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Home My WebLink About2017-00538-VOIDED � � � � City of Orono .� Zoning Permit �pplication Mailing Address: Permit number: (�7��G�� 0 PO Box 66 Crystal Bay, MN 55323-0066 Date received: �2 Z�7 Escrow#and � � Street Address: amount: �� y'v'�'e 2750 Kelley Parkway S. 1 Orono, MN 55356 Permit Fee: .� � 4�'— � � G F, Approved by: �kFSH�� Fax: 952-249-4616 Main: 952-249-4600 Notes: � www.ci.orono.mn.us �, This application form must be completed in full and all required information must be submitted. 1 se print.) Job Site Address: 1095 Ferndale Road West CONTRACTOR/APPLICANT INFORMATION: Name: Welch Forsman Associates Inc Phone: 612-827-4455 (o) Fax: Address: 6026 Pillsbury Ave So City:Minneapolis ZIP: 55419 Contact Person: Don Forsman ContacYs phone number 612-221-0842 (c) Email don@welchforsman.com Applicant is: Contractor Homeowner (Circle One) PROPERTY OWNER INFORMATION: Name: Bill Toles Phone (day): 952-240-2100 Mailing Address: 2510 Crescent Ridqe Drive, Minnetonka MN ZIP: 55305 Email and/or Fax wtoles1041 @aol.com Overall Project Description: Site Grading in preparation for construction of a new residence 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 requires is a Minor or Ma'or Land Alteration Permit Land Alteration,Major(grading,filling,or excavating)of more than 500 cubic yards beyond $50 X the lakeshore setback OR more than 50 cubic yards within the lakeshore setback (also requires Conditional Use Permit) (Reference: Citv Code Sections 78-967. 78-1247 and 78-12861 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, 78-1247 and 78-12861 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 (Reference: Citv Code Section 78-1405(5.111 Retaining Walls which measure 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 se arated b twice the hei ht of the lower wall. Stairway or Lifts to Lake(New or Replacement) (Reference: 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(Reference: Citv Code Section 86-661 Escrow for erosion control and engineering review costs $2,500 Tree Removal or other vegetation removal within 75 feet of lakes No charge. [Reference: Citv Code Section 78-12851 P�e-InspeC � Temporar Construction Office/Trailer associated with buildin permit $30 MAY 2 2 2017 Updated: January 2017 CITY O�L�RONCy �` APPLICANTIOWNER ACKNOWLEDGEMENT: • ApplicanUOwner agrees to provide ali information required or requested by the Planning Department; • Owner agrees to pay the City of Orono for eng(neering consultant review costs where applicable; . AppiicanUOwner 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; • ApplicanUOwner understands their project may require an initial andlor as-built survey per City Code Section 86�8. • 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 a lication ma not be issued. The undersigned certify that the information supplied is true and correct to the best of their knowledge. Applicant's Signature: Date: Property Owner's Signature: � ,� Date: May 19,2017 SUBMISSION RE�UIREMENTS: Except for tree removal permits, all permits require a completed TYPE OF PERMIT: application form,escrow agreement{signed by the prope�ty owner)and escrow check from owner,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,ebsting and proposed 3. Survey Land Alteration,Major 1. Survey/grading p►an including existing and proposed coMours as approved by Conditional Use Permit 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 trigger any of their permitting requirements. Please note,the City will not issue a buildin rmit without information from the MCWD. Land AlterdtiOn,Minor 1. Survey/grading plan including existing and proposed contours 2. Amount of fill to be imported andlor exported and haul route 3. Amount of earth to be moved around on site 4. Erosion conUol 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 rmit without information 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 including 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 d�umentation from the MCWD stating the proposed project dces not trigger any of their pertnitting requirements. Please note,the City will not issue a buildin ermit without information from the MCWD. Stairway 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 Oistrict(MCWD)pertnits 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 pertnit 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 indicaied.The general location of any sewer and water services should be shown if applicable. 3. Grading plan if grading is proposed. 4. Hardcover calculation worksheets 5. Erosion control plan. 8. A copy of Minnehaha Creek Watershed District(MCWD)permits or documentation from the MCWD stating the proposed project does not trigger any of their permitting requirements. Please note,the City will not issue a buildin rmit without information from the MCWD. Tree Removal Call: 952-249-4600 to schedule an inspeciion for removal of an individual tree(s). A re-planting plan!erosion control/ mana ement lan ma be r uired for clear cuttin ,buckthom or other intensive ve etation removal. Updated: January 2017