HomeMy WebLinkAbout2011-00916 - land alteration t
� CITY OF ORONO PERMIT NO.: 2011-00916
2750 KELLEY PARKWAY
ORONO,MN 55356- DATE ISSUEn: 08/30/2011
952 249-4600 FAX: 952 249-4616
ADDRESS : 3745 SHORELINE DR
PIN : 20-117-23-21-0025
LEGAL DESC : TOWNSITE OF LANGDON PARK
: LOT 005 BLOCK 007
PERMIT TYPE : ZONING PERMIT
PROPERTY TYPE : RELIGIOUS
CONSTRUCTION TYPE : LAND ALTERATION(0-500 CU YDS)
NOTE: THIS PERMIT MINOR LAND ALTERATION AND A RETAINING WALL
* SEE 11-18-10 ENGINEER LETTER: PL NOTE COMPLETION OF PHASE 2 OR FUTURE CONSTRUCTION WILL TRIGGER THE
CITY'S WETLAND REGULATIONS.���INITIAL) �
*KEEP SITE DISTURBANCE TO A IMUM OF 5000 SQUARE FEET. z��(INITAL)
C
APPLICANT MINOR LAND ALTERATION 50.00
CHURCH,GOOD SHEPHERD LUTHERAN
3745 SHORELINE DR TOTAL 50.00
WAYZATA,MN 55391-
OWNER
CHURCH,GOOD SHEPHERD LUTHERAN
3745 SHORELINE DR
WAYZATA,MN 55391-
AGREEMENT AND SWORN STATEMENT
The work for which this pertnit 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 ti for due c
�- � ��l�o i Zv l/ 8'��p � �
Appli ermitee Signature Date Issued Signature Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
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. � ' • City of Orono
Zoning Permit Application
Mailing Address: Permit number: � —�d
�Q �1� PO Box 66
�`V Crystal Bay, MN 55323-0066 Date received: �
� .�,� � � Escrow amount: �� . � w� ��
a,�� Street Address: � �� � rV�-
a � "�'� �" 2750 Kelley Parkway Permit Fee:
�- �,
��L f p� �p'�' Orono, MN 55356 Approved by: �
9kESH04 Fax: 952-249-4616 Notes:
Main: 952-249-4600 W�•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: �j7�'-j ='�� ��N� �.��_ (�{1�U, ���. �3��
CONTRACTOR/APPLICANT INFORMATION:
Name: � � � �.� �
Phone: - - Fax: � - - 3
Address: s jy Cit : , Z ZIP: ��39
Contact Person: p, � (? �� Contact's phone number Ge� : (z-�� -� a(o
Email e����y, p�c'c,C��.y�ec�iQ��,1,�,.h�'�pplicant is: ontra tc o� eowner Circle One)
�bfi�f OW��'-- �:
PROPERTY OWNER INFORMATION: �
►vame: �G�'l7 51-��k�D �_� GHU I�
Phone (day): �c,� ;Z- � - ��` "
Mailing Address: ��/ Z,As'�"� ZIP:
Email and/o Fa �� �2 - -� 3
Overall Project Description: (���:�p.� p{ (���-�j�j�.,"j���r�'�{� '�G (���U� �,;75��`�•(�i,��
Check TYPE OF PERMIT COST
Box
Residential Dock- Permanent dock on any lake or initial seasonal dock not on $30 + engineering review
Lake Minnetonka ermanent dock re uires CUP costs
Commercial Dock $50+ engineering review
costs
Escrow for erosion control and en ineerin review costs $2,000
Minor Land Alteration (grading, filling or excavating) -500 or less cubic yards $50+ engineering review
OC� outside of lakeshore setback or less than 10 yards in lakeshore setback costs
Escrow for erosion control and en ineerin review costs $�-6����. ��c-
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 en ineerin review costs As determined b CUP
Stairway to Lake $50+ engineering review
costs
Escrow for erosion control and en ineerin 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 en ineerin review costs sJ'r�;��- ���
Tree Removal or intensive ve etation removal in 0 to 75 foot zone No char e.
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 en ineerin review costs $2,500
(over)
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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 infor ation pplie ' rue and correct to the best of their knowledge.
Applicant's Signature: �".,� y��"2 Date: B Z � �/
Property Owner's Signatu : �i������- ��(�,���� Date: ��p��� //
�—� �-
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 lan or co of MCWD Erosion Control Permit
Last Updated: October,2010
Plan Review Checklist for Zoning Permit Applications
Address: ��� � �� �v �����2 � l�L.y2 �'. .
Description of work: c�tl� ��� ��'�` � � '✓L� `- ��=����� �� _� � �- ���--��'��
Type of permit: ��'�� �u.-�' lS�, �"� � LU �y
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Zoning review by: " Date Approved: '9� `
�
Grading review by. ���:����'�° �'4-� "�. �'`� Date Approved:
Other Review, Reviewed by: � : . Date Approved:
Zonin : (�"�
Zoning File#: .� � Resolution#: Resolutic�n Date:
I� -- � � q �
Lot Area: SF/AC Width: Depth:
ubmitted�0 Yes � No Date of Survey:
�m
Existin Setbacks:
Front(Lake) Rear(Street) ( N S E W ) ( N S E W ) Other Buildings Wettand
Side Side
Pro osed Setbacks:
Front(Lake) Rear(Street) ( N S E W ) ( N S E W ) Other Buildings Wetland
Side Side
Shoreland District MCWD Permit Received Average Lakeshore Setback Met%� Bluff
� Yes � No 0 N/A ❑ Yes 0 No
� Yes � No � Yes 0 No 0 N/A
Permit Number: Setback:
Hardcover Zones Existin Pro osed Variance Required CUP Required
0-75' � Yes � No 0 Yes 0 No
75-250' Type(s): Type(s):
250-500' Zoning File#: Zoning File#:
500-1000' Resolution #: Resolution#:
Created: March 29,2011
z:\forms\plan review checklist for zoning permit applications.docx
Planning Review Checkiist for Zoning Permit Applications
Page 2 of2
Cubic Yards
In Out Total
Haul Route? ? � Yes � No
Explain haul route in detail:
Fees to be Charged Amount Orono Inspections Required
Permit Amount �- F ,. ,
t.��' "'<. �,� 0 Site
Escrow Amount � Hardcover Removal
Footing
Signed escrow received? � Poured Wall
� As-Built Survey
0 Yes 0 No � Planting Pian
0 Wetland
Escrow amount received? 17 Final
❑ Yes � No i � Other(specify)
Engineering review needed?
� Yes 0 No
�
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REMARKS (in-house):_���t�,� � � � _�'; ��=�_' � �����f�2� v� �� �1 �'�-i� � ���/",�J` , �_
_T�`-`
Other Review: Reviewed by: Date Approved:
REMARKS (TO BE NOTED ON PERMIT AND INITIALLED BY PERSON PULLING PERMIT)
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-�{7.t..�'u-t�'�' C�S�Yu ��l ��� 1 f21 la��/� � �' � t�U�fZ¢0201 4�� �.�-��dLr,��
'� ;���D � �,��' �:'5:�,�U'�,`c�'✓�c� 7`U vt ��2�;n YJ�L�s�-, Cj f ��- :�"� �S'-�''�c.�-t^ ��2�,
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Created: March 29,2011
z:\forms\plan review checklist for zoning permit applications.docx
2335 Highway 36 W
�RONO C��p St Paul,MN 55113
� Te1651-636-4600
Fax 651-636 1311
www.bonestroo.com
November 18, 2010 �Bonestroo
Melanie Curtis
Planning and Zoning Coordinator
Ciry of Orono
Post Office Box 66
Crystal Bay, MN 55323
Re: 3745 Shoreline Drive Good Shepherd Church
File No. 000139-10000-1
File No. 10-3493
Dear Melanie:
We have reviewed the plans for a proposed peace garden at the Good Shepherd Church. The
plans are dated 11-9-10. We have the following comments with regards to engineering matters:
� • The plans show a "South Construction Area" and "Future North Construction Area." This
���.�f D� review only considers the "South Construction Area." For future planning consideration,
�la M,t� � the combination of the future building addition and the "North Construction Area" would
���Y,�� likely trigger Orono's wetland bufFer ordinance.
• The project must keep their site disturbance area to a maximum of 5000 square feet.
--.�---`� The construction limits should be clearly defined on the drawings and in the field. A
disturbance area of more than 5000 square feet will trigger the city's wetland buffer
ordinance. To the extent possible, site access should be limited to one narrow path from
the parking lot area.
• This project will disturb less than 100 CY of material. Sediment and erosion control
information meeting the requirements of Orono's City Code 79-7(c)(1) must be
submitted. In general, the grading plans must show silt fence between the grading limits
and the wetlands. The minimum $2000 sediment and erosion control financial security
should be required of the owner for this permit.
If you have any questions, please call me at (651) 604-4894 or send an email to
darren.amundsenCa�bonestroo.com.
Sincerely,
BONESTROO
�`� ���---��----_
Darren Amundsen
Cc: Tom Kellogg
. � � ���7 yS �
, � �� oRONo coPY ����� ��
Melanie Curtis
From: Steve Christopher[SChristopher@minnehahacreek.org]
Sent: Monday, August 22, 2011 4:22 PM
To: Melanie Curtis
Cc: Pastor Loren Davis; davekay.owen@mediacombb.net
Subject: RE: Good Shepherd Church
Melanie,
Following a meeting with Pastor Loren and Dave Owen regarding the proposed work at Good Shepherd Church, District
staff has determined that the project will not require Stormwater Management as it falls under 2.(d):
(d) LINEAR TRANSPORTATION PROJECTS: Construction of a new or reconstruction of an
existing road,trail, sidewalk, utility, or other linear transportation project(see Table 5):
(1)that will create less than 10,000 square feet of new impervious surface; or
(2j for the construction of sidewalks and trails that will not exceed 12 feet in width and
will be bordered on the downgradient side(s) by a pervious buffer averaging at least
one-half the width of the sidewalk or trail.
Given that the Stormwater rule is not triggered,the Wetland Protection rule does not apply. While the project is below
the threshold for a District Erosion Control permit, staff does support the Erosion Control plan that was reviewed on site
with Dave Owen on August 22"a
Let me know if there are any questions.
Steve Christopher
Regulatory Program Manager
1 8202 Minnetonka Blvd.
Deephaven, MN 55391
Direct: 952-641-4506
Office: 952-471-0590
Fax: 952-471-0682
www.minnehahacreek.ora
��.., ;:
MINNEHAHA CREEK
WATERSHED DISTftICt
From: davekay.owenCa�mediacombb.net jmailto:davekay.owenCa�mediacombb.net]
Sent: Monday, August 22, 2011 2:40 PM
To: Steve Christopher
Cc: Pastor Loren Davis
Subject: Good Shepherd Church
i
.� ' "
, Hi Steve,
Thanks for your time this morning. As you suggested, this is a followup reminder for you to
inform the City of Orono, specifically Melanie Curtis, (MCurtis(a�ci.orono.mn.us) of the status of
our project with your agency, and that no permitting is required.
May I ask if you would mention to her, due to the many trees and their roots including sensitive
Oaks, that the use of a Bio-Roll might be a better solution than an erosion fence that is knifed into
the ground. We are afraid of loosing trees by disturbing their roots. This project is expected to last
only 4-6 weeks.
Thank you.
Dave Owen
Chair, Good Shepherd Peace Garden Committee
Good Shepherd Lutheran Church
3745 Shoreline Drive
Orono, MN 55391.
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DAy£ TIME
CITY OF ORONO CALLED IN �
INSPECTION�n g��cE��r� SCHEDULED
PERMIT NO. COMPLETED
ADDRESS ���'I� .���f �P l/� f' � , � ��,/�or�1
OWNER TELEPHONE NO'��'� `3�0�' ���t-T'`��
CONTRACTOR �II�YI N ullc�['�
�; DESCRIPTION ��'�I�' �Q� ��Q�� C�����'�
�
� ❑ FOOTING ❑ PLUMBING FINAL�r �l/I P� EXCAV/GRADING/FILLING
Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS
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
� ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP
_ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL
v ❑ PLUMBING RI ❑ SEPtI�FINAL ❑ FOUNDATION/REMOVAL
� OWNER/CONTRACTOR TO MEET YOU:y��YES_NO
� COMMENTS: �_1'�L���.�%'� ��f �Cat�L'Yl
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V BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pHOTO TAKEN
INSPECTOR W4LL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
0 INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (952� 249-460�
Owner/Contractor on site:
Inspector. �
White Copyllnspector's File Canary CopylSite Notice
DATE TIME V
CITY OF ORONO CALLED IN //-/3—�3
INSPECTION N TICE SCHEDULED /1_/S_/?�
PERMIT NO. - � l-6 COMPLETED
ADDRESS ��Z�� ��1�����t�t
OWNER� ' ' ELEPHONE NO. - �-7
CONTRACTOR ��I
� DESCRIPTION <���i�.�
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� ❑ FOOTtNG ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING
Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORFJWETLANDS
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 REMOVA�
J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL
Z OWNERICONTRACTOR TO MEET YOU:_YES_NO
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� BEFORECOVERING PERMANENT
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INSPECTOR W{LL RETURN ❑CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call forthe next inspection 24 hours in advance. (952) 24�-46��
OwnerlContractor on site:
Inspector.
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To: Finance Department
From: Christine Mattson, Planning Assistant
CC: Street File
Date: May 27, 2014
G/L: 101-22205
Re: Escrow Refund
Building Permit Application #2011-00916 pertaining to 3745 Shoreline Drive is complete.
Please refund$700 to the applicant, Good Shepherd Lutheran Church.
The following is attached:
• Copy of final inspection slip
• Original signed escrow agreement
• Copy of cash register receipt showing escrow amount received
Mail to: Good Shepherd Lutheran Church
3745 Shoreline Drive
Wayzata, MN 55391
w:�.street files�shoreline drive�3745�escrow refund request 2011-00916.docac
, �
DATE TIME V
CITY OF ORONO CALLED IN /l-/3/3
INSPECTION N TICE SCHEDULED //-���
PERMR NO. - � l-� COMPLETED
ADDRESS � 7�� ��1��— ��-
OWNER�J c -
ELEPHONE NO. �-7
CONTRACTOR ��%Gef J '
�, DESCRIPTION <�i��
�
� O FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING
Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORENVETLANDS
❑ FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL
� ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION
� RADON SlA6 ❑ WATER HOOK-UP p pRpdqESS
� ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT
�v ❑ DEMO-SITE � SEPTIC MAINT. ❑ FOLLOW-UP
❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL
v � PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL
2 01NNERlCONTpACTOR TO MEET YpU:_YES_NO
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� ❑WORK SATISFACTORY:PROCEED �PqpJECT COMPLETE
W O CORRECT WORK d�PHOCEED ❑ISSUE CERTIFICATE OF OCCUPANCY
0 ❑CORRECT WORK,CALL FOR flE1NSPECTION TEMPORARY
V BEFORE COVERING PERMANENT
O CORRECT UNSAFE CONDITION WITHIN HOURS. p pMOTO TAKEN
INSPECTOR YVILL RETURN
O STOP ORDER POSTED.CALL INSPECTOR ❑CITATtON ISSUED
❑INSPECTION REOUIRED.CALL TO ARRANGE ACCESS.
Call for the next mspection 24 hours in advance. (g52) 249-46�0
OwnerlContraator on site:
Inspector: __
Whits Copyllnapectopa File Cansry CopyfSlte Notice
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Pe�nni�Address: 3745 Shorei"sne Dr C' �4ddition�l PiN ,�ddres�
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ESCROW AGREEMENT
Land Use Application#10�493
� Permit#2011-00816
AGREEMENT made this�day of v f�, 20��, by and between the CITY OF ORONO,
a Minnesota municipal corporation ("City")and Good hepherd Lutheran Church ("Owners").
Rec' Is
1. A building permit application has been filed for a zoning peRnit for a property located at 3745
Shoreline Drive, the ("Subject Property"), legally described as Lot 5, Block 7, Townsite of Langdon Park,
Hennepin County Minnesota.
2. Owner requests the City to review this application.
3. The Ciiy 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$700.00 with the City. All accn.ied 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 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 zoning 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 worlc 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 by the work (including planning, engineering, or legal consultant
review) associated with Land Use Application # 10-3493 and Zoning Pennit#2011-00916 if compliance with
the approved zoninq permit is not acxomplished.
3. MONTHLY BILLING. As tl�e City receives consultant bills for incurred costs, the City will in tum
send a bill to the Owners. Owners shall be responsibte for payment to the City within 30 days of the Owners'
receipt of bill.
4. DISBURSEMENT FROM ESCROW ACCOUNT. In the event that the Ovmers do not make payment
to the City within the timeframe outlined in#3 above, shall issue a Stop Wortc Order until the Owners pay all expenses
invoiced pursuarrt 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 ESCR�W. The Balance on deposit in the escrow, if any, shall be retumed to the
Owners when the review has been completed and written notfication 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
subje rty pursuant to Minn. Stat. §§415.01 and 366.012.
CITY: CI O OR OWNER:
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ZONiNG PERMIT ESCROW AGREEMENT
Orono Zoning Permit# /D�5��-3
AGREEMENT made this�day of ` � � , 20�Q, by and between the CITY OF ORONO,
a Minnesota municipal corporation ("City") and D� df � ("Owners").
Recitals
,�7� �'�.Y_ �A building permit application has been filed for a zoni � ermit or a property located at
•a�. ,�v,,r,�'iz.Tln�, �he ("Subject Property"), legally described as ,
Hennepin County Minnesota. �� W �������� ���
2. Owner requests the City to review this application. �+0 ��
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 $�700.p0 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 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 zoning 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 atso 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 b the work (including planning, engineering, or legal consultant
review) associated with zoning permit # /D-�y 93 if compliance with the approved zoning 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
subjec,f,proper�ty pursuant to Minn. Stat. §§415.01 and 366.012.
CITY: CI OWNER:
By:
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� • , Date Incomplete Notice Sent: ���"1�� �
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Copy of Application Sent to:
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� Date Property Owners Notified:
Date Legal Notice Published:
PC Meeting(s):
Vote:
� Vote:
Vote:
� Notice of PC Action:
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City Council Meeting(s):
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Notice of Council Action:
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CITY OF ORONO PERMIT NO.: 2010-o�os6
2750 KELLEY PARKWAY
ORONO,MN 55356- DATE ISSUED: iU04/2010
952 249-4600 FAX: 952 249-4616
REPRINTED ON 8/30/2011
ADDRESS : 3745 SHORELINE DR
PIN : 20-117-23-21-0025
LEGAL DESC : TOWNSITE OF LANGDON PARK
: LOT 005 BLOCK 007
PERMIT TYPE : ESCROW FEE-APPLICANT
PROPERTY TYPE : RELIGIOUS
CONSTRUCTION TYPE : ESCROW FEE-APPLICANT
NOTE: THIS$700.00 ESCROW WAS PAID BY GOOD SHEPHERD LUTHERAN CHURCH FOR ZONING PERMIT#1Q3493
APPLICANT ESCROW FEE-APPLICANT 700.00
CHiJRCH,GOOD SHEPHERD LUTHERAN TOTAL 700.00
3745 SHORELINE DR
WAYZATA,MN 55391
OWNER
CHURCH,GOOD SHEPHERD LUTHERAN
3745 SHORELINE DR
WAYZATA,MN 55391-
AGREEMENT AND SWORN STATEMENT
The work for which this pertnit 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 conswction 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.