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• <br /> City of Orono <br /> 1101\ Zoning Permit Application <br /> Permit number: 020// "' D 13(0 0 <br /> Mailing Address: <br /> PO Box 66 Date received: iD`3/-'// <br /> Crystal Bay, MN 55323 0066Escrow#and rum • <br /> Y(---‘,07:4 <br /> ^,, 0 amount: zo c f— d <br /> Street Address: / <br /> � , c� ' '� 2750 Kelley Parkway Permit Fee: C�((-- �6L{ �Ub <br /> 2, 1���%d ti Orono, MN 55356 <br /> 1 'r P1 Approved <br /> ,�i `. PP by: <br /> Es8�8 Fax: 952-249-4616 Notes: <br /> Main: 952-249-4600 www.ci.orono.mn.us <br /> ea_ti w Kai 44:tt—4-t 1 <br /> This application form must be completed in full and all required information must be submitted. (Please print.) <br /> GENERAL INFORMATION: /2 <br /> I �7 <br /> Job Site Address: ?5 - = ao ifr- si2/Z c/ ` ,d. ( 404/1)t fV .5�$3 <br /> CONTRACTOR/APPLI NT INF�� ATION: <br /> Name: CC, - ` ���ziA <br /> Phone: 95;2 4/077"-C/t1 ( Fax: '7'5 - Ocf._ 222 <br /> Address: g'5:....,-5:',0'40 Ci s141 ,, /6) City: l /i3.t rD IP: _`_ <br /> Contact Person: cr�T ,'vc, Contact's phone number <br /> Email ScoVkin Q wAVS inc.,uprn Applicant is: Contractor (Homeowner (c role One) <br /> PROPERTY OWNER IMATION• <br /> Name: c /77/tbr ' <br /> Phone(day): e ,.5-..92- 0of"D4 97 <br /> Mailing Address: ,4 & a/2 / / f,,y‹ /I* ZIP: �57�' <br /> Email and/or Fax ?...5-a7- 4/- 7.,;2-2L-7 <br /> Overall Project Description: , (721O ("(-We/1/`T- )/11 `� <br /> Check TYPE OF PERMIT COST* <br /> Box <br /> Dock, Residential-Permanent dock on any lake or initial seasonal dock not on $30+engineering review costs <br /> Lake Minnetonka (permanent dock requires CUP) <br /> Dock, Commercial $50+engineering review costs <br /> Escrow for erosion control and engineering review costs $2,000 <br /> Driveway Permit(New or Replacement) No charge <br /> Also required is a Minor or Major Land Alteration Permit <br /> Land Alteration,Major(grading,filling, or excavating) more 500 cubic yards or $30 <br /> more than 10 cubic yards in lakeshore setback (also requires CUP) <br /> Escrow for erosion control and engineering review costs As determined by CUP <br /> l / 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 engineering 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 engineering review costs $2,500 <br /> Tree Removal or intensive vegetation removal in 0 to 75 foot zone No charge. <br /> (over) <br /> *Permit fee will be collected at <br /> the time the permit is issued. <br />