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City of Orono <br /> Zoning Permit Application <br /> Mailing Address: Permit number: Z 01 S-- 009 c'9 <br /> IZLO�VO PO Box 66 Date received: �0 <br /> /51 i' <br /> Crystal Bay, MN 55323-0066 <br /> Escrow#and 'P� D `,4 <br /> Street Address: amount: <br /> 2750 Kelley Parkway tPermit Fee: <br /> y Orono, MN 55356 <br /> F G• <br /> `"1kESHO�� Fax: 952-249-4616 Approved by: <br /> Main: 952-249-4600 Notes: <br /> www.ci.orono.mn.us <br /> This application form must be completed in full and all requir d information must be submitted. (Please print.) <br /> Job Site Address: /53t o1'CL 64 C�/j r/ r-an <br /> CONTRACTOR/APPLICANT INFORMATION: <br /> Name: Ltty y! 'tf <br /> Phone: 16-5 � $ / '3S/S� Fax: <br /> Address: X GO3 City: e„!(.tj c,. ZIP: 55-3e-j/ <br /> Contact Person: .4fi(�Linn /I Contact's ph / <br /> Email e G,w/►-.✓,,,ty,,3 Applicant is: Homeowner (circle One) <br /> PROPERTY OWNER INFORMATIO G , <br /> Name: 1Z)4.. 5C- U .�YLLi Z.e <br /> Phone(day): <br /> Mailing Address: at 5g., tt &'' Alt LJ c q / fje 5 CI ZIP: '-34 05-- <br /> Email and/or Fax i2 v S cry)Li— yet ,�_<�y✓�( <br /> Overall Project Description: cii 41.'0%1W440/1 <br /> Check TYPE OF PERMIT <br /> Box COST* <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 $50+engineering review costs <br /> on Lake Minnetonka(permanent dock requires CUP) <br /> Hardcover Permit: Driveway, Patio,Sidewalk,etc. (New or Replacement) No charge <br /> Also requires is a Minor or Major <br /> Land Alteration Permit <br /> Land Alteration, Major(grading, filling, or excavating) more 500 cubic yards $50 <br /> or 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 /> Land Alteration, Minor(grading, filling or excavating)–500 or less cubic $50+engineering review costs <br /> yards outside of lakeshore setback or less than 10 yards in lakeshore setbac <br /> y,\* <br /> Escrow for erosion control and engineering review costs $2,000 <br /> Retaining Wall measuring under four feet require a zoning permit. engineering review costs <br /> Retaining walls measuring more than four feet(from bottom of footings to top <br /> of wall) require a building permit. (Tiered retaining walls are considered one <br /> wall 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 or Lifts 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 <br /> of 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 other vegetation removal in 0 to 75 foot zone No charge. Pre-inspection required. <br /> Temporary Construction Office/Trailer(associated with building permit) $30 <br /> (over) <br /> *Permit fee will be collected when the permit is issued. <br /> Updated: January 2015 <br />