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, <br /> � City of Orono <br /> Zoning Permit Application <br /> ` Z�tS -O1 �l <br /> O Mailing Address: Permit number: <br /> � � PO Box 66 Date received: �I � � <br /> O Crystal Bay, MN 55323-0066 <br /> Escrow#and ,n <br /> Street Address: amount: 1� <br /> � � 2750 Kelley Parkway <br /> y ; Orono, MN 55356 Permit Fee: <br /> F �, <br /> `�kFSHOR� Fax: 952-249-4616 Approved by: <br /> Main: 952-249-4600 Notes: <br /> www.ci.orono.mn.us i �,�5 � � _ �3 .�c.� <br /> This application form must be completed in full and all required information must be submitted. (Please print.) <br /> Job Site Address: ���� V��I`�' � J�}�.� �JV� <br /> CONTRACTOR/APPLI A�NF��OR`MATION�� <br /> Name: 1� <br /> Phone: (�I� � 3LS - `6'8'S 9 Fax: <br /> Address: LO LiY�WI Vl iYc- Cit : CCl i ZIP: <br /> Contact Persorr: �Y� 0`CdYlnoi'' ContacYs phone number <br /> Email j j m (��-y���y-�R� �pyy� Applicant is: ontracto Homeowner (Circle One) <br /> PROPERTY OWNER INFORMATION: "� <br /> Name: jkm, (' q,YtO� �Vll-Pjy ��.�I.�JU <br /> Phone(day): 2„ -;3(3� • � a <br /> Mailing Address: Z(p L5 N 0(`W't Slrl�rL ziP: 553a l <br /> Email and/or Fax <br /> Overall Project Description: _�7� � (,(����,(,� �,��Q <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 $50 <br /> beyond the lakeshore setback OR more than 50 cubic yards within the lakeshore setback <br /> (also requires Conditional Use Permit) <br /> fReference: 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 /> (Reference: 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 /> (Reference: 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 �� <br /> are se arated b twice the hei ht of the lower wall. � 1,� <br /> Stairway or Lifts to Lake(New or Replacement) �Reference: Citv Code Sections 78-12821 $50 +engineering review co ts <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 revie costs <br /> � regulated by the zoning code lReference: Citv Code Section 86-661 �J/ A �y��,p� <br /> Escrow for erosion control and en ineerin review costs $2,500 �� �'I� <br /> Tree Removal or other vegetation removal within 75 feet of lakes No charge. <br /> Reference: Cit Code Section 78-1285 Pre-inSpeCtiOn required. <br /> Tem orar Construction Office/Trailer associated with buildin ermit $30 <br /> Updated: May 2015 <br />