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i 4 City of Orono Zoning Permit Application ,/ Mailing Address: Permit number: 420/ /� - co cli/-( �O� VO PO Box 66 Date received: (2 - '--/ (� Crystal Bay, MN 55323-0066 Escrow#and Street Address: amount: / 2750 Kelley Parkway y � Orono, MN 55356 Permit Fee: G t`9kESHO4� Fax: 952-249-4616 Approved by: Main: 952-249-4600 Notes: www.ci.orono.mn.us This application form must be completed in full and all required information must be submitted. (Please print.) Job Site Address: (Q LJ, (Q,SCU Sof N (` (24 0 10".J° P CONTRACTOR/AP ANTINFORyMAT : Name: roAA,. " e Phone: 02,- 114-NI Fax: Address: 3c 11 4JL>A/rci1 fi City: vig !Cir/ ZIP: `7� c-1 Contact Person: Contact's phone n r i i _ — , , - Email e,l�'Mfe an g p,.r cokapplicant is: ontracto Homeowner (` ircle One J a\- 6 PROPERTY OWNER INFORMATION: Name: i ; ,,t f C,c�,S "c ;+sa 1 Phone(day): '` i-;( - ' iG- 27 c( Mailing Address: 10 yci 6 c= <71.70 Fc)r r,v. c v�v a- ZIP: `:5 1 Email and/or Fax /l T Fit:,i.c� 1 ct, 1 .' 1., LOM Overall Project Description: ke-AA49 Jo 0/1)t - --1`t9._ t SA/A.1( e\1- A,e.)(f- VJ_SA, CBox FEE TYPE OF PERMIT vz �,�lite_ l2-f-ck 41 - collected when permit is issued Dock, Commercial $50+engineering review costs Escrow for erosion control and engineering review costs $2,000 Dock, Residential - Permanent dock on any lake or initial seasonal dock not on Lake $50+engineering review costs Minnetonka(permanent dock requires CUP) Hardcover Permit: Driveway, Patio,Sidewalk,etc.(New or Replacement) No charge Also requires is a Minor or Major Land Alteration Permit Land Alteration,Major(grading,filling,or excavating)of more than 500 cubic yards beyond $50 the lakeshore setback OR more than 50 cubic yards within the lakeshore setback (also requires Conditional Use Permit) (Reference: City Code Sections 78-967.78-1247 and 78-12861 Escrow for erosion control and engineering review costs As determined by CUP Land Alteration, Minor(grading, filling or excavating)of 51 to 500 cubic yards beyond the $50+engineering review costs lakeshore setback OR 50 cubic yards or less within the lakeshore setback (Reference: City Code Sections 78-967. 78-1247 and 78-12861 Escrow for erosion control and engineering review costs $2,000 Retaining Walls which exceed two feet in height above existing grade; or result in more $50+engineering review costs than 20 cubic yards of imported fill; or are located less than five feet from the property line. Escrow for erosion control and engineering review costs $2,500 (Reference: City Code Section 78-1405(5.1)1 Retaining Walls which measure more than four feet(from bottom of footings to top of wall) require a building permit.Tiered retaining walls are considered one wall unless the walls are separated by twice the height of the lower wall. Stairway or Lifts to Lake(New or Replacement) (Reference: City Code Sections 78-12821 $50+engineering review costs Escrow for erosion control and engineering review costs $2,000 Structure Permit for other structures 200 sf or less not requiring a building permit but $50+engineering review costs regulated by the zoning code(Reference: City Code Section 86.661 Escrow for erosion control and engineering review costs $2,500 Tree Removal or other vegetation removal within 75 feet of lakes No charge. x/ (Reference: City Code Section 78-12851 Pre-inspection required. Temporary Construction Office/Trailer(associated with building permit) $30 Updated: January 2017