HomeMy WebLinkAbout2016-01022 - tree removal + i CITY OF ORONO
2750 KELLEY PARKWAY * 2 0 1 6 - PJ 1 0 2 2 *
DATE ISSUED: 08/29/2016
ORONO,MN 55356-
' , 952)249-4600 FAX: 952) 249-4616
ADDRESS : 679 MINNETONKA HGLD LA
PIN : 06-117-23-44-0008
LEGAL DESC : MINNETONKA HIGHLANDS ESTATES
: LOT 004 BLOCK 002
PERMIT TYPE : TREE REMOVAL WITHIN 0-75'(DON'T USE
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : TREE REMOVAL WITHIN 0-75
NOTE: TREE REMOVAL
APPLICANT TREE REMOVAL 0.00
TOTAL 0.00
NELSON,ROBERT&VICKY
679 MINNETONKA HGLD LA
LONG LAKE,MN 55356-
OWNER
NELSON,ROBERT&VICKY
679 MINNETONKA HGLD LA
LONG LAKE,MN 55356-
AGREEMENT AND SWORN STATEMENT
The work for which this permit is issued shall be performed according to
the approved plans and specifications,applicable City approvals,and the
State Building Code. This permit is for only the work described and dces
not grant permission for additional or related work which requires separate
permiu. All provisions of laws and ordinances governing 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 constrvction is
suspended for a period of ISO days at any time after work has commenced.
The applicant is responsible for assuring all required inspections are
requested in wnformance with the State Building Code.This permit may be
revoked at any time for due cause.
�"�' �' i• `�il,C�
Applicant Permitee Signature Date Issued By gnature Date
� .,
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City of Orono
Zoning Permit A lication
� O Mailing Address: Permit number. ��(� "��� �
� � PO Box 66 �a �
O Crystal Bay, MN 55323-0066 Date received:
Escrow#and
Street Address: amount:
2750 Kelley Parkway
y � Orono, MN 55356 Permit Fee:
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�qk�SHO�� Fax: 952-249-4616 Approved by:
Main: 952-249-4600 Notes:
www.ci.orono.mn.us
This application form must be completed in fuU and all required information must be submitted. {P/ease print.)
Job Site Address: ��� i !1 e h�d, t�-��o �i �Gt-rt d L /� . . �ran� � /j1/'1� SS3.3�b
CONTRACTOR/APPLI ANT INFORMATION:
►vame: �o b e rfi l�le��'8 h
Phone: �s4s�— �]S- �f'S� Fax:
Address: ` Cit : � ZIP: S(�
Contact Person: lQ, ✓' Contact's phone number — 'Z$ Z.
Email �n � ��yy� �-(�Q,��.y���'��icant is: Contractor omeowne (Circle One)
PROPERTY OWNER FORMATION:
Name: .523 Yl
Phone(day): —14
Mailing Address: e � I� ZIP:
Email and/or Fax � � !rr
Overall Project Description:
CBoXk TYPE OF PERMIT collected whenE ermit is issued
Dock,Commercial $50+engineering review costs
Escrow for erosion control and en ineerin review costs $2,000
Dock, Residential - Permanent dock on any lake or initial seasonal dock not on Lake $50+engineering review costs
Minnetonka ermanent dock re uires CUP
Hardcover Permit:Driveway,Patio,Sidewalk,etc.(New or Replacement) No charge
Also re uires is a Minor or Ma'or Land Alteration Partnit
Land Alteration, Major (grading, filling, or excavating) of more than 500 cubic yards $50
beyond the lakeshore setback OR more than 50 cubic yards within the lakeshore setback
(also requires Conditional Use Permit)
IReference: Citv Code Sections 78-9B7.7&1247 and 7&12861
Escrow for erosion control and engineering review costs As determined b CUP
Land Alteration,Minor(grading,filling or excavating)of 51 to 500 cubic yards beyond the $50+engineering review costs
lakeshore setback OR 50 cubic yards or less within the lakeshore setback
(Reference: Citv Code Sections 78-967.7&1247 and 7&12861
Escrow for erosion control and engineering review costs $2,000
Retaining Walls which exceed two feet in height above existing grade; or result in more $50+engineering review costs
than 20 cubic yards of imported fill;or are located less than five feet from the property line.
Escrow for erosion control and engineering review costs $2,500
lReference: Citv Code Section 7&1405(5.111
Retaining Walls which measure morie than four feet(from bottorn of footings to top of wall)
require a building permit. Tiered retaining walls are considered one wall unless the walls
are se arated b twice the hei ht of the lower wall.
Stairway or Lifts to Lake(New or Replacement) [Refenence: Citv Code Sections 78-12821 $50+engineering review costs
Escrow for erosion control and engineering review costs $2,000
Structure Permit for other structures 200 sf or less not requiring a building permit but $50+engineering review costs
regulated by the zoning code IReference: Citv Code Sectfon 86-661
Escrow for erosion control and en ineering review costs $2,500
�• Tree Removal or other vegetation removal within 75 feet of lakes No charge.
�� rence: Ci Code SecH n 7&1285 Pre-ins ction required.
Tempora Construction Office/Trailer associated with buildin permit $30
Updated: May 2015
�
' I�PPLICANT/OWNER ACKNOWLEDGEMENT:
• Appiicant/Owner agrees to provide ail information required or requested by the Planning Department;
• Owner agrees to pay the City of Orono for engineering consultant review costs where applicable;
: AppHcanUOwner 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
altemative but to reject it until it is complete;
• Applicant acknowledges the attached Escrow Agreement is completed and signed by Owner;
• Applicant/Owner understands their project may require an initial and/or as�iuiit survey per City Code Section 86-68.
• 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 cannvt 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
ou refuse to su I the information,the a lication ma not be issued.
The undersigned certify that the info ation supplied is true and correct to the best of their knowled e.
Applicant's Signature: Date: ��y( ��
Property Owner's Signature: Date: �� ��h
SUBMISSION REQUIREMENTS: Except for tree removal permits, all permits require a completed
TYPE OF PERMIT: application form, escrow agreement(signed by the property owner) and escrow check from awner,
two copies of each,where applicable,plans,landscape plans,grading plans,surveys or site plans.
Dock,CommerCial 1. Structural plans for the dock
2. Survey/site plan showing the proposed location of the dock
3. Copy of LMCD permit
DoCk, Residential Seasonal Dock—survey showing proposed dock
Permanent Dock—plans as approved by CUP and copy of LMCD permit(if applicable)
Hardcover Permit 1. All Minor or Major Land Alteration Permit requirements apply as appropriate
2. Hardcover calculations,existing and proposed
3. Survey
Land Akeration,Major 1. Survey/grading plan induding ewsling and proposed contours as apprrned by Conditional Use Pertnit
2. Erosion control plan.
3. A copy of Minnehaha Creek Watershed District(MCWD)permits or documentation from the MCWD stating the
proposed project dces not Uigger any of their pertnitting requirements. Please note,the City will not issue a
buildin rmit without informaflon from the MCWD.
Land Alteration,Mlnor 1. Survey/grading plan induding e�dsting and proposed contours
2. Amount of fill to be imported and/or expoRed and haul route
3. Amount of earth to be moved around on site
4. Erosion control plan.
5. A copy of Minnehaha Creek Watershed District(MCWD)permits or documentation from the MCWD stating the
proposed project dces not trigger any of their permitting requirements. Please note,the City will not issue a
buildin permit without infortnation from the MCWD.
Retaining Wall 1. Plans for wall(s)
2. Unless repair or exact replacement of existing wall,submit an updated survey with grading plan inGuding existing and
proposed contours
3. Hardcover calculation worksheets if in shoreland district
4. Erosion control plan
5. A copy of Minnehaha Creek Watershed District(MCWD)permits or documentation from the MCWD stating the
proposed project dces not Vigger any of their pemiitting requirements. Please note,the City will not issue a
buildin rmit without information from the MCWD.
Stairwey or Lifts to 1. Construction plans for stairway or lift,including footings
Lake 2. Topographical survey of property with proposed stairs or lift shown
3. Erosion control plan
4. A copy of Minnehaha Creek Watershed District(MCWD)pertnits or documentation from the MCWD stating the
proposed project dces not trigger any of their pertnitting requirements. Please note,the City will not issue a
buildin permit without information from the MCWD.
Structure Permit 1. Construction plans.
2. Survey/site plan of property with proposed structure shown 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 ff grading is proposed.
4. Hardcover calculation worksheets
5. Erosion control plan.
6. A copy of Minnehaha Creek Watershed District(MCWD)permits or d�umentation from the MCWD stating the
proposed projed does not trigger any af their permitting requirements. Please note,the City will not issue a
buildin rmit without information from the MCWD.
Tree Removal Call: 952-249�600 to schedule an inspection for removal of an individual tree(s). A re-planting plan 1 erosion control/
mana ement lan ma be r uired for Gear cuttin ,buckthom or other intensive ve etation removal.
Updated: May 2015
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� p/�7� TIME
CRY OF ORONO c�►��iN
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� ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑COMPLAINT
� ❑ FINAL ❑WATER HOOK-UP ❑ FOLLOW-UP
41 ❑ AS BUILT-SURVEY 0 SEWER HOOK-UP ❑ FOUNDATION/REMOVAL
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Call for the next inspection 24 urs in advance. 49-46��
OwnerlCorrtractor on site:
Inspector.
Whits CopyAnapectors File Canary CopylSita Notice
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DATE TIME
CITY OF ORONO caLLED IN
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Call for the next inspection 24 hours in advanoe. (952) 249-4600
OwnerlContractor on site:
Inspector: � 1 ��-- �
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