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City of Orono
<br /> Zoning Permit A lication
<br /> MailingAddress: Permit number: "�� 7 � (i� ����
<br /> �Q� PO Box 66
<br /> O Crystal Bay, MN 55323-0066 Date received: - Z-% -7
<br /> Escrow#and In/� I � �-%
<br /> Street Address: amount: �� �' t w� `� �- �SY����`,YY� • �
<br /> � � 2750 Kelley Parkway
<br /> y� � Orono, MN 55356 Permit Fee: f�0
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<br /> t�KESHO�� Fax: 952-249-4616 Approved by:
<br /> Main: 952-249-4600 Notes:
<br /> www.ci.orono.mn.us �� ..�--�,_ �_l--1
<br /> This application form must be completed in full and all required information must be submitted. (Please prinf.)
<br /> Job Site Address: �„��, `'�,,�,;�,��j-rt �, � /� ,.
<br /> CONTRACTOR/APPLICANT INFORMATI�OjN:
<br /> Name: �.� -� ,��= �. /\4n • �F�!C ^J' .it)�'
<br /> Phone: �s i - '7 . -oo;� Fax:
<br /> Address: �S�c <�n"c Sr. �S� City:,�c s- , ZIP� ��.>n i
<br /> Contact Person: �„� ,�/,,.,,-�,�,,,,, ContacYs phone number �S�j- ?5�� -�Q�;�
<br /> Email �;,..�,,:�,y,., � L,��,,, , .,,,_,J,,,«,a� Applicant is: ont� Homeowner (Circle One)
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<br /> PROPERTY OWNER INFORMATIONl• /
<br /> Name: �c r_�-�, /��,�.L.��,_. ,„
<br /> Phone(day): �i z � 75'� - ��,;i
<br /> Mailing Address: i„Z�O /3.z-��x�-rs�s /`o.�� Kc� o ZIP� t'j'y 3q /
<br /> Email and/or Fax .�,�>,.� � �;�c? .Q�.�,�.
<br /> Overall Project Description: N - .� ,vas ,� ,.,���- � , � 2� ,�•r •�
<br /> Check TYPE OF PERMIT FEE
<br /> Box collected when 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 Pertnit
<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 /> fReference: Citv Code Sectlons 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 /> j� lReference: Citv Code Sections 78-967.78-1247 and 78-l2861
<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 ftom the property line.
<br /> )C, Escrow for erosion control and engineering review costs $2,500
<br /> fReference: Citv Code Section 78-1405/5.1)1
<br /> Retafning 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) fReference: 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 lReference: C;tv Code Section 86-s61
<br /> Escrow for erosion control and en ineerin review costs $2 500
<br /> Tree Removal or other vegetation removal within 75 feet of lakes No charge.
<br /> Reference: Ci Code Section 78-1285 Pre-ins ection re uired.
<br /> Tem ora Construction Office/Trailer associated with buildin ermit $30
<br /> Updated: January 2017
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