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CITY OF ORONO PERMIT NO.: 2010.00614
2750 KELLEY PARKWAY
" ORONO, MN 55356- DATE ISSUED: 03/04/2011
952 249-4600 FAX: 952 249-4616
' ADDRESS : 1348 REST POINT CIR
PIN : 07-117-23-31-0023
' LEGAL DESC : REST POINT PARK LAKE MTKA
: LOT O11 BLOCK 000
PERMIT TYPE : ZONING PERMIT
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : RETAINING WALL<4 FEET
NOTE: $50.00 PERMIT FEE WAS COLLECTED ON JULY 23,2010 BUT PERMIT WAS NOT ISSED AT THAT TIME.
APPLICANT RETAINING WALL<4' S0.00
CORNERSTONE IND. INC.
P.O. BOX 374 ENGINEERING REVIEW COSTS
EXCELSIOR,MN 55331 TOTAL 50.00
(612)226-8344
OWNER
JONES, RYAN&JAMIE
1348 REST POINT CIR
MOLIND,MN 55364-
AGREEMENT AND SWORN STATEMENT
The work for which this permit is issued shall be performed according to
the approved plans and specifications,applicable City apprpvals,and the
State Building Code. This permit is for only the work described and does
not grant permission for additional or related work which riequires separate
permits. All provisions of laws and ordinances goveming this type of work
shall be compied with whether or not specified herein.This permit will
expire and become null and void if construction authorized is not
commenced within 180 days of the date of issuance,or if cbnstruction is
suspended for a period of 180 days at any time after work has commenced.
The applicant is responsible for assuring all required inspe�tions aze
requested in conformance with the State Building Code.This permit may be
revoked at any time for due cause. '
l l 3/ l l
Applicant Permitee Signature Date Issue y Signa ure Date
SEPARATE PERMITS REQUIRED FOR WORK O ER THAN DESCRIBED ABOVE.
� CITY OF ORONO PERMIT NO.: 2oiaoo6ia
2750 KELLEY PARKWAY
, ORONO, MN 55356- DATE IssvEn: 03/04/2011
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 1348 REST POINT CIR PERMIT APPLICANT:
PIN : 07-117-23-31-0023 CORNERSTONE IND. INC.
LEGAL DESC : REST POINT PARK LAKE MTKA P.O. BOX 374
: LOT O11 BLOCK 000 EXCELSIOR,MN 55331
PERMIT TYPE : ZONING PERMIT
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : RETAINING WALL<4 FEET
$50.00 PERMIT FEE WAS COLLECTED ON JULY 23,2010 BUT PERMIT WAS NOT ISSED AT THAT TIME.
BUILDING INSPECTION RECORD
48 HOUR NOTICE REQUIRED FOR ALL INSPECTIONS.
CALL FOR INSPECTIONS WEEKDAYS:
INSPECTION TYPE DATE INSPECTOR INSPECTION TYPE DATE INSPECTOR
ENGINEERING REVIEW
FINAL
INSPECTION COMMENTS:
IN ACCORDANCE WITH CITY ORDINANCE,NEW OR SUBSTANTIALLY REMODELED BUILDINGS SHALL NOT BE OCCUPIED UNTIL ALL
;WORK HAS BEEN APPROVED,AND A CERTIFI�ATE OF OCCUPANCY HAS BEEN ISSUED BY THE BUILDING DEPARTMENT.
THIS CARD MUST BE POSTED AND VISIBLE AT ALL TIMES UNTIL WORK IS COMPLETE.
" . ' ' City of Orono
� Zoning Permit Application oio-oa�i -�a�l
Mailing Address: Permit number: d �'J�Q�� �•�
0�.,�,�0 PO Box 66
Crystal Bay, MN 55323-0066 Date received: � /D
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a ` -�� � Street Address: Escrow amount:
�'� ='� �ti 2750 Kelley Parkway Permit Fee:
t9'kESH�4'� Orono, MN 55356
Received by: ,��
Main: 952-249-4600 Fax: 952-249-4616 www.ci.orono.mn.us
This application form must be completed in full and all required information must be submitted. (Please print.)
GENERAL INFORMATION: n
Job Site Address: � �j �-� � Iv��;� }�'F L� �.
CONTRACTOR/APPLICANT INFORMATION•
Name: �„fv�t���,�1� �,.�c� , �vt�-,
Phone: (��- Z�(,,- `�"?,y- �-{ Fax:
Address: �'O 1�0-,�'�l� En�e.(7��� 77'7 � City: ZIP:
Contact Person: • ,y..� L��,;�-}#- Contact's phone nu -. ���L l-Lc,� ��3'�4
Email L�'y L,;�;� 7cr�^,_+� �1 Applicant is� ontractor ; Homeowner (Cirde One)
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PROPERTY OWNER INFORMATION:
Name: ��.,� .�ie`�
Phone (daY): � 1� �;��G� � (.���
Mailing Address: ZIP:
Email and/or Fax
Overall Project Description:
Check TYPE OF PERMIT COST
Box
Residential Dock- Permanent dock on any lake or initial seasonal dock not on $30 +engineering review
Lake Minnetonka ermanent dock re uires CUP costs
Commercial Dock $50+ engineering review
costs
Escrow for erosion control and en ineering review costs $2,000
Minor Land Alteration (grading, filling or excavating)-500 or less cubic yards $50+ engineering review
outside of lakeshore setback or less than 10 yards in lakeshore setback costs
Escrow for erosion control and en ineering review costs $2,000
Major Land Alteration (grading, filling, or excavating) more 500 cubic yards or $30
more than 10 cubic yards in lakeshore setback (also requires CUP)
Escrow for erosion control and en ineerin review costs As determined b CUP
Stairway to Lake $50+ engineering review
costs
Escrow for erosion control and en ineering review costs $2,000
Retaining Wall not requiring a building permit(A building permit is required for any $50+ engineering review
�� retaining wall that measures more than four feet from bottom of footings to top of costs
wall. Tiered retaining walls are considered one wall unless the walls are separated
by twice the height of the lower wall.)
Escrow for erosion control and en ineerin review costs $2,500
Tree Removal or intensive vegetation removal in 0 to 75 foot zone No char e.
Structure Permit for other structures not requiring a building permit but regulated $50+ engineering review
by the zoning code (including, but not limited to accessory building of less than 120 costs
square feet, detached deck or platform and sport court)
Escrow for erosion control and engineerin review costs $2,500
(over)
/'�PPLICANT/OWNER ACKNOWLEDGEMENT:
• Agrees to provide all information required or requested by the Planning Department;
• Owner agrees to pay the City of Orono for engineering consultant review costs where applicable;
• Certifies that the information supplied is true and correct to the best of his/her knowledge. The applicant
recognizes that they are solely responsible for submitting a complete application being aware that upon failure to
do so, the staff has no alternative but to reject it until it is complete;
• Acknowledges the attached Escrow Agreement is completed and signed by Owner;
• Some or all of the information that you are asked to provide on this application is classified by State law as either
private or confidential. Private data is information which generally cannot be given to the public but can be given to
the subject of the data. Confidential data is information which generally cannot be given to either the public or the
subject of the data. Our purpose and intended use of this information is to annually update our records and records
of other governmental agencies required by law. If you refuse to supply the information, the application may not be
issued.
i
The undersigned certify that the information upplied is true and correct to the best of their knowledge.
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Applicant's Signature: � ' �c��°f Date: 7-L� - I U
Property Owner's Signature: Date:
TYPE OF PERMIT: SUBMISSION REQUIREMENTS:
Except for tree removal permits, all permits require a completed application
form, escrow agreement(signed by the property owner) and escrow check
from owner, two copies of all plans, and three copies of all grading plans or
surveys/site plans
Residential Dock Seasonal Dock—survey showing proposed dock
Permanent Dock- plans as approved by CUP and copy of LMCD permit
Commercial Dock 1. Structural plans for the dock
2. Survey showing the proposed location of the dock
3. Copy of LMCD permit
Minor Land Alteration 1. Grading plan including existing and proposed contours
(Less than 10 cu.yds. within 75' of lake 2, Amount of fill to be imported and/or exported and haul route
or less than 501 cu.yds elsewhere.) 3. Amount of earth to be moved around on site
4. Erosion control plan or copy of MCWD Erosion Control Permit
Major Land Alteration 1. Plans as approved by Conditional Use Permit
2. Erosion control plan or copy of MCWD Erosion Control Permit
Stairway to Lake 1. Construction plans for stairway
2. Topographical survey of property with proposed stairs drawn in.
3. Erosion control plan or copy of MCWD Erosion Control Permit
Retaining Wall 1. Plans for wall(s)
2. Unless repair or exact replacement of existing wall, grading plan including
existing and proposed contours
3. Hardcover calculation worksheets if in shoreland district
4. Erosion control plan or copy of MCWD Erosion Control Permit
Tree Removal Call 952-249-4600 to schedule inspection.
Structure Permit 1. Plans for structure.
2. Survey of property with proposed structure drawn in and with setbacks to
property lines, other structures on property and the septic system indicated
.The general location of any sewer and water services should be shown if
applicable.
3. Grading plan if grading is required
4. Hardcover calculation worksheets if in shoreland district
5. Erosion control lan or co of MCWD Erosion Control Permit
Last Updated: July,2010
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Total �pQlied; ----------
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