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-y �, ��,� City of Orono
<br /> � � ��oning Permit Application
<br /> � � �
<br /> /� Mailing Address: Permit number: ��/p�—�/ /
<br /> .Q,� I1� " PO Box 66 Date received: �4�"����
<br /> �' �`V Crystal Bay, MN 55323-0066
<br /> Q � Q Escrow#and � � �� ,(� ���
<br /> ���'�" � Street Address: amount:
<br /> `� �� ��'a��J F 2750KeIleyParkway PermitFee: `�� -� �-T�-- �5� -_ ���(�
<br /> �c� y '' � Orono, MN 55356
<br /> ��k sH��G Approved by: �(�
<br /> Fax: 952-249-4616 Notes:
<br /> Main: 952-249-4600 �,�;•;,;; c, ar;n� r ��_�s
<br /> This application form must be completed in full and all required information must be submitted. (P/ease print.)
<br /> Job Site Address: �1..��1�.,�� � �,'1�� ��� ����;"Y� �����
<br /> CONTRACTOR I APPLICANT INFORMATION:
<br /> Name:
<br /> Phone: Fax:
<br /> Address: -� � Cit : ZIP:
<br /> Contact Person: ContacYs phone number
<br /> Email Applicant is: Contractor Homeowner �c���ie o�e�
<br /> PROPERTY OWNER INFORMATION:
<br /> Name: ��.��� '� 5/,0_l/��, 5.�, -IC
<br /> Phone (day): �� � � �; � � q;, 7Y
<br /> Mailing Address: �,v�� ��;,,�� y�,,� ��r ZIP:
<br /> Email and/or Fax rr,��, „ �,,,,, ,� �a VE>� ,��,�,;,, . � ,,,t
<br /> Overall Project Description: �-i, I,1�, ��l/
<br /> Check TYpE OF PERMIT
<br /> Box COST*
<br /> Dock, Residential— Permanent dock on any lake or initial seasonal dock not on $50 + engineering review costs
<br /> Lake Minnetonka permanent dock re uires CUP
<br /> Dock, Commercial $50+ engineering review costs
<br /> Escrow for erosion control and en ineerin review costs $2,000
<br /> Driveway Permit(New or Replacement) No charge
<br /> Also re uired is a Minor or Ma�or Land Alteration Permit
<br /> Land Alteration, Major(grading, filling, or excavating) more 500 cubic yards or $50
<br /> more than 10 cubic yards in lakeshore setback (also requires CUP)
<br /> Escrow for erosion control and en ineering review costs As determined b CUP
<br /> Land Alteration, Minor(grading, filling or excavating)—500 or less cubic yards $50+ engineering review costs � .
<br /> outside of lakeshore setback or less than 10 yards in lakeshore setback
<br /> Escrow for erosion control and en ineering review costs $2,000
<br /> Retaining Wall measuring under four feet require a zoning permit. $50+ engineering review costs
<br /> Retaining walls measuring more than four feet(from bottom of footings to top of
<br /> wall) require a building permit. (Tiered retaining walls are considered one wall
<br /> unless the walls are separated by twice the height of the lower wall.)
<br /> Escrow for erosion control and engineering review costs $2,500
<br /> Stairway to Lake (New or Replacement) $50+ engineering review costs
<br /> Escrow for erosion control and engineering review costs $2,000
<br /> Structure Permit for other structures not requiring a building permit but $50+ engineering review costs
<br /> regulated by the zoning code (including, but not limited to accessory building of
<br /> less than 120 square feet, detached deck or platform and sport court)
<br /> Escrow for erosion control and en ineerin review costs $2,500
<br /> Tree Removal or other ve etation removal in 0 to 75 foot zone No char e.
<br /> (over)
<br /> *Permit fee will be collected at
<br /> the time the permit is issued.
<br /> Updated: December 30,2011
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