HomeMy WebLinkAbout2010-01206 - land alteration CITY OF ORONO PERMIT NO.: 2010-01206
2750 KELLEY PARKWAY
ORONO, MN 55356- DATE ISSUED: 01/14/2011
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 85 OLD CRYSTAL BAY RD S
PIN : 04-117-23-21-0004
LEGAL DESC : AUDITOR'S SUBD.NO.230
: LOT 009 BLOCK 000
PERMIT TYPE : ZONING PERMIT
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : LAND ALTERATION(0-500 CU YDS)
NOTE: $2,000 S/B COLLECTED IN ESCROW FEE(WAIVED PER MELANIE-AFTER THE FACT)
APPLICANT MINOR LAND ALTERATION 50.00
MILLER, SCOTT&MICHELLE ENGINEERING REVIEW COSTS
85 OLD CRYSTAL BAY RD S
LONG LAKE,MN 55356 TOTAL 50.00
PAID WITH CC# 7460
OWNER
MILLER, SCOTT&MICHELLE
85 OLD CRYSTAL BAY RD S
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 does
not grant permission for additional or related work which requires separate
permits. 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 construction is
suspended for a period of 180 days at any time after work has commenced.
The applicant is responsible for assuring all required inspections are
requested in conformance with the State Building Code.This permit may be
revoked at any time for due cause. 6((41-Zd 116/
12, 11
Applicant Permitee Signature Date Issued By Signature Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
I
City of Orono
Zoning Permit Application
Mailing Address: Permit number: v2O/0 `"'0 / a' D L
PO Box 66
O�OHO Crystal Bay, MN 55323-0066 Date received: I - '- 10 41� ��
't-l:'''-' 7::
Escrow amount: W1 o /2C �' ,
-- . , Street Address:
t' ', - 2750 Kelley Parkway Permit Fee: 4 GOC12. //24 W/ U i S/q. /2/i 0
"4,.
� tt i:.;%Ijo os Orono, MN 55356 , f"
,t 1., 1. Approved by: (/,
9kEstie" }�A
Fax: 952-249-4616 Notes: ‘-le,Nom:4 NA cI''mo°o- i(44^
Main: 952-249-4600 www.ci.orono.mn.us
This application form must be completed in full and all required information must be submitted. (Please print.)
GENERAL INFORMATION: �(,
Job Site Address: WS. 01 J , c L(x (, W.) °ono LI-5 -19
CONTRACTOR/APPLICANT I FORMAI1.
Name: XfT l k ti IXW
� . I,
Phone: �J Z.---1..,)- Ci Fax LLQ'
Address: j� �( City: ( Y-,0146 ZIP: ✓�'Y�
Contact Person: ✓l.(IIC.Y Contact's phone number
Email jyt L WQ\ ae_..co W\Applicant is: Contractor -omeowne' (Circle One)
PROPERTY OWNER MFTrolir:/Name:
Phone (day):
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(permanent dock requires CUP) costs
Commercial Dock $50+ engineering review
costs
Escrow for erosion control and engineering review costs $2,000
V Minor Land Alteration (grading, filling or excavating)—500 or less cubic yards $504- engineering review
outside of lakeshore setback or less than 10 yards in lakeshore setback costs
Escrow for erosion control and engineering review costs ,,;eee"—
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 engineering review costs As determined by CUP
Stairway to Lake $50+ engineering review
costs
Escrow for erosion control and engineering 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 engineering review costs $2,500
Tree Removal or intensive vegetation removal in 0 to 75 foot zone No charge.
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 engineering review costs $2,500
(over)
•
APPLICANT/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.
The undersigned certify that the information supplied is true and correct to the best of their knowled .
Applicant's Signature: 1%AJtG11LL1iL ilaV Date: "24/0
I '
12
Property Owner's Signature: "S v'�'t..V W4
la Date: 15//b
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 plan or copy of MCWD Erosion Control Permit
Last Updated: October,2010
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