HomeMy WebLinkAbout2013-00603 - pool in ground e
� � CITY OF ORONO * Z 0 1 3 - 0 P1 6 0 3 *
2750 KELLEY PARKWAY DATE ISSUED: 10/04/2013
� ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 2216 SHADYWOOD RD
PIN : 17-117-23-42-0004
LEGAL DESC : WILEYS PARK LAKE MTKA
: LOT O11 BLOCK 001
PERMIT TYPE : ACCESSORY STRUCTURE
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : POOL-IN GROUND
ACTIVITY : 329-STRUCTURES OTHER THAN BUILDINGS
VALUATION : $ 30,000.00 '
NOTE: SPEARATE ERMITS REQUIRED: MECHANICAL,ELECTRICAL(STATE)
POOL(SPA)
NOTE: -BUILT SURVEY AND HARDCOVER CALCULATIONS TO BE PREPARED BY REGISTERED LAND SURVEYOR D ON THE
TY' COVER CALCULATION SHEET TO BE SUBMITTED AND APPROVED BEFORE ESCROW ILL BE REFUNDE .
� ITIAL)
� '
NOTE: PERMITS REQUIRED FOR ANY ADDITIONAL HARDCOVER INSTALLATION,I.E.DECKING AROUND SP . (INITIAL)
APPLICANT pERMIT FEE SCHEDULE 466.75
SIGNATURE POOLS LTD. STATE SURCHARGE(VALUATION) 15.00
P O BOX 299
EXCELSIOR,MN 55331- TOTAL 481.75
(612)867-3457
OWNER
SHABAZ,REBECCA L
2216 SHADYWOOD RD
WAYZATA,MN 55391-
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 sepazate
pertnits. 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 aze
requested in conformance with the State Building Code.This permit may be
evoke t an cause.
l0 / l Zm l �Q--y�l l
p ' ' e i Date Issue By S' ature Dat
SEPARATE PERMITS REQUIRED FOR WORK OTHER AN DESCRIBED AB
City of Orono � _
Building Permit Application �� �S
for a Swimming Pool
���� Mailing Address: Permit number. ���- ���
PO Box 66 �
� Crystal Bay, MN 55323-0066 Date received: � �
( Street Address: Received by: �
� �' � 2750 Kelle Parkwa
� � � O, Y Y Plan review fee: 3 C�3_3 G(
�t,� � � Orono, MN 55356 a0(3- -1
�FS►�o � O
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: ��(� ����W d dQ/ ��p(
CONTRACTOR/APPLICANT INFORMATION:
Name: �/C-��/¢?7�/�E- ,�DOLS �7'�.
State License# iV Expiration Date:
Phone: S - 7 - �7 � Fax: - D �
Address: /' Cit : S!D IP:
Contact Person: E - Contact's phone nu - , - S
Email: yn�/ o� ; n S cd. A licant is: ntracto Homeowne� (circ�e one)
PROPERTY OWNER INFORMATION: Q
Name: e-/9 Sf�l�l/�}"� �'�L �lZf��i/�'�
Phone(day): - o r � /�Z- S'o - 3
Mailing Address: �/�DD / / rY1 ZIP:
Email and/or Fax: ,/" G/ /'G �-{�.�'�'12.
� CO i'�
ENGINEER INFORMATION:
Name:
Phone:
Address: City: ZIP:
Email: Fax:
PROJECT INFORMATION•
1.Pool Dimensions: � �/�� 4.Accessory to: 5.Pool Type: 7. Retaining Walls?
X feet �ingle Family ❑Above ground ❑yes �no Height '
2.Heated? ❑ Multiple Family/Condo ❑ In-ground *A building permit is required
�ies ❑no � public for any wall over 4 feet in
�.Other(specify) height measured from the
3. Excavated materials will be: ❑Commercial /������;\ ��� bottom of the footing to the top
J of the wall, even if it replaces
❑ Industrial 6.Sewa e Dis osal 8 an existin wall.
removed from site 9 P 9
❑used on site ❑Other: (specify) Water Supply Tiered walls are considered
❑Other:(specify) �Public Sewer one wall unless they are
separated by twice the height
/� ❑ Private Sewer of the higher wall.
Total Cubic Yards �Public Water
❑ Private Well
Estimated Construction Value $ �n �
Packet Last Updated: 03/29/13
Page 19 of 21
REQUIRED SUBMITTALS:
All of the information must be submitted in order for your application to be processed:
Not
Enclo ed A licable
❑ Permit A lication
❑ Plan Review Fee
❑ Pool Plans
❑ Surve includes radin plan
❑ Hardcover Calculation Worksheets
❑ Erosion Control Plan or co of MCWD Permit
� Se tic S stem Certification
❑ �' Wetland Buffer Im rovement Plan
❑ ❑ Escrow&Escrow A reement ,— LL � �L 1 07���
❑ ❑ Other
❑ ❑ Other
❑ ❑ Other
❑ ❑
APPLICANT ACKNOWLEDGEMENT:
. Agrees to provide all information required or requested by the Planning&Building Departments;
• Understands, if applicable, an as-built survey and as-built hardcover cover calculations, are required to be submitted after the
project is complete(including final grading and landscaping)prior to refunding the escrow;
• 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;
• 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 permit may not be issued.
ApplicanYs Signature: � Date: /0 �✓
;
Owner's Signature � Date: � j Z �
Q� A . �"�---. � ��Z��
Packet Last Updated: 03/04/13
Page 20 of 21
CITY OF ORONO
BUILDING PERMIT APPLICATION
FOR NEW STRUCTURES OR ADDITIONS
���� Mailing Address: Permit number: Q- -�Q
PO Box 66
Crystal Bay,MN 55323-0066 Date received: ' �
Street Address:' Received by:
� �` 2750 Kelle Parkwa
ti�, G` Y Y Plan review fee:
Orono,MN 55356
tqkF��o'��' Total Fee:
Main: 952-249-4600 Fax: 952-249-4616 www.ci.orono.mn.us
This application form must be completed in fuil and alf required information rriu§t t�e submitted.
Incamplete applications witl be returned. (Please print)
GENERAL INFORMATION: ,,,, ��j
Job Site Address: � �� [,c�OC�� !�`-`'
Will this be a Parade of Homes, Remodelers Showcase ome or other Display Home? ❑Yes No
lf yes,a specia/event permit is required with Police Department and City Council approva/60 days prior to the event. Shuttle bus service will 6e
required un/ess applicant demonstrates s�cienf on-site parking is available. Non-permitted events will not be allowed.
CONTRACTOR/APPLICAN INFORMATION: �
Name: � � �d�,S
State License# Expiration Date:
Phone: cell . — office �
Mailing Address: Cit : ZIP:
Contact Person: Applicant is: on ractor / Homeowner (Clrele One)
Email and/or Fax: —
PROPERTY OWNER INF RMATION:
Name: i ` �
Phone (day): _
Address: Cit : � ZIP• S
Email and/or Fax f�i o '' 1 ' C r1�•''�Y� �
ARCHITECT/ENGINEER INFORMATION:
Name:
Phone(day):
Address: City: ZIP:
Email and/or Fax:
PROJECT INFORMATION: Descri tion of ro'ect: ���C.-��-- � ��
1.Type of Project 2.Proposed Use 3.Structure Type 4.Sewage Disposal 8��
Water Supply !,�
❑New Construction �gle Family with ❑ Residence
❑Addition ^ attached garage ❑Garage/Accessory Bldg. ❑ Public Sewer
❑Accessory Building r�,�y�u./�.G�' ❑ Single Family with ❑ Deck
❑ Relocation � -J detached garage ❑Office/Commercial ❑ Private Sewer
`�Other: (specify) C./�G� ❑Multiple Family/Condo ❑Warehouse
❑Public ❑Storage ❑ Public Water
**Any earth movement may also require ❑Commercial `�:Qther(specify)
MCWD review&permits. ❑ Industrial ra C`�O ❑Private Well
Minnehaha Creek Watershed District(MCWD) �Other: (Specify) cn
18202 Minnetonka Blvd �/A��
Deephaven,MN 55391 ��
Phone: 952-471-0590
Fax: 952-471-0682
www.minnehahacreek.or
Estimated Construction Valuation (excluding land) $ �
STRUCTURE INFORMATION:
1.Structure Dimensions 1.Structure Dimensions(continued) 2.Type of Construction
a. Length(ft.)= Number of bedrooms=
❑Wood/Frame
b.Width(ft.)= Number of garage stalis: ❑Masonry
Areas in sauare feet Attached= ❑Metal
❑ Pole Bidg.
c.Basement= Detached= ❑ ICF
d. 151 Story = ❑On-site Prefab
e.2nd Story= ❑Off-site Prefab
f. '/:Story =
❑Other(please specify):
g.Total Area=
REQUIRED SUBMITTALS:
All of the information must be submitted in order for your application to be processed:
Not
Enclosed licable
❑ O Permit A lication
❑ ❑ Pro osed Buildin Plans
❑ ❑ MN State Ener Code Calculations and Mechanical Code Re uirements Form
❑ ❑ Surve meetin all re uirements
0 o Stormwater Pollution Prevention Plan
� ❑ 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
❑ ❑ Minnehaha Creek Watershed District Permit s
❑ ❑ Plan Review Fee
❑ ❑ Application Escrow&Agreement
❑ 0 Other:
APPLICANT/OWNER 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;
• Understands 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.
. Agrees ihat in the event that weather or other conditians prevent the completion of an as-buitt survey at tlte time the
Certificate c�f Occupancy is requested,a femporary Certi�cate of OcGupancy may be issued upon receipt of a S1t1}Ofl0
escrow to ensure completian of the as-built survey and alt site irnprcvem�nts.
r
ApplicanYs Signature: � Date: � � ��
Owner's Signature: Date:
Christine Mattson
From: Christine Mattson
Sent: Tuesday, July 16, 2013 9:57 AM
To: 'rick.etrheim@parkersfarm.com'
Cc: Melanie Curtis
Subject: 2216 Shadywood Road /#2013-00603
Attachments: admin@ci.orono.mn.us 20130716 094024.pdf; Escrow Agreement- Building Permit w
Erosion Control 2013-00603.pdf; Swimming Pool Building Permit Application -2013.pdf;
Hardcover Calculation Worksheet 2013 .pdf; Hardcover Information Packet-2013.pdf; Survey
Requirements-2013.pdf
Attached is a copy of a letter being mailed today. Please don't hesitate to contact me if you have any
questions.
Christine Mattson
Planning Assistant
City of Orono
2750 Kelly Parkway Orono MN 55356 (physical addressJ
PO Box 66 Crystal Bay MN 55323-0066 (mailing addressJ
`l�' 952.249.4620 8 952.249.4616
� cmattson@ci.orono.mn.us � www.ci.orono.mn.us
Summer Office Hours: (Monday, May 20 through Friday,August 30,2013)
Monday-Thursday: 7:30 am to 5 pm
Friday: 7:30 am to 11:30 am
OUR OFFICE WILL BE CLOSED: Monday,September 2, 2013
1
. � �-��o
C ITY OF ORONO
�, �„ Street Address: Mailing Address: Telephone(952)249-4600
��, ` 2750 Keliey Parkway P.O.Box 66 Fax (952)249-4616
lq �,�' Orono,MN 55356 Crystal Bay,MN 55323 www.ci.orono.mn.us
kFsxo�
July 16, 2013
Mike Randall
Signature Pools Ltd
PO Box 299
Excelsior, MN 55331
Re: Building Permit Appiication#2013-00603
2216 Shadywood Road
On July 2, 2013 the City received a building permit application for an in-ground spa. On July 8�' I spoke with
finro employees of Signature Pools about the required submission requirements. After a cursory review, we
have determined, your application is incomplete. The following items must be submitted or revised in order
for your application to be considered complete and for the plan review to continue:
1. Swimming Pools Application. The application completed was a building permit application for new
structures. Please complete the correct Building Permit Application for a Swimming Pool. A copy is
attached.
2. Building Plans. Please submit two sets of plans of the proposed pool.
3. Certificate of Survey. Please provide two copies of an updated, full size certificate of survey which
meets all of the City's survey standards (enclosed) indicating the location of the proposed pool and
decking (and any proposed grading).
4. Hardcover Calculations. The property is located in Tier 1 of the Stormwater Quality Overlay
District. Please have the sunreyor prepare hardcover calculations, showing existing and proposed
hardcover. Attached is our hardcover information packet.
5. Escrow 8� Escrow Agreement. Permits involving grading and/or review by the City's engineer
require submittal of an escrow and an escrow agreement. The purpose of the escrow is to
guarantee reimbursement to the City for out-of-pocket costs incurred during the review of your plans.
Additionally this escrow will guarantee conformance with City Code Chapter 79 relating to erosion
control and stormwater. The required escrow amount for this project is $2,500. The escrow
agreement is enclosed. The property owner must sign the escrow agreement and submit a check
for$2,500.
Your project may trigger the Minnehaha Creek Watershed District's (MCWD) permitting requirements;
please contact the MCWD regarding your project. Please note, the City of Orono will not issue a building
permit without a copy of MCWD permits or documentation from the MCWD stating the proposed project
does not trigger any of their permitting requirements. The above information is required in order for the plan
review to continue. Please feel free to contact me at 952.249.4620 or by email at cmattson@ci.orono.mn.us
if you have any questions on the above requirements.
Sincerely,
C TY OF RONO
.
C ristine Mattson
Planning Assistant
c Lyle Oman, Building Official
Rick Etrheim via email at rick.etrheim@parkersfarm.com
enclosures
` PLAN REVIEW CHEC�CLIST FOR NEW STRUCTURES / ADDITIONS
Address/Permit Number: �`� l �� � l`- r� c.� �--( �«, C�
� � �
Description of work: °� �
w .� .�
Septic review by: �� �� Date Approved: �� J � � -�
Zoning review by: ���L �� ��� �1' �`� Date Approved: ��' � (�
Building review by: Date Approved: � �'�� �'�
Grading review by: J-����-- Date Approved: �0 ' � � �3
"� �- Reso#: Z-�- Reso Date:
Zoning District: Zoning File#: � �3 . �
5 )M1 '. _ ".
Zoning: Lot Area: 1 �`�.�- SF�/AC Width: Lot Coverage: SF _%
Survey Submitted: Yes 0 No Date of Survey: �'� ��' �� Revised date(?):
Proposed Setbacks:
_�.
Front ake ` Rear(Street) N �6 E W ) ( N S� E W ) Other Buildings Wetland
�Side de �,i_�
� � , �� � � � � � �
r
Defined Height: Peak Height: FFE: FFE minus 6 feet= (Existing Contour)
Perimeter(linear feet) = 50% _ #of Stories Ok? � YE5
FOR A BUILDING WITH A BASEMENT OR CRAWL SPACE:
The distance between the lowest FOR A BUILDING ON A SLAB FOUNDATION:
START WITH proposed floor(of the basement or crawl
space)and the highest point of the roof. START WITH The distance between the top of slab and
If you hav,e a... the highest point of the roof.
If you have a...
• GABLE OR HIPPED ROOF(no . GABLE OR HIPPED ROOF(no
windows): Subtract half the windows): Subtract half the distance
distance between the highest point between the highest point of the roof
of the roof to the low point of the to the low point of the corresponding
SUBTRACTION corresponding gable or hipped roof SUBTRACTION gable or hipped roof
(BASED ON RO . GABLE OR HIPPED ROOF(with (BASED ON • GABLE OR HIPPED ROOF(with
NPE) windows): Subtract half the ROOF TYPE) windows): Subtract half the distance
distance between the top of the between the top of the highest
highest window and the highest window and the highest point of the
point of the roof roof
ALL OTHER ROOF TYPES(flat, • ALL OTHER ROOF TYPES(flat,
• mansard,etc):No subtraction. mansard,etc:No subtraction.
ADDITION Add the distance between the top of slab
UBTRACTION Subtract the distance between the (BASED ON and the highest existing grade adjacent to
(BASED ON EXISTING basemenUcrawl space floor and the EXISTING the foundation.
GRADES) highest existing grade adjacent to the GRADES
foundation OR 10 feet(whichever is less). EQUALS Defined building height
EQUALS Defined building height
Shoreland District MCWD Permit Receive Avera e Lakeshore Setback Met? Bluff
� Yes � No N/A � Yes No
Yes � No � Yes � No 0 N/A
Permit Number:��� �", !' Setback:
Stormwater Quality Existing Proposed Variance Required CUP Required
Overla District Tier Hardcover Hardcover
I .
_.. Yes 0 No 0 Yes No
� �� ���,��� ���J����`�.,..� T e(s): y� �� � Type(s).
�� t' : . -
t
Updated: January 2013 ��'�.;°-�' j , ���� ���
v:\forms�plan review checklist 2013.docx
�
REMARKS (in-house):
Fees to be Charged YES NO
Permit
Plan Review �, �
State Surcharge '����'��`���� � �/'
> .: �
Investigation Fee
SAC—Number of SAC Units
Other(specify)
Square Foota e $per Square Footage
Basement X = $
15t Floor X = $
2nd Floo� X = $
Garage X = $
Estimated Construction Value: ��C�.(�OD°�
Orono Inspections Required Work Requiring Separate Permits Required State Permits
� Site 0 Plumbing 0 Grading/ Filling 0 Well
� Hardcover Removal Mechanical � Fire Electrical
ooting � Septic � Water Connection
0 Poured Wall 0 Fireplace 0 Sewer Connection
� Foundation Survey � Masonry 0 Lawn Irrigation
0 Radon Rock Bed � Mfg. �
0 Frarning 0 Other(specify)
0 I nsulation
� s-Built Survey
� Final
� Wetland Buffer
0 Other(specify)
REMARKS (in-house):
�
Other Review: Reviewed by: Date Approved: � � ����
, �
Access: Existing: 0 YES � NO New: � YES 0 NO , j',�%`'�y ' l,f ��CC`��•t��'
S��(�('�,� r��„t�:r
�, �����, � ;y,
OFFICIAL REMARKS -TO BE NOTED ON PERMIT AND INITIALLED l� � l'S�'��'
� - , � � �r� �i,���v�, a��t 4�r�� � s� � � � � � �����
�v- �'' ' ��, � ��C�C: � � �� � ,� �� ��
IIA 'o�..
de.c.,Ki n� a,r�+�xld� �,p�,.
Updated: January 2013
v:\forms�plan review checklist 2013.docx
Christine Mattson
From: Brett Eidem [BEidem@minnehahacreek.org]
Sent: Thursday, October 03, 2013 2:09 PM
To: dana@signaturepoolsltd.com
Cc: Christine Mattson; Chris Meehan
Subject: Proposed spa pool at 2216 Shadywood Rd, Orono
Dana,
After reviewing your plan, it does not appear that this project will trigger any District rules.This project does not require
a MCWD permit.
The erosion control should be sufficient to protect any sediment from draining into the lake.
Thank you for your attention to protecting our lakes.
Brett Eidem
District Representative
Minnehaha Creek Watershed District
15320 Minnetonka Boulevard
Minnetonka, MN 55435
Direct: (952) 641-4517
Main Office: (952)471-0590
Fax: 952-471-0682
www.minnehahacreek.org
MINNEHAHA CREEK
WATER$kER DISTRICT
New office address July 1: 15320 Minnetonka Blvd., Minnetonka, MN 55345
From: Dana Butler fmailto:dana@si�naturepoolsltd.com]
Sent: Wednesday, October 2, 2013 1:43 PM
To: Chris Meehan
Subject: 2216 Shadywood Rd., Orono
Chris,
Attached, please find the survey showing the location of the proposed 100 sq. ft. spa at the referenced
address. Please provide us with a letter to the City of Orono stating that the proposed project does not trigger
any of the MCWD permitting requirements.
Thank you
Dana Butler
Sigrlature Pools,Ltd.
952.474.0702 office
1
ORONO COPY
City of Orono
����,,, Hardcover Calculation Worksheet
'��_���� ! Property Address: � �
v -�� 2 �t�� � � . _ � �- c, _ - ._.._ _m�=?���_.
'�v`�'�'� �-' Prepared by: � �� , Date:
�.�l.�1�. �'�� ��ss���� __.�__.��—t.�
��.t`,�.:�j, �.A.. �C,Yl_� .
_�
Stormwater Quality Overlay District Tier: (Circfe one) Tier 1 Tier 2 Tier 3 Tier 4 Tier 5
`�-.,__�__..�
Step 1: EXISTING HARDCOVER
In the following tabfe identify al! items of existing hardcover on the property, keyed by letter to Certificate
of Survey(survey must accompany this form). Use as many iines as necessary to accurately depict
existing hardcover status of the property. For Tier 1 properties, identify any features by letter which are
split at the 75' setback iine and calculate hardcover square footage separately for each portion.
-- -�- � � _._.._—_.
Key to ; Hardcover item�Describe) Length x Width Total
' Survey __ � _� _ (Square Feet �
�)._._..
Exam ie Gara e _�_� 24'x 30') (720 S.F.) !
� A L-' S.F. �
B �_,� _�_�-~�c�.� _ U�� ._..�_ _._ ....�:C"�,.t"�..___.....S.F.���
---� — — �
` _-- �-
; � ' ss�.�.a .� \! .r- t , S.F.
E �.��..,:�_�-- 11.� S.F.
_�... ��� _....._....M
_F __ _ S F. ;
G '
_---__��
S.F. '
H S.F.
____ -... �
° � S.F.
__._._ _
____ _ .... _m� _--
� �.......
—____ ..___.___,_....,..S.F.
-- _�-_ _
K S.F.
� _ S.F.
M __. ._ _
� S.F,
N --�_...__
� S.F.
O
___ ._ __. S.F.
P ___ �__ _...._ ..�.�.. .. _ .___�,____ .......�..._. __ __S.F.
__.... ._._
� _Q S.F.
__._.
�R _ S.F.
S .�......_ __ ___._ S.F,
T
_ �«—_,
�___.._�_____._...__ S.F. �
U _.__.___M...�. �-.-.. S.F.
V ___.
_... ._ .� .._.._. __ ,._ ..
_ _,..� _.�.- _... _. �.__ _ �
W _���� ___
�_ , S.F,
__ X ._.. S.F.
Y _...
�_ - w..._�._.�.�. �_�._.�_.�__� S.F
Z __ _......
S.F. ,
�7 ._Total Existing Hardcover _. . __ __��_ .____ ...... . __ _ _,,.._.. ����-- S.F.
Excludable Hardcover{See Git�r Code Sec 78-1684�:
� _ _ _
-- �� ���
__.....__ S.F.
�._.__ �
____.�__. �........__.____....__.. S.F.
. ,....... �
� � a� -�--_ _---_ S.F.
__—____��__
_.._ ___ .. ...�.......w_._....._
S.F.
�__.._
S.F.
�2� Total Excludable Hardcover S.F.
_______._.�� __ . __._ __.____..
3) Net Existing Hardcover (Subtract hne{2} from line(1 � �"�.._. S.F.
_� .__.....
4 Total Lot Area � �,�..� S.F.
Existing Hardcover Percentage [(3)=(4j] �,,'�'�„L�... %
�..._.e. ��.__ _ _ _____..._ d.,_w�
(Proposed Hardcover next page)
>anuary B,2013
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sCi� DA E TIME V
CITY OF ORONO CALLED IN ��—
INSPECTION NOTICE SCHEDULED /o�l� /D_'3.�
PERMIT NO.���-����3 COMPLEfED
ADDRESS a�� � �
OWNER LEPHONE NO. ��Z' �6�' 3�S 7
CONTRACTOR S( �8� L�
� DESCRIPTION �OD�I�/�v
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Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORENVETLANDS
y ❑ FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL
Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION
Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS
� ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT
J ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP
_ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL
J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATIOWREMOVAL
� OWNER/CONTRACTOR TO MEET YOU:_YES_NO
ti COMMENTS:
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V BEFORE COVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. ❑ pHOTOTAKEN
INSPECTOR WILL RETURN ❑CITATION ISSUED
❑STOP ORDER POSTED.CALLINSPECTOR
O INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Cail for the next inspection 24 hours in advance. (952) 249-4600
OwnerlContractor on site:
Inspector. i'-�
White Copy/lnspector's File Canary CopylSite Notice
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CITY OF ORONO CALLED IN ��" �
INSPECTION�rI���� SCHEDULED � — " �u�
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ADDRESS ��� '�(� � �-�
OWNER TEL HONE NO. �� Z g�o7 3 �j
CONTRACT �p p L d .�'�
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O ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORFJWEfLANDS
❑ FRAMING O MECHANICAL FINAL Q TREE REMOVAL
Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE O SITE INSPECTION
Q�DON SLAB ❑ WATER HOOK-UP ❑ PROGRESS
� FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT
v O DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP
_ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL
� 0 PLUMBING RI ❑ SEPTiC FIN�� / ❑ FOUNDATION/REMOVAL
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� O CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECAMERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ pHOTO TAKEN
INSPECTOR WILL REfURN ❑CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑INSPECTIONREWIRED.CALLTOARRANGEACCESS.
Ca11 for the next inspection 2a hours in advance. (952) 249-4600
OwnerfCorrtractor on site:
Inspector:
Whits Copyllnspector's File Cenary CopylSite Notiee
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To: Finance Department
Fr�m: Christine Mattson, Planning Assistant(J�
�
CC: Street File
Date: March 31, 2015
G/L.: 101-22205
Re: Escrow Refund
Building Permit #2013-00603 and Variance #13-3627 pertaining to 2216 Shadywood Road
are complete. Please refund $2,500 to the property owner, Rebecca Shabaz.
The following is attached:
� Original signed escrow agreement
• Copy of cash register receipt showing escrow amount received
Mail to: Rebecca Shabaz
2216 Shadywood Rd
Wayzata, MN 55391
w:�.street files�shadywood road�2216�escrow refund 2013-0OG03&13-3627.doac
� � �
BUILDING PERMIT ESCROW AGREEMENT ��,����,� ���./U`-'
Orono Building Permit# ?�13 ��(Q�3 �' �2 _ Z�
J
AGREEMENT made this�ay of � , 20 �, by and between the CITY OF ORONO, a
Minnesota municipal corporation("City")and t� L Wl ("Owners").
Recitals
1. A i ' g permit application has been filed for �n loc�ated at
0 e("Subject Property"), legally described as , Hennepin
County Minne ota.
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-0f-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 City to eliminate any
hazardous conditions associated with the work and to repair any damage to public property or infrastructure that is caused
#y th �� including planning, engineering, or legal consultant review) associated with building permit
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 tum 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 retumed 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
property pursuant to Minn. Stat. §§415.01 and 366.012.
CITY• I OF ORANO O R:
By ` �.
Its:
Internal Use Only: G Origina!to Firtance Department G Copy to Str�eet File
Padcet Last Updated: 03/29/13
Page 21 of 21
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M�NNESOT��ACCORDING�TO TH��RpEpNp��qT TM�EO OIN FlLE'
RECORp IN TME pFFlCE OF THE COUNTY RECORDER, NENNEPIN COU
MINNESOTA
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• , '' CITY OF ORONO
2750 KELLEY PARKWAY * Z 0 1 3 - 0 0 7 8 3 *
DATE ISSUED: 08/12/2013
ORONO,MN 55356-
(952) 249-4600 FAX: 952)249-4616
ADDRESS : 2216 SHADYWOOD RD
PIN : 17-117-23-42-0004
LEGAL DESC : WILEYS PARK LAKE MTKA
: LOT O11 BLOCK 001
PERMIT TYPE : ESCROW FEE-APPLICANT
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ESCROW FEE-APPLICANT
NOTE: THIS$2500 ESCROW IS TIED TO ZONING APPLICATION 13-3627 AND BUILDING PERMIT 2013-00603,PAID BY CHECK# 1251
BY REBECCA SHABAZ.
APPLICANT ESCROW FEE-APPLICANT 2,500.00
SHABAZ,REBECCA L ESCROW FEE-DEVELOPER 0.00
2216 SHADYWOOD RD TOTAL 2,500.00
WAYZATA,MN 55391-
OWNER
SHABAZ,REBECCA L
2216 SHADYWOOD RD
WAYZATA,MN 55391-
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 goveming 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 S�gnature Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.