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Home My WebLink About2014-00835 - addn/remodel/repair � � CITY OF ORONO 2750 KELLEY PARKWAY * z 0 1 4 - 0 0 B 3 S * DATE ISSUED: 08/06/2014 ORONO, MN 55356- (952) 249-4600 FAX: (952) 249-4616 ADDRESS : 1480 SIXTH AVE N PIN : 26-118-23-32-0008 LEGAL DESC : DOUGLAS ESTATES : LOT 001 BLOCK 001 PERMIT TYPE : ADDITION/REMODEL/REPAIR PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR ACTIVITY : 434-RESIDENTIAL VALUATION : $ 15,000.00 NOTE: SEPARATE PERMITS REQUIRED: PLUMBING,MECHANICAL,SEPTIC CONNECTION,WATER CONNECTION,SEWER CONNECTION,ELECTRICAL(STATE) REBUILD BARN IN-KIND ON EXISTING FOUNDATION. APPLICANT PERMIT FEE SCHEDULE 265.50 GORDON JAMES CONSTRUCTION PLAN REVIEW 172.58 5159 MAIN STREET E STATE SURCHARGE(VALUATION) 7.50 P.O.BOX 306 TOTAL 445.58 MAPLE PLAIN,MN 55359- Payment(s) (763)479-3117 CHECK 11467 445.58 Minnesota State License#:BUIL-20531961 OWNER GULBRANDSON,DAN&ERICKA 1480 SIXTH AVE N 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 aze requested in confo with t tate Building Code.This permit may be revoked at any � e e. �(Y /�� — � / lC/ /�� Ap icant Permitee Signature Date Issue y Signature Date ' � City of Orono Building Permit Application for Maintenance / Replacement / Renovation (No structural expansion. Only windows, doors, siding, re-roof, etc.) �O�O Mailing Address: i PO Box 66 Permit number: Crystal Bay,MN 55323-0066 Date received: � � Street Address: l Received by: � y GZ 2750 Kelley Parkwa al�'YI' Plan review fee: `� Orono,MN 55356 � � � l9kES HO�� /� 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: �'= ,/�vE. Q , �� '1� Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑Yes No !f yes,a specia/event permit is required with Police Department and City Council approva/60 days prior to the event. Shutt/e bus service wil!be required unless applicant demonstrates sufficient on-site parking is available. Non-permitted events will not be allowed. CONTRACTOR/APPLICANT INFORMATION: Name: CTc�Oa►.� '�✓aµ6s Cc�.n-�dwG'�6aIUV State License# �,�,S3�q�� Expiration Date: 30 3��9� Lead Certification Number: �-- Expiration Date: �--' (for work on homes that were constructed prior to 1978 Phone: (cell) CoS� �a�-�$1a�. (o�� .��3� ��a-3�\� Mailing Address: S65q M,A,1t�� City: Mqp�, p�.qo� ZIP: �j53S� Contact Person: �„q��- NGuSc,9�w��l�YC Applicant is:�on r" at—"c�o� / Homeowner (Circle One) Email and/or Fax: �A-��v .�,2,g��,-��LS C.c�M ^- (�� - �6�1� PROPERTY OWNER INFORMATION: Name: �,paN �- l:n-��Ld�. C-��-'(3R.Po�N�S(NJ Phone(day): (qsz) G3�-3�4�-4`7 Address: ��c� �o� ,,t�v� � City: �� ZIP: �j5 3S� Email and/or Fax: g�q.,,C,-�yl��,��,�Sp�� ('_y..ti,q�� PROJECT INFORMATION: Overall ro�ect descri tion: ��( . 6� �� 5�► 4�Y� ` dJ'nc-Sc�'�+t�o,x�.��c�! Type of Project: Any earth move nt may also require ❑Door(s) �E2emodel ❑Fire Damage MCWD review 8�permits: ❑Re-roof,asphalt ❑Repair ❑Storm Damage Minnehaha Creek Watershed District(MCWD) 18202 Minnetonka Blvd �Re-roof,cedar �Restora6on ❑Water Damage Deephaven,MN 55391 ❑Re-roof,other(specify) ❑Siding ❑Other: (specify) Phone: 952�71-0590 Fax: 952-471-0682 ❑Window(s) www.minnehahacreek.orq Estimated Construction Valuation of Project(excluding land) $ �.'S�CX3� — '6 n�,n,o_Q p�t,��,v�� v�/us� ��;r,�: APPLICANT ACKNOWLEDGEMENT: dp'O . Agrees to provide all information required or requested by the Building Department; . 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 prowlke 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. Confidenfial 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 govemmental agencies required by law. If ou refuse to su I the information t e a lication ma not be issued. ApplicanYs Signature: Date: �'�J�'�� Owner's Signature: Date: Last Updated:03/06/2013 � � PLAN REVIEW CHECKLIST FOR NEW STRUCTURES / ADDITIONS Address/Permit Number: ��0 5�-�'n-� R� NO• Description of work: �i3�� Q Ra N K� L' ��?' �6 v�l�► A� r� Septic review by: N�A Date Approved: Zoning review by: /�� Date Approved: Building review by: Date Approved: 8— y� ��Y Grading review by: ��/a Date Approved: oning District: Zoning File#: Reso#: Reso Date: Zonin • Lot Area: SF/AC Width: Lot Coverage: _% Survey Su itted: � Yes 0 No Date of Survey: Revised te(?): i Pro osed Set cks: %� , Front(Lake) Rear(Street) ( N S E W ) ( N S E W ) Other�iildings Wetland Side Side , Defined Height: Peak Height: FFE: FFE min s 6 feet= (Existing Contour) Perimeter(linear feet) = 50%_ #of Stor' s Ok? � YES FOR A BUILDING WITH A BASEMENT OR CRAW PACE: The distance between lowest FO BUILDING ON A SLAB FOUNDATION: START WITH proposed floor(of the bas ent or crawl space)and the highest pofn f the roof. START WITH The distance between the top of slab and If you have a... the highest point of the roof. If you have a... • GABLE OR HIPPED ROOF( . GABLE OR HIPPED ROOF(no windows): Subtrad 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 conesponding SUBTRACTION corresponding gable or hipped roof SUBTRACTION gabie or hipped roof (BASED ON ROOF . GABLE OR HIPPED ROOF(wit (BASED ON . GABLE OR HIPPED ROOF(with TYPE) windows): Subtract half the ROOF TYPE) windows): Subtract haif the distance distance between the top of e between the top of the highest highest window and the h' hest window and the highest point of the point of the roof roof • ALL OTHER ROOF PES(flat, • ALL OTHER ROOF TYPES(flat, mansard,etc):N ubtraction. mansard,etc:No subtraction. ADDITION Add the distance between the top of slab SUBTRACTION Subtrad the distan tween the (BASED ON and the highest existing grade adjacent to (BASED ON EXISTING basemenUcrawl s ce floor and the XISTING the foundation. GRADES) . highest existin rade adjacenY to the G DES foundation O 10 feet(whichever is less). EQ LS Defined building height EQUALS Defined flding hefght Shoreland District MCWD Permit Received Avera e Lakeshore Setbac et? Bfuff � Yes � No � N/A 0 Yes C No 0 Yes � o � Yes � No 0 N/A Permit Number: tback: Stormwat Quality Existing Proposed Variance Required CUP Required Overla �strict Tier Hardcover Hardcover 0 Yes 0 No 0 Yes 0 0 Type(s): Type(s): Updated: January2013 ll,u �/,��G,� v:\formslplan review checklist 2013.docx v� REMARKS (in-house): Fees to be Char ed YES NO �P�'�. w,, � k Plan Review "5tate�uncfig�ge ti!'� �K, Investigation Fee �'S�i�C«=�1'u�r of_SAC�Inits •�: ,�" `� � ... � _ , .,,.. _ .. � _. : Other(specify) S uare Foota e $ er S uare Foota e Basement X = $ 18`Floor X = $ 2nd Floor X = $ Garage X = $ 9S.ou o Estimated Construction Value: $ i�,4l�0�" — 9e�o� — P�`O"� ��'''''T �SAdJ Orono lnspections Required Work Requiring Separate Permits Required State Permits O Site J�Plumbing O Grading/Filling � Well 0 Hardcover Removal ,�Mechanical � Fire � Electrical � Footing eptic CoNN Q cri�+y,�Water Connection 0 Poured Wall � Fireplace ,�Sewer Connection � Foundation Survey 0 Masonry � Lawn Irrigation G Radon Rock Bed G Mfg. Framing �� Other(specify) �Insulation � As-Built Survey �Final 0 Wetland Buffer � Other(specify) REMARKS (in-house): Other Review: Reviewed by: Date Approved: Access: Existing: 0 YES � NO New: � YES 0 NO OFFICIAL REMARKS-TO BE NOTED ON PERMIT AND INITIALLED Updated: January 2013 v:\forms�plan review checklist 2013.docx �� 7 t � • -~ City of Orono Building Permit Application for IVla�ntenance / Replacement / Renovation (No structural expansion. Only windows, doors, siding, re-roof, etc.) ��q� Mailing Address: �VO PO Box 66 Permit number: / � Crystal 8ay,MN 55323-0066 Date received: Sfreet Address: Received by: tiF � 2750 Kelley Parkway �' Orono,MN 55356 Pian review fee: 1qkFs x o��' Total Fee: Main: 952-249-4600 Fax: 952-249-4616 www.ci.orono.mn.us This appiication form must be completed in full and all required information must be submitted. Incomplete applications will be returned. (Please print) GENERAL INFORMATION: ��, JobSiteAddress: ��-4`�uv t`�`='' ,�„l3�, � ��7��, �,@J Will this be a Parade of Homes,Remodelers Showcase Home or other Display Home? ❑Yes � No 1f yes,a special evenf pennit is required with Police Department and City Council approval 60 days prior to the event. Shuttle bus service will be required unless applicant demonstrates s�cient on-site paiking is available. Non-permitted events will not be allowed. CONTRACTOR/APPLICANT 1IVFORMATlON: Name_ �;�3�01.� J�. ^ �-�:=.> ��;�-;.�;-�-;.,�J State License# �y f,:�� a�f ` Expiration Date_ .� ��3�� 'a� Lead Ceriification Number= Expiration Date: (f+�r work on homes that uvere constructed prior to 9978 � Phone_ (cel!) ��g� ��}`�-s��:; (office) ��io�� i�i _=�►� : Mailing Add�ess: �a r,� '$�lAi+� �e'. C�h'= 9"SA�i.e, t��1�i� ZIP: `�S�cj 4� Contact Person: �� -��.o�b�g��` Applicant is: ont / Homeowner (Circle One) Email and/or Fax: �,n�:��—�:A��=�..C'� � f ;��o +�`?� - � ,�,X e ..� - PROPERTY 01MdER INFORMATlON: Name: ,^,�� `►- ;:��:•e�U ��i.��_.�.SJ":>"�T�:�--� Phone(daY)= r a�;�; a ;`,-"�s�i o Address: 'i 45��1 �:j`�� J C�Y� ��;,� ��'�.� Z1P: rj j j�J t� Email and/or Fax: y_ L�;��,��j��U�,�� Aoi.��.,� tJwW�. P..oJ4i1a:T.<e��LJ'c- �'�UJ��,�i PROJECT INFORMATION: Overall pro"ect description: RL'�"d�pi�- �1a�2� .�.»� �(z ��,�;e� �-��;,a��. Type of Project� Any earti�movement may also reyuire ❑Door(s) �Remodel ❑Fire Damage MCWD review�permits: �Re-roof,asphalt ❑Repair ❑Storm Damage Minnehaha Creek Watershed District(MCWD) ❑Re-roof,cedar 18202 Minnetonka Blvd �,Restoration ❑Water Damage Deephaven,MN 55391 ❑Re-roofi other(specify) ❑Siding ❑Other:(speciiy) Phone: 952-479-0590 Fax. 952-479-0682 ❑Window(s) www.minnehahacreek.orq Estirriated Construction Valaation of Project(excluding land) $ �' 7� � APPLICANT ACKNOWLEDGEMENT: � Agrees to provide all informafion required or requested by the 8uilding Department; � Certifies that the information supplied is tn.ie and correct to the best of his/her Imowledge. The applicant recognizes that they are solely responsibie 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; • 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 generaUy cannof be given to either the public or the subject of the data. Our purpose and intended use of this information is to annuaily update our records and records of other govemmental agencies required by law. If ou reiuse to suppl the informaSon, pplication ma not be issued. ApplicanYs Signature: � Date: �!��, r Owr�er's Signature: Date: Last Updated_03/06l20'!3 DATE TIME � CITY OF ORONO CALLED IN INSPECTION NOTIGCE � SCHEDULED PERMIT NO. Q�7 "' �� COMPLETED �S �� ADDRESS /�j'�6 ��l.. �u� . � OWNER TELEPHONE NO. CONTRACTOR GaraQ�c cT4 rvi�S � DESCRIPTION �/'G-►"+�K s re�Kt�tc L�ro„ � ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FIWNG Q ❑ POURED WALL O MECHANICAL RI ❑ LAKESHORFJWEfLANDS O �RhMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q ❑ RADON SLAB O WATER HOOK-UP ❑ PROGRESS � ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPIAINT v ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP _ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL v ❑ PLUMBING RI ❑ SEPTIC FINAL O FOUNDA710N/REMOVAL 2 �NNERICONTRACTOR TO MEET Y�OU:_YES_NO � COMMENTS: �.��. �� IS K �6—��f S� � �r��.. .�.c a,n�e�.�� 4K � 0 �. o� 0 k W � Q � W � W � j O W ❑WORK SATISFACTORY:PROCEED ❑PRW ECT COMPLETE � ❑CORRECT WORK 8 PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY W O O CARRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOWERINC, PERMANENT �CORRECT UNSAFE CONDiT10N WITHIN HOURS. p pH0T0 TAKEN INSPECTOR WILL REfURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED ❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. (952) 249-4600 OwnerlContractor on site: �d�`� Inspector: •�-� # White CopyltnspectoPs File Canary CopylSMe Notice INSPECTION NOTICE DATE TIME CITY OF _�� CALLED-IN SCHEDULE � _�/�(;cl C� PERMIT NO. COMPLETE � ��9'��' � ADDRESS � OWNER/CONTR. �� ❑SITE INSPECTION ❑MECHANICAL RI �❑BEINSPECTION ❑CONC SLABS ❑MECHANICAL FINAL }�FOLLOW-UP ❑FOOTING ❑INSULATION %�'COMPLAINT ❑POURED WALL O RATED ASSEMBLY ❑FIREPLACE ❑FOUND.DRAINAGE O BUILDING FINAL ❑SPRINKLER SYSTEM ❑FRAMING ❑SEPTIC INSTALL ❑ >- ❑SHEATHING ❑SEPTIC FINAL ❑ ❑PLUMBING RI ❑S&W HOOKUP O � �PLUMBING FINAL ❑GAS LINE MANOMETER ❑ o COMMENTS: !� Q � - � J Q �7 11i _ � / • J Z ✓ O � W � / Q. � � O R O W � Q � W W Q � C7 � F HER CORRECTIONS MAY BE RE(�UIRED ❑ PERMIT FINALED W WORK SATISFACTORY: PROCEED ❑ PHOTO TAKEN p 0 CORRECT WORK&PROCEED V ❑CORRECT WORK.CALL FOR REINSPECTION BEFORE COVERING ❑CORRECT UNSAFE CONDITION IMMEDIATELY. ❑ STOP ORDER POSTED.CALL INSPECTOR ❑ INSPECTION REQUIRED. CALL TO ARRANGE ACCESS. TO SCHEDULE YOUR INSPECTIONS PLEASE CALL: (76 ) 479-17 Metro West Inspectio ervi Owner/Contr.on site: Inspector: J DATE TIME CITY OF ORONO CALLED IN INSPECTION NOTICE SCHEDULED J PERMIT NO.Z4 COMPLEfE,,,.r( ADDRESS OWNER TELEPHONE NO. CONTRACTOR � � DESCRIPTION � W ❑ FOOTtNG ❑ PLUM ING FINAL ❑ EXCAV/GRADING/FILLING � ❑ POURED WALL ❑ MECHA AL RI ❑ LAKESHORE/WEfLANDS y O O FRAMING ❑ M ANICAI FINAL ❑ TREE REMOVAL Z ❑ INSULATION OOD BURNER/FIREPLACE ❑ SITE INSPECTION Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS � p FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT � ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP _ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVA� � OWNERICONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W a � � O �. � O � W � Q � 2 W � W � J W ❑WORKSATISFACTORY:PROCEED ❑ PROJECT COMPLEfE � ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY W 0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECWERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. p pHOTO TAKEN INSPECTOR WILL REfURN ❑CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Cail for the next inspection 24 hours i a an . 95 49-46�� OwnerlContractor on site: ,' Inspector. White Copyllnspector's Ffle Canary CopyfSite No iee �,� INSPECTION NOTICE - d,.,. y�D� � DATE TIME CITY OF ��/< CALLED-IN SCHEDULED � PERMIT NO. � �f� �' O ��oZ � COMPLETED I � ADDRESS �51�� `� Co. � �o OWNER/CONTR. ❑SITE INSPECTION ❑MECHANICAL RI ❑ REINSPECTION ❑CONC SLABS ❑MECHANICAL FINAL ❑ FOLLOW-UP ❑ FOOTING ❑INSULATION ❑COMPLAINT ❑POURED WALL ❑ RATED ASSEMBLY ❑ FIREPLACE ❑ FOUND. DRAINAGE ❑BUILDING FINAL ❑SPRINKLER SYSTEM ❑ FRAMING �SEPTIC INSTALL �jf�✓�� ❑ � ❑SHEATHING ❑SEPTIC FINAL ❑ ❑ PLUMBING RI ❑S&W HOOKUP ❑ � ❑ PLUMBING FINAL ❑GAS LINE MANOMETER ❑ o COMMENT : Q �.K.w� .�v �c c.t. 5 � �sd o s,,�� a� J W � �sl'�h/� �'s�G�a. Z c O � � W � � � O � O W � Q � W � W � � CJ � FURTHER CORRECTIONS MAY BE REQUIRED ❑ PE IT FINALED � �WORK SATISFACTORY: PROCEED ❑ PH TO TAKEN p ❑ CORRECT WORK& PROCEED U ❑ CORRECT WORK. CALL FOR REINSPECTION BEFORE COVERING ❑ CORRECT UNSAFE CONDITION IMMEDIATELY. ❑ STOP ORDER POSTED. CALL INSPECTOR ❑ INSPECTION REQUIRED. CALL TO ARRANGE ACCESS. TO SCHEDULE YOUR INSPECTIONS PLEASE CALL: (763) 479-1720 Metro West Inspection Services Inc. Owner/Contr. o ' e: Inspecto . I�-� � ✓ DATE TIME CITY OF ORONO CALLED IN ,"�.ZGI�� INSPECTION NOTIC SCHEDULED �3-.'S�/—�� 9':�— PERMIT NOvaD �R�S COMPLETED ADDRESS � � � OWNER TELEPHON NO.6��7-ggg 3a�7 CONTRACTOR dy Gv�I � � DESCRIPTION�l��W' ' �� ry �� • � �y ❑ FOOTING ❑ EMO-FINAL ❑ SEPTIC FINAL � ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING Q ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ RATED WALLS � ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT Q ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP _ ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL v ❑ DEMO-SITE ❑ SEPTIC INSTALL 2 01MNEWCONTRACTOR TO MEET YiOU:_YES_NO y COMMENTS: ��C L(� 4YL T/ ' 4GQ � � j �''ICG `'�� 2 � N��e��' �G ��cv��ad� ��e�r�' �'a-�i m yy 0 W � � �� 0 Q � � W � j O W ❑WORKSATISFACTORY:PROCEED PROJECT COMPLETE � ❑CORRECT WORK&PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY W O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWffHIN HOURS. p pHOTOTAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED ❑INSPECTION REWIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. (g52) 249-4�� OMrnedContra r on site: � Inspector: Mm��e coPynnspec�ors F�� Canary CopylSite Nofiee . � . . • , • . • • � • . emo To: Finance Department From: Christine Mattson, Planning Assistant (`'(� CC: Street File l� , Date: April 19, 2016 GIL: 101-22205 Re: Escrow Refund Building Permit#201400835 pertaining to 1480 Sixth Ave North is complete. Please refund $700 to the applicant, Daniel 8�Erika Gulbrandson. The following is attached: • Original signed escrow agreement • Copy of cash register receipt showing escrow amount received Mail to: Daniel&Erika Gulbrandson 1480 Sixth Ave N Long Lake, MN 55356 �,, � �'� w:�street files�th avenue\1480\escxow refund 201400835.doac �� . � . ►w� �� A� � � ' dIJILY11Y�11 1'CI'{MI I C1{..1'[V W A�711'itCMCIV 1 Orono Bullding Permit#2014-00627 AGREEMENT made this �6�day of�� 20t L� by and between the CITY OF ORONO, a Minnesota municipal corporation ("City") Daniel 8 Erika G brandson ("Owners"). Rec Is 1. A building pennit application has been filed for a remodeling in an existing accessory structure including plumbing (sink and toilet) located at 1480 Sixth Avenue North the ("Subject Property"), legally described as Lot 1, Block 1, Douglas Estates, Hennepin County, Minnesota. 2. Owners request the City to neview this applica�on. 3. The Ciry 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 tt�e 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 shatl deposit$700 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�e 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 infrastructu.re that is caused by the work(including planning, engineering, or legal consultant review) associated with building permlt #2014-00627 if compliance with the approved building peRnit is not accomplished. 3. MONTHLY BILUNG. 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 OHmers do not make payment to the City within the timeframe outlined in#3 above, shall issue a Stop Work Orcter until the Ovmers 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 Ciiy has incuRed. 5. CLOSING ESCROW. The Balance on deposit in the escrow, if any, shall be retumed to the Owners when all requirements related to the project are complete. City Staff shall review the terms of this escrow agreement two times per year to determine whether the requirements of the project have been successfully completed and whether it is appropriate to retum the funds. Owner may also request the release of the funds, and such funds shall be released upon City Staff receiving the appropriate verification that all requirements of the project have been successfully completed. 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. CtTY: CITY OF ORONO OWN : By:��1�1�►�"�-' it�:� � ., m. - n... ..... . ..-n. .. a. v3'. ;'Rbr.�� f �.-. ,pg•'�F��' .. .'�� O �l�:� '��°�..� '.��.� . . , r I City of Orono � 2750 Keliey Parkway Orono MN 55356 952-249-4600 Receipt No: 3.U11311 Jul 14. 2014 Dan Gulbrandson Previous B�,' �e: .00 Permits 2014-00627 � ,dU 6th Ave 700.00 101-22205 Deferred Rev-Developer Deposit Total: --------700 00 _______________ Check Check No: 7426 700.00 Payor: Dan Gulbrandson Total Applied: 700.00 --------------- Change Tendered: .00 07/14/2014 04:02PM� + � � . CITY OF ORONO * 2 0 1 4 - 0 0 7 4 3 * 2750 KELLEY PARKWAY DATE ISSUED: 07/14/2014 ORONO,MN 55356- 952)249-4600 FAX: (952 249-4616 ADDRESS : 1480 SIXTH AVE N PIN : 26-118-23-32-0008 LEGAL DESC : DOUGLAS ESTATES : LOT 001 BLOCK 001 PERMIT TYPE : ESCROW FEE-TIED TO BUILDING PERMIT PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ESCROW FEE-TIED TO BUILDING PERMIT NOTE: THIS$700 ESCROW IS TIED TO BUILDING PERMIT 201400627 APPLICANT ESCROW FEE-BUILDING 700.00 ESCROW FEE-EROSION CONTROL 0.00 GULBRANDSON,DAN&ERICKA ESCROW FEE-GRADING 0.00 1480 SIXTH AVE N LONG LAKE,MN 55356- TOTAL 700.00 Payment(s) CHECK 7426 700.00 OWNER GULBRANDSON,DAN&ERICKA 1480 SIXTH AVE N 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 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 consVuction is suspended for a period of 180 days at any time after work has commenced. The applicant is responsible for asswing all required inspections aze 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 �o�o C ITY OF ORONO � � Street Address: Mailing Address: Telephone(952)249-4600 'S'�, � 2750 Kelley Parkway P.O. Box 66 Fax (952)249-4616 l,q ts,�' Orono, MN 55356 Crystal Bay,MN 55323 www.ci.orono.mn.us kESHOR �r',ll ,�� -� � �� ;�m March 23, 2016 � � Dan & Erika Gulbrandson �� J '/ � 1480 Sixth Avenue N /� //] ,�/ � � � � �, Long Lake, MN 55356 �� C � ��' 't l � J The City of Orono issued permits for work to be completed at 1480 Sixth Avenue North. Our records indicate there are open inspections. The contractor that pulled the permit was required to call when the work was ready to be inspected. Permit Number: 2014-00835 Contractor: Gordon James Construction Type of Work: Addition/Remodel- In-kind replacement of barn—final inspection Permit Number: 2014-01225 Contractor: Fireside Hearth & Home Type of Work: Mechanical-final inspection for wood burning fireplace Please call 952-249-4600 to schedule the inspections within 10 business days so we can verify correct installation for your safety. If this project has not been inspected within the 10 days allotted a new permit will be required before this work can be inspected. If we do not receive a response your property address file will reflect an uninspected improvement and could be problematic when selling your home. Prior to the release of the $700 currently held in escrow all inspections must be completed. Please note all expenditures, including escrow refunds, require council approval. Depending upon the timing, it may take several weeks before the check will be issued. If you have any questions please do not hesitate to call me at 952-249-4625 Monday through Friday during business hours 8:00 am—430 pm. I can also be reached via email at rpeitso@ci.orono.mn.us. Sincerely, CITY OF ORONO � �.�i� Roger Peitso Building Official c Gordon lames Construction; PO Box 306; Maple Plain, MN 55359 Fireside Hearth & Home; 2700 Fairview Ave N; Roseville, MN 55113 C1ate 7ime' Inspectc�r Inspectitm Type_ __,_ Stat �H �Permk� +Addre�s Rermd Type_w_ ____ ;Praperty Type �Construction Type 1 ' 1 M 5l�015 12:00 AM METD Plumbing-Rough In P Y 2015-00018'1480 Sixth Aue N Plumbing ftesidential Fi:dures-Muftiple _.__ __. 4I7I2015 12:00 AM METJ Plumbmg-Final P Y 2015-00018 1480 Sixth Ave N;Plumbing ;Residerrtial Fixtures-Multiple , .__ __ ___. � ; _. _ 1 f23C2015 =12:00 AM'METD Plumbing-Rough In P Y 2014-01465 1480 Sixth Ave N Plumbing(<$500)(DON T USE) Residerrtial Water 5oftener __ _ . _ — —. __ � 1 P9l201 S 12:OD AM METD Plumbing-Final �P �Y '2D14-01465 1480 Sixth Aae N;Plumbmg(a$500)(DON T USEJ ;Resideritial Water Softener � _ . _ ___. ._ _ , _ _ ,...._. _.....____..._._ 1 M SC2015 ;12:OD AM METD Framing ,P Y ;2D14-01397'1480 Sixth Aue N'Addition 1 Remodel I Repair �Resider�tial Addn f Remodel I Repair _.r _ __. ., __. �. .__ _._._. . _ _____...__ 1!20l�D15 ;12:00 AM METJ Insulation P Y '2014-01397 1480 Sixth Ave N Adddion/Remodel f Repair Residential Addn I Remodel!Repair _.. ._ _.__ . ... _ _e__.e q �--e. _ .. __.______ _ __ � �_ _ �____ 417f2015 12:DO AM METJ Final F Y '2014-01397.1480 Sixth Ave N Addition J Remodel I Repair Residential Addn 1 ftemodel I Repair - _ _. ._ . .__ .,, ___ � _ __... �__ ___ _- ...____________ __._ ____ __. _._ � 4f22l2015 12:DO AM'METD Final REINSPECTION P �Y i 2014-D1397 1480 Sixth Ave N Addition/Remodel I Rapair Residerrtial Addn!Remodel/Repair � ` � __ _. �� a__� e__ _ _ � — __ - --- r 11 M 3�2014 12:00 AM:LKOH Rock Bed or T rench!Tank P �Y 2014-01324 1480 Sixth Ave N:Septic ;Residerrtial Septic(New or Replacemerit) _ . _m _ .�_... . m_. �____ ,_, __ _ � ___ . � .W. 3C31 C1016 12:00 AM ROGP As-Buitt Hand Drawing P 'Y 2014-01324 1480 Sixth Ave N'Septic 'Residerrtial Septic(New or Replacemerrt) _. ,. . � __ _. �__ ___ — ___. M ROGP Final P 4-01324 1480 Si�cth Ave N Septic Residential Septic(New or ReplacemerR) _ __. 3f31 f2016 12:00 A I Y 201 ` _ . __ . v __._.. _._.... _. _ _ 11(Tt2014 12:00 AM METD Mechanical-Rough In P ':Y ;2014-01225 148D Sixth Ave N Mechanical Residerrtial Fireplace-Wood _. _. . __ . __ r _ w.. __. . . __ ___--�- � -- ------ � 3C31 f2016 .12:00 AM ROGP Final P Y 2014-01225 1480 Sixth Rve N Mechanical Resider�ial Fireplace-Wood _ . . , _ , __ _..__� .. __ _ _ _� _ � a____ __ ._ �. 10M SC2014 12:00 AM METJ Mechanical-Air Test P Y 2014-01111 1480 Sixth Ave N Mechanical Residential Mechanical-MuRiple �; __: _... e . _.. a _ __ _____._. _._ _____ .: 11 f25C2014 12:00 AM METJ M9[�ical-Fi�l P �Y .201 4-01 1 1 1 :1480 Sixth Ave N Mechanical Residerrtial Mechanical-Muttiple �. _<_ < _� __ - -_ L- � -__ __ _ __.� �. 10M r2014 I 12:00 AM METJ Mechanicai-Rough In P Y 2014-01111 1480 Sixth Ave N Mechanical Residerdial Mechanical-Muttiple _ � .__ _. _ �_ ___.,_.._ .___ ,____ . ; _ _ _ _ __ � 10M SC2D14 12:00 AM METJ Framing P I Y 2014-00835 1480 Sixth Ave N Addition 1 Remodel 1 Repair ;Residerdial Addn I Remodel 1 Repair __ _.___:� ______m.>. __ �_. __.._. . _ —,� _.__ __ _._ 10M 7f2014 12:00 AM METD Insulation P 'Y i 2014-00835 I 1480 Sixth Ave N'Addi[ion I Remodel 1 Repair >Residerdial Addn I Remodel I Repair � . _ . _ ____--__ _-_,a _ , _ _. . �-._, ___ __ __ 3f30C2016 12:00 AM ROGP Final P Y 2d14-00835 1480 Sixth Ave N Addition I Remodel!Repair ,Resider�tial Addn I Remodel 1 Repair � _ _______.. , . �� _ __ _� _.. ..... . .. __.. _ ._�. .._. _,._ __ e__.__ � 11 lTC2014 12:00 AM METD Fireplace P 'Y ,2D14-00835 1480 Sixth Aue N Addition I Remodel I Repair Resider�tial Addn 1 f�emodel 1 Repair `,', __ . __. . .__..__e. _ __ __ _ —� -- - _ _ ,. 8P5C1014 12:00 AM METJ Plumbing-Rough In P Y 2014-00832 1480 Sixth Ave N Ptumbing Residerrtial Fixtures-Muttiple _, . . __._ __ _ _..__. > 3f24/2015 ;12:OD AM METJ Plumbing-Final P Y 2014-00832 1480 Si�h Ave N Plumbing Residerrtial Fixtures-Muttiple = _� __ � __...<__ .. _ :_ _ ___ __ _. . 10M 6C2014 12:00 AM METD Plumbing-ftough In P Y 2014-00796 1480 Sixth AWe N Plumbing Residerrtial Fixtures-Muttiple � —._ � < _ _ _ _ _ f 3t24l1D1 S 12:00 AM METJ Plumbug Fr� P Y 2014-00796 1480 Sixth Aue N Plumbmg ;Residerrtial Fixtures-Muttiple � _____..__ __ . _ _ __..._ . 8I5l2014 12:00 AM METJ Framing P 'Y :2014-00748 1480 Sixth Awe N'Addition/Remodel I Repair ;Residerrtial Addn!Remodel f Repair s _�.___ ___ ______�. . ___ _-_ a___ ,__ _ __ .. _ _. _ _ __.__ ,, ,v_._._,. � 8I�f2014 12:00 AM METD Ir�sulation P 'Y 2014-00748'1480 Sixth A�e N Addition 1 Remodel l Repair ;Resider�tial Addn I Remodel!Repair � _ . .__ _ __ _ .. . , _ . ., � __ .___ .. ..�m _„_e.ee_ __ . _ 10M 6f2014 12:00 AM METD Final P 'Y 2014-00748 1480 Sixth Ave N Adddion J Remodel I Repair Resideritial Addn 1 Remodel I Repair _ —_ __.�_ .,__. _ _a__,__. __ _ _ __ __ . _ __ .. ..._ __ e _ . _._._ _ _ Escrow Refund Requested 2014-00743 1480 Sixth Ave N Escrow Fee-Tied to Building Permit Residential Escrow Fee-Tied to Building Permit _. _ , �_ ; , __. __� _v, ,.e , �_.. . . _ ___ .. v__. ._. _._ . __ __,_._ _ __ Escra�,v Refunded 2014-00743 1480 Sixth Rve N Escrow Fee-Tied to Building Permrt ;Residentisl Escrow Fee-Tied to Building Permit