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. � City of Orono <br /> Zoning Permit Application <br /> Mailing Address: Permit number: c�l-� � �� - , <br /> ���0 PO Box 66 Date received: — "� <br /> Crystal Bay, MN 55323-0066 � <br /> Escrow#and (�(1�'l� I�l� 1'�1� �3q <br /> Street Address: amount: �)��G LC' ��-(, �� ;�r� -,� ��,; <br /> � � 2750 Kelley Parkway Permit Fee: � �C-'�% <br /> y ` Orono, MN 55356 <br /> F G _. -1 <br /> `�k@S}�p��' Fax: 952-249-4616 Approvedby: `^�,l". <br /> Main: 952-249-4600 Notes i �� <br /> www.ci.orono.mn.us <br /> This application form must be completed in full and all required information must be submitted. (P/ease print.) <br /> Job Site Address: �,� G ���'G f �V� <br /> CONTRACTOR/APPLICANT INFORMATION: <br /> Name: <br /> Phone: S2 �-1 ^ bZ,� Fax: <br /> Address: � Cit : ZIP: <br /> Contact Person: � ContacYs phone number �,�� <br /> Email p, � j�� her�ir,aS•t"1�4— Applicant is: Contract Homeowner (Circle One) <br /> PROPERTY OWNER INFORMATION: <br /> Name: �(4 S�(Q,� <br /> Phone(day): <br /> Mailing Address: 2�}S"� -}�,�.,���n«L ZIP: <br /> Email and/or Fax ��5�nDL.E 12� yr��•�ow1 <br /> Overall Project Description: �����.{.���,,�^ �,�r yy��(;S;�a� <br /> CBoXk TYPE OF PERMIT collected whenE ermit is issued <br /> Dock, Commercial $50+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 uires 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 Permit <br /> Land Alteration,Major(grading,filling,or excavating)of more than 500 cubic yards beyond $50 <br /> the lakeshore setback OR more than 50 cubic yards within the lakeshore setback (also <br /> requires Conditional Use Permit) <br /> (Reference: Citv Code Sections 78-967,78-1247 and 78-12861 <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 /> � lReference: Citv Code Sections 78-967.78-1247 and 78-12861 <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 /> lReference: 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 are <br /> 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 engineerin review costs $2,500 <br /> Tree Removal or other vegetation removal within 75 feet of lakes No charge. <br /> (Reference: Citv Code Section 78-12851 Pre-inspection required. <br /> Tem ora Construction Office/Trailer associated with buildin ermit $30 <br /> Updated: January 2017 <br />