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City of Orono <br /> Zoning Permit Application <br /> Mailing Address: Permit number: -40 3 <br /> PO Box 66 <br /> Crystal Bay, MN 55323-0066 Date received: /D -/ 7- / <br /> Escrow#and <br /> Street Address: amount: <br /> 2750 Kelley Parkway Permit Fee: <br /> y SI Orono, MN 55356 <br /> G <br /> � <br /> A r kES H O9� Fax: 952-249-4616 PP oved 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. (Please print.) <br /> Job Site Address: <br /> CONTRACTOR/APPLICANT INFORMATION: <br /> Name: 1F5 K a 6,V <br /> Phone: Z 44/ Fax: <br /> Address: 'i_n" (xD & R-h City: W4WAA ZIP: 5 S37j <br /> Contact Person: Contact's phone number 2 <br /> Email _7k�@V,*C#5r CSC Applicant is: Contractor eowne (Circle One) <br /> PROPERTY OWNER INFORMATION: <br /> Name: ffl+ LES IeA4:1 f <br /> Phone(day): 4551 V d <br /> Mailing Address: ZIP: .3 J <br /> Email and/or Fax <br /> Overall Project Description: <br /> Check <br /> TYPE OF PERMIT E <br /> collected whenpermit is issued <br /> Dock, Commercial $50+engineering review costs <br /> Escrow for erosion control and engineering 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(permanent dock requires CUP <br /> Hardcover Permit: Driveway, Patio,Sidewalk,etc. (New or Replacement) No charge <br /> Also re uires is a Minor or Major 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 /> [Reference: City Code Sections 78-967. 78-1247 and 78-12861 <br /> Escrow for erosion control and engineering review costs As determined by 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: City 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: City 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 separated by twice the height of the lower wall. <br /> Stairway or Lifts to Lake(New or Replacement) [Reference: City 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: City Code Section 86-661 <br /> Escrow for erosion control and engineering review costs $2,500 <br /> Tree Removal or other vegetation removal within 75 feet of lakes No charge. <br /> Reference: City Code Section 78-1285 Pre-inspection required. <br /> Temporary Construction Office/Trailer associated with building permit) $30 <br /> l55 uf-A ►ZOu aA.h i ,T` /^! L��� O� 4.A•� �4 t.T c.c.,r��sri Rs��M �.«// <br /> Updated: May 2015 fwlr^ _V <br />