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<br /> Zor� g Permit A lication
<br /> A��,,s_ Permit number. /�—"ODb �
<br /> y 9t"6� Date received: ���7�7
<br /> , Ktal Bay,MN 55323-0066
<br /> � ' Escrow#and
<br /> t �et Address: amount:
<br /> 2750 Kelley Paricway Pertnit Fee:
<br /> O N C. Orono,MN 55356
<br /> � APProved bY;
<br /> � F� 952 249-4616 Notes:
<br /> pAain: 952-249-4600 ! .
<br /> �ww.ci.orono.mn.us
<br /> �,�n fam must be completed in full and all required information must be submitted. (P/ease print)
<br /> • �vC.ZO N.�A< e'<-}7't' /� .��- �j��f
<br /> /APPUCANTINFORM ON:
<br /> �L.O=£G-. G: ' 7•C 7�/G l`�J
<br /> 6� ,o Fax:
<br /> �;zsis` v�"'� sr � City: ��o,., ZIP: 53on_�
<br /> �ontact Nerson: ,��„� �/.,,,,,-,,,cn,:� Contact's phone number 6�i— �;��s -,��;-��
<br /> Email �s�/<.%�`�.4'�L'j ���,a,u,.�C1•A�i(?L1kT�lr#�•�;.�Applicantis: `ontractor Homeowner (CircleOne)
<br /> PROPERTY OWNER INF RMATION;,f- , �`�� K�Y►n��an � 1 and.5c�e►zvlcNah�o►�'`'°1'.'
<br /> Name: S�; .� ��. ,: �L
<br /> Phone(day): =, �
<br /> Mailing Address: Z1P: _ "o
<br /> Email and/or Fax �1„ ��A i ' 1 �1 G��L . � ��^^
<br /> OverallProjectDescription: �.��-,, ,c- � ��K �: �,-r'ft �r'.e�cf;,,�.aC.. /.��.7.acc- .(�' .�•�,�o,ec�..c.,�G-
<br /> CBoxk TYPE OF PERMIT collecfed whenEE rmit is issued
<br /> Dock,Commercial $50+engineering review costs
<br /> Escrow for erosion control and en ineerin review costs $2 000
<br /> Dock, Resider�tia! — Permanent dodc on any lake or ini6al seasonal dodc not on Lake $50+engir�ering review costs
<br /> Minnetonka ermanent dodc uires CUP
<br /> Hardcover Permit:Driveway,Patio,Sidewalk,etc.(New or Replacement) No charge
<br /> Also uires ia a Minor or Ma or Land Alberation Permit
<br /> Land Akeration, Wajor (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 /> lReferer►ce: CHv Code Sectlons 7&967.7&1247 and 7&1286I
<br /> Escrow for erosion control and engineering review costs As debermined b CUP
<br /> Land Alteration,Minor(grading,fillir�or excavating)of 51 to 500 cubic yarcls beyond the $50+engineering review costs
<br /> lakeshore setbadc OR 50 cubic yarcls or less within the lakeshore setback
<br /> IReference: CJtv Code Sectlons 7&967.78-1247 and 7&12861
<br /> Escrow for erosion coMrol and engineering review costs $2 000
<br /> Retaining Walls which exceed iwo 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 revievv costs $2,500
<br /> /Re%rence: Ckv Code Section 78-1405f5.111
<br /> Retafning Walls which measure more than four feet(from bottom of footings to top of wall)
<br /> require a building permi� 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) lReference: Cm+Code Secvons 7&12821 $50+engineering review costs
<br /> Escrow for erosion control and engineering revlew 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 oode fReference: Cfev Code SectJon 8�661
<br /> Escrow for erosion control and en ineerin review costs $2 500
<br /> / Tree Removal or other vegetetion removal within 75 fieet of lakes No charge.
<br /> Z� nce: 8- Pre-ins ection re uired.
<br /> Tem ora Construction OfficelTrailer associated with buildin rmit $30
<br />
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