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Home My WebLink Aboutzoning permit application-no date-no permit City of Orono � � � � Zoning Permit Application Mailing Address: Permit number: .Q,Q JI� PO Box 66 Date received: Qy �`V Crystal Bay, MN 55323-0066 � Q Escrow#and ��'�'� � Street Address: amount: `� � �'�;��_.�.•> ti � 2750 Kelley Parkway Permit Fee: �� ` � ��'�y p� Orono, MN 55356 t�y �1� YT` �v Approved by: kESH��' - Fax: 952-249-4616 Notes: Main: 952-249-4600 `,',',',�,', =' ��=''�� ` '—:� This application form must be completed in full and all required information must be submitted. (P/ease print.) Job Site Address: c��rU�c'�� ,�� <�: �(�'S /lc��i �� ,�d•. . � .�y�/�/ .�S:s'E'y 1 � ��:�- l.r,� i vn csu, CONTRACTOR!APPLICANT INFO�ATION: Name: ;T,y-�o= �,r.:� � Phone: � - �/gz -$/� Fax: 5�-5z �/ L � S I�I' Address: .�y y� ,ala fiF 1�-,k<< City: ,T-� w� ZIP: �'S.� 5 2. Contact Person: � ContacYs phone n r gs� - � 1 -jit�c Email ';��l1er�� ` � L,�;,�pplicant is: ontractor\� Homeowner (CircleOne) PROPERTY OWNER INFORMATION: Name: ��,.n� C.U-t%,t�(s�r.��✓�. Phone (day): E�e2-3Z�-7Sp! Mailing Address: /C��,r � �� 1`` � . . - d�li ZIP: S,` �s Email and/or Fax [;��rf'. � � �. �'� -,r, f- -t:c�n Overatl Project Description: �� {�,� ,„.� T��{-�� 4 ;, ;,�,,. f �\� t cAv-�..1 Lel.� � . �v.�_ i,� _ � :,�: � . �- Check l(�,c.:�� TYPE OF PERMIT Box COST* Dock, Residential - Permanent dock on any lake or initial seasonal dock not on $50 + engineering review costs Lake Minnetonka permanent dock requires CUP Dock, Commercial $50+ engineering review costs Escrow for erosion control and engineerin review costs $2,000 Driveway Permit (New or Replacement) No charge Also re uired is a Minor or Ma'or Land Alteration Permit Land Alteration, Major(grading, filling, or excavating) more 500 cubic yards or $50 more than 10 cubic yards in lakeshore setback (also requires CUP) Escrow for erosion control and engineering review costs As determined b CUP Land Alteration, Minor(grading, filling or excavating)-500 or less cubic yards $50+ engineering review costs outside of lakeshore setback or less than 10 yards in lakeshore setback Escrow for erosion control and engineering review costs $2,000 Retaining Wall measuring under four feet require a zoning permit. $50+ engineering review costs Retaining walls measuring 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.) Escrow for erosion control and engineerin review costs $2,500 Stairway to Lake (New or Replacement) $50+ engineering review costs Escrow for erosion control and engineering review costs $2,000 Structure Permit for other structures not requiring a building permit but $50+ engineering review costs regulated by the zoning code (including, but not limited to accessory building of less than 120 square feet, detached deck or platform and sport court) Escrow for erosion control and en ineerin review costs $2,500 Tree Removal or other ve etation removal in 0 to 75 foot zone No char e. (over) *Permit fee will be collected at the time the permit is issued. Updated: December 30,2011 APPLICANT/OWNER ACKNOWLEDGEMENT: • Applicant 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; ^ • Applicant 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; • Applicant 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. The undersigned certify that the information supplied is true and correct to the best of their knowledge. Applicant's Signature: '��(r!��--=�-t Date: � 3/ /3 � Property Owner's Signature: i��/� �,�J�w��- Date: / �� SUBMISSION REQUIREMENTS: Except for tree removal permits, all permits TYPE OF PERMIT: require a comp�eted application s,.....,. ,,..,,_,,... ..,._..,...,...... �_:___� �..��_ ____�rty owner) and escrow check from f- � � �, ( �ies of all grading plans or surveysls ( �iIJG!U�'�G�-� f0 Dock, Residential Seasonal Dock-survey showing p Permanent Dock- plans as approv� �� Dock, Commercial 1. Structural plans for the dock 2. Survey showing the proposed 3. Copy of LMCD permit Driveway Permit 1. All Minor or Major Land Alterat 2. Hardcover calculations, existin 3. Driveway plans Land Alteration, Major 1. Plans as approved by Conditic 2. Erosion control plan or copy of Land Alteration, Minor 1. Grading plan including existinc (Less than 10 cu.yds. within 75' of 2. Amount of fill to be imported ai lake or less than 501 cu.yds 3. Amount of earth to be moved � elsewhere.) 4. Erosion control plan or copy of ��Y�� „�,�, �C�� Retaining Wall 1. Plans for wall(s) ' - � ��-� 2. Unless repair or exact replace M�0 ►"/p Va/9 P ✓ith grading plan including existing- - 3. Hardcover calculation workshe �,(GN,/a{-L G�(S�'�G✓�ith�- 4. Erosion control lan or co oi �-��7 �� .l��oP ;� Stairway to Lake 1. Construction plans for stairwa� 2. Topographical survey of prope IV1�G�'1Q� 2 l�R�� 3. Erosion control plan or copy of � ��.,,/ Structure Permit 1. Plans for structure. �r��G � � �-�/K� `� 2. Survey of property with propos �v�rti pG� � �iU t� �' �� lines, other structures on propE y ' a (��'' location of any sewer and watE ��,y�a� �� 3. Grading plan if grading is requ 4. Hardcover calculation workshe 5. Erosion control plan or co of Tree Removal Call: 952-249-4600 to schedule a sin� mana ement plan required for clear c� Updated: December 30,2011 . . _ " ZONING PERMIT ESCROW AGREEMENT Permit# AGREEMENT made this day of , 20_, by and between the CITY OF ORONO, a Minnesota municipal corporation ("Cit�')and ("Owners"). Recitals 1. A building permit application has been filed for a zoning permit for a property located at the ("Subject Property"), legally described as , Hennepin County Minnesota. 2. Owner requests the City to review this application. 3. The City will commence its review of the application and mcur'costs associated with said review only if the Owner establishes an escrow to ensure reimbursement to the Ci#y of its costs. NOW THEREFORE,THE PARTIES AGREE AS FOLLOWS: ;, , 1. DEPOSIT OF ESCROW FUNDS. Contemp�fi�neously with t��t�e,. execution of this Escrow Agreement, the Owners shall deposit $ with the City. All accrued interesfi„�if,any, shall.'be paid to the City to reimburse the City for its cost in administering the es�row accourat. 2. PURPOSE OF ESCROW. The purpps.e`of th��row is#o;guarantee reirri'liursement to the City for all out-of-pocket costs the City has incurred (inclu�ling planning,�.engineer�r�g or le��l-consultant review) or will incur in reviewing the plan. Eligible expenses sf�all be cc�nsistent with expenses;;�he a,rivners would be responsible . . �. � �. ,,,. for under a zonmg permit application. The esGnQW will als�,;gua��ntee reimbur`serxient to the City for all out-of- pocket costs the City has incurred to assure th�t �the wor'k fs��completed in accordance with the Stormwater Pollution Prevention Plan and the provisions of�K�ron�r,City Code':�hapter 79. The financial security may also be used by the City to eliminate any hazardous conclitions associated�°�vith the work and to repair any damage to public property or infrastructure th�t�is caused by�Yhe wob`�k:�(including,planning, engineering, or legal consultant review) associated with permit ;# if compliance with the approved zoning permit is not accomplished. �r�;.. 3. MONTMLl1(,.BILLING. As.'tJ�e City�r��eiVes consultant bills for incurred costs, the City will in turn send a bill to the Owners. fJwvners shall be�.responsible for payment to the City within 30 days of the Owners' receipt of bill. 4. ��SBURSEII��MT FR�MIif'�S�ROW'��fi�COUNT. �In the event that the Owners do not make payment to the City w'rthin the timeframe'outlin�d in#3'abeu;e, shall issue a Stop Work Order until the Owners pay all expenses invoiced pur`suant to #3. The City;iaiay draw from the escrow account without further approval of the Owners to reimburse the.Ci,ty for eligible expen5�s the City has incurred. 5. ��O�1KIG E�S'�ROV�I:-� The Balance on deposit in the escrow, if any, shall be �returned to the Owners when the review has be�n completed and written notification is received from the Owners requesting the funds. 6. CERTIFY�Mf'AID CHARGES. If the project is abandoned by Owners, or if the eligible expenses incurred by the City exceed the amount in escrow, the City shall have the right to certify the unpaid balance to the subject property pursuant to Minn. Stat. §§415.01 and 366.012. CITY: CITY OF ORONO OWNER: ' By: its: ��::.� Updated: December 30,2011 2 . �;: rt� _ � � s `� � � 1 ` � � /� k� ..' - ' \�. � `�.�. .�� d:,'�� .� . . " _ �i-.'. N f _ , . . � . : �� v`�,; . . . 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