of wall) <br /> require a building permit. Tiered retaining walls are considered one wall unless the walls <br /> are se arated b twice the hei ht of the lower wall. <br /> Stairway or Lifts to Lake (New or Replacement) [Reference: Citv Code Sections 78-12821 $50+engineering review costs <br /> Escrow for erosion control and engineering review costs $2,000 <br /> Structure Permit for other structures 200 sf or less not requiring a building permit but $50 +engineering review costs <br /> regulated by the zoning code �Reference: Citv Code Section 86-661 <br /> Escrow for erosion control and engineering review costs $2,500 <br /> Tree Removal or other vegetation removal within 75 feet of lakes No charge. <br /> (Reference: City Code Section 78-1285] Pre-inspection required. <br /> Tempora Construction Office/Trailer associated with buildin permit $30 <br /> `""G��WC.)�J0.7F�C/ ` `--YI�C.A � �� VO�' `r�� �/�' )L � �� � �7�O V <br /> � ///��� �v <br /> Updated: May 2015 �' �1'^ /n' ���,�1��,�^ ' � <br /> Vc�r � lv� C yP 1�y <br /> �.. <br />