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Home My WebLink About2010-00377 - escrow fee CITY OF ORONO PERMIT NO.: 2010-00377 ' 2750 KELLEY PARKWAY ' ORONO, MN 55356- �ATE ISSUED: OS/24/2010 952 249-4600 FAX: 952 249-4616 ADDRESS : 2172 SHADYWOOD RD PIIv : 17-117-23-42-0010 LEGAL DESC : WILEYS PARK LAKE MTKA : LOT 000 BLOCK 001 PERMIT TYPE : ESCROW FEE-TIED TO BUILDING PERMIT PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ESCROW FEE-TIED TO BUILDING PERMIT NOTE: ESCROW TIED TO DEMO PERMIT 2010-00376 BUILDING PERMIT 2010-00336 `;�`' '�.',:c'1 :-`,ir'h.�d3'i i i;�nr� pMN�ii SS3�� SS2—�4�--4bf� ; i �'�:E°A�11 �J: ,`..�)Qc.'tr1.S�� sj� �:!i.� ?�i�� 1 I >,rt �. h6t"e i i i;iY1Q ei� L�t�fi;P1� �:,1�-i;��377 �1 i� 5'F�aclya+c�sd �:,SCO,tk"t � , ��a � . � ':%1•'��.�C:'�'(!J i ;r,�rr�d r,ev-I1�velc,.�er �e�c�sii� ___.--�-- - .._ I "c,ta 1: t.-,54t7.{�j � n�ci! .__—-_ _-.__ i Ut'Fec�, ��. T .�3,.`r �'.,`�tri�.�:'� ��yfil': . i :it84�71 �i. �h`f! .,�3i A,�U`'!+.�: ?,:�s±tr' ;K� APPLICANT ESCROW FEE-BU[LDING 2,500.00 DORE, STEVEN TOTAL 2,500.00 835] WEST 109TH STREET BLOOMINGTON, MN 55438- (952)358-3303 OWNER DORE, STEVEN 8351 WEST 109TH STREET BLOOMINGTON, MN 55438- AGREEMENT AIYD 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 S[ate 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. / / / / Applicant Permitee Signature Date Issued By Signature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. ^ � � �� ,o � � City of Orono � Buiiding Permit Application for New Structures or Additions Mailing Address: Permit number: dl�-d6 'g+�.�j PO Box 66 Q 0 Crystal Bay, MN 55323-0066 Date received: /O ►� ;•.�. � StreetAddress:' Received by: /L-L/C ��t � " ��`� 2750 Kelley Parkway �� /Z�� Plan review fee: ""'3�7,J � �'kESH04�' Orono, MN 55356 C��'lIZ3 do a_ oo3.�S Total Fee: 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. Incomplete applications will be returned. (Please print) GENERAL INFORMATION: Job Site Address: 2�7Z S��r�y�uooc� ��G c� Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes � No If yes, a special event permit is required wifh Police Department and City Council approval 60 days prior to the event. Shuttle bus service wiB be required unless app/icant demonstrates su�cient on-site parking rs available. Non-permitted events will not be allowed. CONTRACTOR/APPLICANT INFORMATION: Name: �� d��o��- l��es ��,c State License# 2d6 3� g g Expiration Date: /l�ttia��, ao,� Phone: �� _Zg�_� q d office cell Mailing Address: y�o L�-kP��;�w �. City��'o,�c, �y ZIP� 5533� Contact Person: ctqce UP��L�.r Applicant is: ontractor / Homeowner (Circle One) Email and/or Fax: -f�„��d�i,,e�s I�u; I r2 (� av<.co� PROPERTY OWNER INFORMATION: Name: �Tev� �o�r� Phone (day): �SZ- 2 S_ d 75 Address: 2� » sl,Q��u,��,c� Cit � (�eo�p ZIP� 5.53�r� Email and/or Fax ARCHITECT/ENGINEER INFORMATION: Name: ��.5 J�v�c1�:�-Pc�-S Phone (day): 6�2- gl G� - �6:�� Address: Cit : � n�o�f'1� ZIP: Email and/or Fax: ►rS f al� ic�► (�sw� (��s,—, ,vP'i- PROJECT INFORMATION: 1. Type of Project 2. Proposed Use 3. Structure Type 4. Sewage Disposal & � New Construction Water Supply � Single Family with � Residence ❑ Addition attached garage ❑ Gara e/Accesso Bld ❑ Accessory Building ❑ Single Famity with ❑ Deck9 ry g' � Pubfic Sewer ❑ Relocation detached garage ❑ Office/Commercial ❑ Other: (specify) ❑ Multi le Famil /Condo ❑ Private Sewer p Y ❑Warehouse ❑ Public ❑ Storage � Public Water *`Any earth movement may require � ❑ Commercial ❑ Other(specify) MCWD review 8�permits. ❑ Industrial ❑ Private Well Minnehaha Creek Watershed District(MCWD) ❑ Other: (speCify) 18202 Minnetonka Blvd Deephaven, MN 55391 Phone: 952-471-0590 Fax: 952-471-0682 www.minnehahacreek.or Estimated Construction Valuation (excluding land) $ �ys 5 �oo, c,o Last Updated: 9/29/2009 - 17- STRUCTURE INFORMATION: 1.Structure Dimensions 1.Structure Dimensions(continued) 2.Type of Construction a. Length(ft.}= 7Z Number of bedrooms= �Wood/Frame ❑ Masonry b.Width (ft.)= Y� Number of garage stalis: ❑ Metal Attached=_,� ❑ Pole Bldg. 'Areas in sauare feet Detached= ❑ ICF ❑ On-site Prefab c. Basement= ❑ Off-site Prefab d. 1 S'Story = ❑ Other(please specify): e.2"d Story= f. '/Story = g.Total Area= REQUIRED SUBMITTALS: _ All of the information must be submitted in order for your application to be processed: Not Enclosed A licable � ❑ Permit A lication ❑ Pro osed Buildin Plans ❑ ❑ MN State Ener Code Calculations and Mechanical Code Re uirements Form m ❑ Surve meetin all re uirements ❑ ❑ Stormwater Pollution Prevention Plan 6� ❑ Hardcover Calculation s ❑ ❑ Se tic S stem Site Evaluation Re ort ❑ ❑ Access Permit � ❑ Wetland Buffer Im rovement Plan ❑ ❑ En ineered Plans for Retainin Walls 4 feet or above ❑ ❑ Plan Review Fee O ❑ Other � (':�j� l�s a!l Ov��9hys C��Ptes Fvoryr �c,vN�� ( V��e�t� ��croti0ny ^ �sl�o��a APPLICANT ACKNOWLEDGEMENT: • Agrees to provide all information required or requested by the Building Department; • Agrees to pay the City of Orono for engineering consultant review costs in excess of$500; • 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 Escrow Agreement is completed and signed; • Some or all of the information that you are asked to provide on this application is Gassified 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. Applicant's Signature: Date: �II-'lD Last Updated: 9/29/2009 - 18- , � . , DEMOLITION AND BUILDING PERMIT ESCROW AGREEMENT , Orono Building Permit Application#2010-00336 AGREEMENT made this Z��' day of Yr,� , 20L, by and between the CITY OF ORONO, a Minnesota municipal corporation ("City")and Steven . Dore("Owner"). Recitals 1. A building permit application has been filed for demolition of the existing residence and construction of a new home located at 2172 Shadywood Road the ("Subject Property"), as more fully shown and described on Exhibit"A"attached hereto. 2. Owner requests the City to review this application. 3. The City will commence its review of the application and incur costs associated with said review only if the Owner establishes an escrow to ensure reimbursement to the City of its costs. NOW THEREFORE,THE PARTIES AGREE AS FOLLOWS: � 1. DEPOSIT OF ESCROW FUNDS. Contemporaneously with the execution of this Escrow Agreement, the Owners shall deposit$2,500 with the City. All accrued interest, if any, shall be paid to the City to reimburse the City for its cost in administering the escrow account. 2. PURPOSE OF ESCROW. The purpose of the escrow is to guarantee reimbursement to the City for all out-of-pocket costs the City has incurred (including planning, engineering, in excess of $500, or legal consultant review) or will incur in reviewing the plan. Eligible expenses shall be consistent with expenses the Owners would be responsible for under a building permit application. The escrow will also guarantee reimbursement to the City for all out-of-pocket costs the City has incurred to assure that the work is completed in accordance with the Stormwater Pollution Prevention Plan and the provisions of Orono City Code Chapter 79. The financial security may also be used by the Ciry to eliminate any hazardous conditions associated with the work and to repair any damage to public property or infrastructure that is caused by the work(including planning, engineering, or legal consultant review) associated with building permit #2010-00336 if compliance with the approved building permit is not accomplished. 3. MONTHLY BILLING. As the City receives consultant bills for incurred costs, the City will in turn send a bill to the Owners. Owners shall be responsible for payment to the City within 30 days of the Owners' receipt of bill. 4. DISBURSEMENT FROM ESCROW ACCOUNT. In the event that the Owners do not make payment to the City within the timeframe outlined in #3 above, shall issue a Stop Work Order until the Owners pay all expenses invoiced pursuant to #3. The City may draw from the escrow account without further approval of the Owners to reimburse the City for eligible expenses the City has incurred. 5. CLOSING ESCROW. The Balance on deposit in the escrow, if any, shall be returned to the Owners when the review has been completed and written notification is received from the Owners requesting the funds. 6. CERTIFY UNPAID 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 roperty pursuant to Minn. Stat. §§415.01 and 366.012. CITY: CI F��NO OWNER: By: S�1 tE l�� n �'c � q�/��1-,(�' its: - b�3� Q�k•►�� a ,>�� S� ►°� �sr`�2(p ,_ .�, a . �` . ,.� ��..� .w .��.��:f.�'e