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� . � . , , city of or�no <br /> Zoning Permit Applicat�on <br /> �O� Mailing Address: <br /> Permit number: � —U d <br /> PO Box 66 Date received: �(� Z "� <br /> � Crystal Bay, MN 55323-0066 Escrow#and <br /> Street Address: amount: ���3 ' ��b�7 �00� �� <br /> � �., 2750 Kelley Parkway Permit Fee: <br /> yF � � Orono, MN 55356 � ���` �'� <br /> f �' Approved by: <br /> qKEs H��� Fax: 952-249-4616 Notes: <br /> Main: 952-249-4600 - <br /> This application form must be completed in full and ail required information must be submitted. (Please print.) <br /> Job Site Address: • <br /> ��J No►�I'h Sl�t�� fi�✓iV'� <br /> CONTRACTOR/APPLICANT INFORMATION: <br /> Name: , � e,K <br /> Phone: - 3 F�+ ,3 <br /> Address: p Cit � ZIP: ,3 <br /> Contact Person: S�y�p as a6e�Q Contact's phone n er _ ^., <br /> Email r Applicant is: ontractor Homeowner (Circle One) <br /> `T �00. C or� <br /> PROPERTY OWNER INFORMATION: <br /> Name: ,v,t <br /> Phone (day): <br /> Mailing Address: ZIP: <br /> Emaii and/or Fax �p P�,�L� <br /> Overall Project Description: <br /> Check TYPE OF PERMIT COST* <br /> Box <br /> Dock, Residential — Permanent dock on any lake or initial seasonal dock not on $50 + engineering review costs <br /> Lake Minnetonka ermanent dock re uires CUP <br /> Dock, Commercial $50+engineering review costs <br /> Escrow for erosion control and en ineerin review costs $2,000 <br /> Hardcover Permit: Driveway, Patio, Sidewalk, Etc. (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�xcavating) more 500 c�ibic y�rJs or $50 <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 /> � Land Alteration, 11�or(grading, filfing 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 ineerin 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 en ineerin 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 /> Tem ora Construction Office/Trailer associated with buildir ermit $30 <br /> (over) <br /> *Permit fee will be collected when the permit is issued. <br /> Updated: November 30,2012 <br />