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� <br /> � � " . v � City of Orono o � <br /> . . . . �'J`C'!'?� ��itlyf•� � !O-q0'!/� <br /> Zoning Permit Appl�catio <br /> Mailing Address: Permit number: V�/�• �Q <br /> O�O.�O PO Box 66 t� <br /> Crystal Bay, MN 55323-0066 Date receiv�i: : v� � <br /> ,yr �scrow amount: GT��oa <br /> �, Street Address: <br /> �� �ti�' 2750 Kelley Parkway Permifi Fee: ��0. � --- <br /> �9x�H�g�' Orono, MN 55356 <br /> Received by: �� <br /> Main: 952-249-4600 Fax: 952-249-4616 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 /> GENERAL INFORMATION: 'AA 1 <br /> Job Site Address: ��0� YV`�llst�� �Z.q�l�I <br /> CONTRACTOR/APPLICANT INFORMATION: <br /> Name: r O i,/�� �h C. ' <br /> Phone: - - F�: _ � <br /> Address: 1 t Kh� �,,� Cit : ZIP: <br /> Contact Person: G ContacYs phone number (QLL-3Z�-LLG�2. <br /> Email ,Se,� � , r,prv�P►pplicant is: ontractor Homeowner (Circle One) <br /> PROPERTY OWNER IN qRMATION: <br /> Name: e v�, r ��� <br /> Phone (day): a(�a- 1(0- "� <br /> Mailing Address: (tflD IA�.►t Sr�-��►n , f�►no Z�P: L1� 1 <br /> Email and/or Fax ,b�,iw���hG � qp i. �b,M• <br /> Overall Project Description: ����G �d ��� eX�S,�-�� �S�r.�. <br /> a{r1 Vcu�a� a.,�( �on��C'f'� cvr�� ' . <br /> � <br /> Check TYpE OF PERMIT COST <br /> Box <br /> Residential Dock-Permanent dock on any lake or initial seasonal dock not on $30 + engineering review <br /> Lake Minnetonka ermanent dock re uires CUP costs <br /> Commercial Dock $50+engineering review <br /> costs <br /> Escrow for erosion control and en ineerin review costs $2,000 <br /> Minor Land Alteration (grading,filling or excavating) -500 or less cubic yards $50+engineering review <br /> outside of lakeshore setback or less than 10 yards in lakeshore setback costs <br /> Escrow for erosion control and en ineerin review costs $2,000 <br /> Major Land Alteration (grading,filling, or excavating) more 500 cubic yards or $30 <br /> more than 10 cubic yards in lakeshore setback (also requires CUP) <br /> Escrow for erosion control and en ineerin review costs As determined b CUP <br /> Stairway to Lake $50+ engineering review <br /> costs <br /> Escrow for erosion control and en ineerin review costs $2,000 <br /> Retaining Wall not requiring a building permit (A building permit is required for any $50+ engineering review <br /> retaining wall that measures more than four feet from bottom of footings to top of costs <br /> wall. Tiered retaining walls are considered one wall unless the walls are separated <br /> by twice the height of the lower wall.) <br /> Escrow for erosion control and en ineerin review costs $2,500 <br /> Tree Removal or intensive ve etation removal in 0 to 75 foot zone No char e. <br /> Structure Permit for other structures not requiring a building permit but regulated $50+engineering review <br /> by the zoning code (including, but not limited to accessory building of less than 120 costs <br /> square feet, detached deck or platform and sport court) <br /> Escrow for erosion control and en ineerin review costs $2,500 <br /> (over) <br />