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� � � City of Orono
<br /> Zoning Permit Application
<br /> Mailing Address: Permit number: —1 - �,; � - �-
<br /> �,Q� PO Box 66
<br /> O Crystal Bay, MN 55323-0066 Date received: Z �'1
<br /> Escrow#and
<br /> Street Address: amount: �"
<br /> � � 2750 Kelley Parkway Permit Fee: '
<br /> y ` Orono, MN 55356
<br /> F �,
<br /> `qkf S H O�� Fax: 952-249-4616 Approved by:
<br /> Main: 952-249-4600 Notes:
<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: 3 f2� C ts�o C:i 5
<br /> CONTRACTOR/APPLICANT INFORMATION:
<br /> Name: Fi«�hbew 'T.-,r,e.rc CE.�.�, L+.�►�c�sE�on.�
<br /> Phone: �,�?_ 3c,c� -�3c.-1 Fax:
<br /> Address: __IIS�� �c-"CF� D. Ciry: fh.,,,,�}a,,� ZIP: s53�iS
<br /> Contact Person: �,� L�,„dsf� ContacYs phone number Grz• 3�c, - 73�"l
<br /> Email E l.,.rds�r.-o�^ � �,.,6�wf��c.r� Applicant is: cto Homeowner (Circle One)
<br /> . c.n
<br /> PROPERTY OWNER INFORMATION:
<br /> Name: I�o„ 7 ublt�
<br /> Phone(day): �c�- y-t� - o�Z$
<br /> MailingAddress: 3�zY C.,.,�o C.�, _,. ZIP: 5S3a�
<br /> Email and/or Fax
<br /> Overall Project Description: T�.�� (-��,,.,o�l o� 54,.�.,., �,,,w��.l "jr.�
<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 (atso
<br /> requires Conditional Use Permit)
<br /> lReference: 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) lReference: 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 en ineerin review costs $2,500
<br /> � Tree Removal or other vegetation removal within 75 feet of lakes No charge.
<br /> Reference: Cit Code Section 78-1285 PYe-inspection required.
<br /> Temporar Construction Office/Trailer associated with buildin permit $30
<br /> Updated: January 2017
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