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Home My WebLink About2010-01042 - addn/remodel/repair CITY OF ORONO PERMIT NO.: 2oiaoioa2 ^ 2750 KELLEY PARKWAY f ORONO, MN 55356- DATE ISSUEn: 1 U17/2010 952 249-4600 FAX: 952 249-4616 , ADDRESS : 1980 SIXTH AVE N � PIN : 27-118-23-42-0004 LEGAL DESC : LJNPLATTED 27 118 23 : LOT 000 BLOCK 000 PERMIT TYPE : ADDITION/REMODEL/REPAIR PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR ACTIVITY : 434-RESIDENTIAL VALUATION : $ 100,000.00 . NOTE: ADVANCED PLAN REVIEW WAS PAID WITH VISA 4583-IN THE AMOUNT OF$686.89 BY CONTRACTOR ADDITONAL PERMITS REQUIRED:PLUMBING,MECHANICAL,SEPTIC,FIREPLACE,ELECTRICAL(STATE) APPLICANT pERMIT FEE SCHEDULE 1,056.75 BRIAN STEPHENSON CONST. INC. STATE SURCHARGE(VALUATION) 50.00 2025 PAWNEE RD TOTAL 1,106.75 MEDINA,MN (612)889-0477 PAID WITH CC# 4583 Minnesota State License#:20222459 OWNER PIERPONT,JUDY&JIM 1980 SIXTH AVE N LONG LAKE,MN 55356- AGREEMENT AND SWORN STATEMENT The work for which this permit is issued sha(1 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 re onsible for assuring all required inspections aze requeste � con an e with t State Building Code.This permit may be revoke at any ti e o � ' � � 0 � � p ' nt Permitee Sign t re Date Issued By ature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER HAN DESCRIBED A E. ' City of Orono Building Permit Application for New Structures or Additions Mailing Address: Permit number: �- d/� 4.,0,� PO Box 66 Q Q Crystal Bay, MN 55323-0066 Date received: � .� f�''��-�" �, Street Address:' Received by: � 'E,�,y � / �'�nt� '� p'C�,� �ti 2750 Kelley Parkway Plan review fee: �'kESH�4'� Orono, MN 55356 � — 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: �� G? U�/�� Z�'i� � �t��,.-g-�� Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home. ❑ Yes �[No If yes, a special event permit is required with Police Department and City Council approval 60 days prior to the event. Shuttle bus service will be required unless applicant demonstrates sufficient on-site parking is available. Non-permitted events will not be allowed. CONTRACTOR/ ICANT INFORMATION: Name: � � .-� .�� henbr�:� �r'rS�� .-�'�J�= State License# �p��y '�j Expiration Date: '�-- 3/- I � Phone: - - p�/-7 (office � -- � j�-�,,�c'%,:z cell Mailing Address: ' _�;,vF€ "R Cit : � �.�;� ZIP: �yl. Contact Person: �R�.�►-� �Sffp e.��5c�.t/ Applicant is: ontrac / Homeowner (Circle One) Email and/or Fax: PROPERTY OWNER INFORMATION: � Name: ___,"'"r�.� v+�-�-��Y /�/ �'�►'�� Phone (day): ��- �3 eJ— �p 3 S / " L Address: ��'{�Q ��,1;�}�' jZ}j �,, City:1i>nqG.?-�(�ZIP: Email and/or Fax ARCHITECT/ ENGINEER INFORMATION: Name: Phone (day): Address: Cit : ZIP: Email and/or Fax: 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 ❑ Garage/Accessory Bldg. ❑ Public Sewer ❑ Accessory Building ❑ Single Family with ❑ Deck ❑ Relocation detached garage ❑ Office/Commercial �Private Sewer ❑ Other: (specify) ❑ Multiple Family/Condo ❑Warehouse ❑ Public ❑ Storage ❑ Public Water ""Any earth movement may require ❑ Commercial ❑ Other(specify) MCWD review&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) $ �' �fl��' -- Last Updated: 9/29/2009 - 17 - �T ._ r ..� �, �� _� . _.� _ STRUCTURE INFORMATION: � 1.Structure Dimensions 1. Structure Dimensions (continued) 2.Type of Construction � a. Length (ft.)= �� Number of bedrooms= � �Wood/Frame � / ❑ Masonry b.Width (ft.)= Number of garage stalis: ❑ Metal Attached = ❑ Pole Bldg. Areas in square feet Detached = ❑ ICF ❑ On-site Prefab c. Basement= ❑ Off-site Prefab d. 1 St Story = _�,,� ❑ Other(piease specify): e. 2"d StOry= �Dc� f. '/z Story = g.Total Area= REQUIRED SUBMITTALS: All of the information must be submitted in order for your application to be processed: Not Enclosed A piicable ❑ Permit A lication ❑ Pro osed Buildin Plans ❑ �' MN State Ener Code Calculations and Mechanical Code Re uirements Form ❑ Surve meetin all re uirements ❑ '� Stormwater Pollution Prevention Plan ❑ Hardcover Ca�culation(s ❑ ❑ Se tic S stem Site Evaluation Re ort ❑ Access Permit ❑ Wetland Buffer Im rovement Plan ❑ En ineered Plans for Retainin Walis 4 feet or above ❑ ❑ Plan Review Fee ❑ ❑ Other 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 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. _ Applicanf s Signature: Date: �� /�� !� Last Updated: 9/29/2009 . - 18 - �.� ' �;' } , . � -- -...�., Plan Review Checklist for Ne�v Structures / Additions ' ( �� Address/PID/Legal: �'� n -}- c.� �c1 � Description of work: �rOD 1�7 0�l S Septic review by: `� Date Approved: /�� - 1 J Zoning review by; � � ' Date Approved: ✓ / l Building review by: Date Approved: ( ( - L-(O Grading review by: _ IJ /l�► Date Approved: Zoning File#: Resolution#: Resolution Date: Zonin District Fire De artment Post Office School District Zoning: Lot Area: SF/AC Width: Depth: Survey Submitted: � Yes 0 No Date of Survey: Pro osed Setbacks: Front(Lake) Rear�St�se� ( N S E � ) ( N S� W ) Other Buildings Wettand Side Z3a ` ISa £�b ' �3 ? Building Defined Height:�/L- �„�.s� �,,�,,,, Building Peak Height: #of Stories Ok?: � YES FOR A BUILDING WITH A BASEMENT OR CRAWL SPACE: FOR A BUILDING ON A SLAB FOUNDATION: START WITH the distance between the basement floor/crawl START the distance between the slab and the highest space floor and the highest roof peak,the top of WITH roof peak,the top of the cornice of a flat roof, the cornice of a flat roof,the deck line of a the deck line of a mansard roof, or the mansard roof,or the uppermost point on a round uppermost point on a round or other arch-type or other arch- e roof roof SUBTRACT half the distance between the highest window and SUBTRACT half the distance between the highest window hi hest roof eak of a itched roof and hi hest roof eak of a itched roof SUBTRACT the distance between the basement flooN crawl ADD the distance between the slab and the highest space floor and the highest existing grade within existin rade within the foundation the foundation or 10 feet, whichever is less. EQUALS Defined buildin hei ht EQUALS Defined buildin hei ht Lot Coverage: O.�- SF o�o Shoreland District MCWD Permit Received Avera e Lakeshore Setback Bluff 0 Yes ❑ No � N/A 0 Yes ❑ No ❑ Yes ,�f No Permit Number: 0 Yes ❑ No ❑ N/A Setback: Hardcover Zones Existin Pro osed Variance Re uired CUP Re uired 0-75' ❑ Yes No 0 Yes No 75-250' Type�S�: Type�s�. 250-500' 500-1000' REMARKS (in-house): • Updated: 09/11/2009 z:\formslplan review checklist.docx - -- - - Fees to be Char ed YES NO �etari�t:z=� ., r � ;,� ,. Plan Review - :'Sta't�°�urc'�a%�e investigation Fee <S�4�G�;�I�r�be��o�tiS��n'�ts � �� _ � �: Sewer Connection ;�,l�ate��tan�ic�on, � ;; > _ w-,, Park Fee i�1,�'P.�i1S�;BCt1013 r'a r � i '' � f h �3•i � Other(specify) e°,M,��.lSCO��„�',,�'eOL1Sa��,@'S y�r4. ,i'��.. � ;ia �wt..�r�;„. 7�'i r�r � I r^�,�:"s e° �4'," '`+�'>�M.a Calculated By: S uare Foota e $ per S uare Foota e Basement X = $ 1�Floor X = $ 2nd Floo� X = $ Garage X = $ Estimated Construction Value: $ I o�� o� Orono Inspections Required Work Requiring Separate Permits Required State Permits � Site �Plumbing 0 Grading / Filling ❑ Well � Hardcover Removal Mechanical � Fire Electrical � Footing Septic 0 Water Connection ❑ Poured Wall Fireplace � Sewer Connection � Foundation Survey 0 Masonry 0 Lawn Irrigation ❑ Radon Rock Bed �Mfg. Framing � Other(specify) Insulation 0 As-Built Survey Final � Other(specify) REMARKS (in-house): Other Review: Reviewed by: Date Approved: Access:Existing: � YES ❑ NO New: 0 YES 0 NO REMARKS (TO BE NOTED ON PERMIT AND INtTIALLED BY PERSON PULLING PERMIT) Updated: 09/11/2009 z:\forms�plan review checklist.docx �" D E TIME v CITY OF ORONO CALLED IN �!'�� INSPECTION NOTICE SCHEDULED � '� PERMIT NO�ID'�ld ��COMPLETED ADDRESS �g�� d"�� TCG� S• OWNER TELEPHONE NO.��Z �O �Z�� CONTRACTOR ,�'(Cl.y� 7�Go C?B'N�� DESCRIPTION �r�n � ❑ FOOTING ❑ PLUMBIN F AL ❑ 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 � ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP _ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL v ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATIOWREMOVAL � OWNERICONTRACTOR TO MEET YOU:_YES_NO y COMMENTS: � W a o ." 4 • v N o IL- To '' Po�� 0 � W � Q � z W � W � � � �1fORK SATISFACTORY:PROCEED ❑ PROJECT COMPLEfE W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY � ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORE C�/ERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. p pH0T0 TAKEN INSPECTOR WlLL REfURN ❑STOP ORDER POSTED.CALI INSPECTOR �CITATION ISSUED ❑INSPECTIONREQUIRED.CALLTOARRANGEACCESS. Ca11 forthe next inspection 24 hours in advance. (g52) 249-460� OwnerlContractor on sit . Inspector. � White CopyllnspectoPs File Canary CopylSite NoNce �"�' � �DAT TIME � CITY OF ORONO CALLED IN �"" INSPECTION NOTICE SCHEDULED a— � D: PERMIT NO�,�— ��D�Z COMPLETED ADDRESS�9�� -S�/�G�� OWNER TELEPHONE NO��Z Z��O S 3 CONTRACTOR A�'!l- � DESCRIPTION �DO T7� � ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRAOING/FILLING 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 � ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP _ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATIOWREMOVAL � OWNERICONTRACTOR TO MEET YOU:_YES_NO v�, COMMENTS: � W 0. j O � � ° t�. � W � Q � � �V �� t �� Z W c Lt! . � � � �RKSATISFACTORY:PROCEED ❑ PROJECTCOMPLEfE W ❑CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. p pH0T0 TAKEN ►NSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED ❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS. Ca11 for the next inspection 24 hours in advance. (g52) 249-4600 OwnerlContractor on site: Inspector. White Copyllnspector's File Canary CopylSite Notice __ _ ao t�- o0o Zb P� � aQ�� OD�� M� � DA� TIME CITY OF ORONO �CALLED W ` INSPECTION OT C� SCHEDULED ��L� 3 = � PERMITNO.�� O�� `�OMPLETED ADDRESS I9BC� �� v� OWNER � TELEPHONE NO. ��Z. Z9� 5`�3 CONTRACTOR � >; DESCRIPTION � � e� � P � LV ❑ FOOTING ❑ PLUMBING AL ❑ EXCAV/GRADING/FILLING � ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORENVETLANDS � Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL Z ❑ INSULATION ❑ WOOD BURIVER/FIREPLACE ❑ S�TE INSPECTION Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS � ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPII�INT J ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP _ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL � OWNER/CONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W � n o ` ' , � �3-) .��a �-�l .� -4--� �� N �� ! a � o `: �� '.-�.�'S"'1` !7( � ,�,� ; � � �"i� W -. _ � Q , � f, ,f� �`s. � /�J� �< ' S'.�- �(�;4�,�'•..r ��' z W � W � � d W ❑WORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLETE � �CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY W ,. Oy ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR � CITATION ISSUED ❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. �95Z� Z49-46�� OwnerlContractor on site: Inspector. �/`;l � l� � White Copyllnspector's File Canary CopylSite Notice ✓ i\ D TE T E �� CITY OF ORONO CALLED w ��I � � ��'' INSPECTION NOTICE SCHEDULED � �•�'� �'� PERMIT NO.�' Z��U ��4'�' COMPLETED ADDRESS I a��= S c �E h fPt,c_e �� OWNER ��e-r (��'``� TELEPHONE NO. �� -'��O ��3 CONTRACTOR �� S-�'v.�2.'�5v�� DESCRIPTION .�5.., � �.-�-ta� � ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS y ❑ FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL Z �NSULATION ❑ 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 J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL � OWNER/CONTRACTOR TO MEEf YOU:_YES_NO � COMMENTS: � W � � � O � � ._ � �` i� C�� ( 0 � W � Q � Z W � W � � � �WORK SATISFACTORY:PROCEED Cl PROJECT COMPLETE W ORRECT WORK&PROCEED C ISSUE CERTIFICATE OF OCCUPANCY 0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ pHOTO TAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED ❑ INSPECTION REQUtRED.CALLTO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. �95Z� Z49-460� Owner/Contractor o site: Inspector. � �,�' � White Copyllnspector's File Canary CopylSite Notice V"" DA � TIME V CITY OF ORONO CALLED IN �'�� INSPECTION1VO ICE SCHEDULED �3-� � PERMIT NO�,r,� �� COMPLETED ADDRESS lg�� . � �v• OWNER TELEPHONE NO. ��z �9�O ✓�7� CONTRACTaR ►{r� � DESCRIPTION � ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORFJWETLANDS y � FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL Z ❑ INSU�ATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS � ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT v ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP _ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL � OWNER/CONTRACTOR TO MEEf YOU:_YES_NO v�, COMMENTS: � W a � � O � � O � W � Q � 2 W � W � � � �VORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY 0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORE C�/ERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. p pH0T0 TAKEN INSPECTOR WlLL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED O INSPECTION REQUtRED.CALL TO ARRANGE ACCESS. Cail for the next inspection 24 hours in advance. (g52) 249-460� Owner/Contractor on site r Inspector. White Copyllnspecto�'s File Canary CopylSite Notice �� DA �j TIME V CITY OF ORONO CALLED IN -3"' T 1 INSPECTION � CE� SCHEDULED . � �� LSL PERMITNO ��> COMPLETED Z- ( � � \ .�\�� ADDRESS f"/�D d'"�-�'l; N . OWNER TELEPHONE NO. Q�2 ��S /3 S� CONTRACTOR , .l�f �6'/v ��-S lv �: DESCRIPTION �hS�� ❑ FOOTING ❑ PLUMBING FINAL ❑ 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 J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL � OWNERICONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W 0. � � O ( � � � fr� � _ O . _ . . � . .., ........... _. .....,_-� W ..___.....,..- � Q � Z W � W � � GW,.�WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE �' ❑CORRECT WORK&PROCEED C ISSUE CERTIFICATE OF OCCUPANCY W O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN tNSPECTOR WILL REfURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED ❑ iNSPECTION REQUIRED.CALLTO ARRANGE ACCESS. Ca11 for the next inspection 24 hours in advance. (952� 249-46�� OwnerlContractor on site: Inspector. ��,'� " � �� White Copyllnspector's File Canary CopylSite Notice e —l DAT // TIME L� C OF ORONO �� CALLED IN l INSPECTION NOTIC SCHEDULED �i� PERMIT NO. ��l �co �e� ADDRESS � OWNER TELEPHONE N CONTRACTOR �-� �: DESCRIPTION � ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCA�f�AA ING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS y ❑ FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q ❑ RADON SLAB O WATER HOOK-UP ❑ PFOGRESS � ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPIAINT � ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP _ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL � OWNERICONTRACTOR TO MEET YOU:_YES_NO c�., COMMENTS: � W a � �-r�✓�s 0 �. � 0 � W � Q � 2 W � W � � W�Q(ORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLEfE W ❑CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. p pH0T0 TAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED �IIVSPECTION REQUIRED.CALLTOARRANGE ACCESS. Cail for the next inspection 24 hours in advance. (g52) 249-46�� OwnerlContractor on te: inspector. � ,L_�� White Copyllnspector's File Canary CopylSite Notice / �l./� n, [�,TF TIME CITY OF ORONO CALLED IN �v�_ � INSPECTION NOTICE SCHEDULED �� PERMIT NO.�IJID �0��COMPLETED ADDRESS 14�� S�� /V • OWNER TELEPHONE NO. ��Z-��-a�77 CONTRACTOR ��Lf �J�f'1� �� C-�7<-d-� �; DESCRIPTION ��n� � � ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORENVETLANDS y ❑ FRAMING ❑ MECHANICAL FINAL O ❑ 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 J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL Z OWNER/CONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W � � ��l�e 1�� S � -�-N �3�e �c�� C � 0 � W � Q � Z W � W � � � d W ❑WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE � ❑CORRECT WORK&PROCEED C ISSUE CERTIFICATE OF OCCUPANCY W �'CORRECT WORK,CALL FOR REINSPECTION TEMPORARY �j LBERORE COVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. ❑ pHOTOTAKEN INSPECTOR WILL RETURN ❑CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑ INSPECTION REOUIRED.CALI TO ARRANGE ACCESS. Cal1 for the next inspection 24 hours in advance. (952� 249-4600 OwnerlContractor on te: Inspector_ White Copy/lnspector's File Canary CopylSite Notice 5 e fi DATE TIME � CITY OF ORONO CALLED IN /, ,rQ . � INSPECTION NOTICE SCHEDULED l d �U 11 PERMIT N0.�2,4IO -O � ��ZcOMPLETED ADDRESS ' l gD �3 W.�`�'�l �, OWNER TELEPHONE NO.�p�� g�� r77 CONTRACTOR �L �: DESCRIPTION ��S�C�� I � h� � � ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS y ❑ FRAMING ❑ MECHANICAL FINAL Q ❑ 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 ❑ FOUNDATION/REMOVAL � OWNER/CONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W 0. � J O a � O � ti � Q � Z W � w � � a � ❑WORK SATISFACTORY:PROCEED JECT COMPLETE W ❑CORRECT WORK 8 PROCEED '=1 ISSUE CERTIFICATE OF OCCUPANCY � ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. r-; pH0T0 TAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR � CITATION ISSUED C INSPECTION REOUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. �95Z� Z49-46�� OwnerlContractor on si : Inspector. White Copyllnspector's File Canary CopylSite Notice . • , • . � • � • emo To: Finance Department From: Christine Mattson, Planning Assistant CC: Street File Date: 10/31/2011 G/L: 101-22205 Re: Building Permit Escrow Refund Building Permit #2011-01042 pertaining to 1980 Sixth Ave N is complete. The Applicant, James Pierpont, has requested a refund of the$2,500 escrow. The following is attached: • Email from Bonestroo indicating no unbilled WIP on this project • Email from Campbelt Knutson indicating no unbilled WIP on this project • Original signed escrow agreement • Copy of cash register receipt showing escrow amount received Mail to: James Pierpont 1980 Sixth Ave N Long Lake, MN 55356 w:�street files\sixth avenue\1980�escrow refund memo 2011-01042.doc Checklist for Refunding Building Permit Escrows Building Permit # Z�10 -0104�Z Street Address: �q� �S� X� 6�ve� N Applicant Name: .�QI�Y1� 1 i e,r''po�1�}-' ,� Escrow request received Date: 1�� 0 • ► I (to be completed by Are all inspeetions completed? es No If not, list what is outstanding: Was there a Temporary Certificate of Occupancy issued? Yes No Date: Was there a Final Certificate of Occupancy issued? Yes No Date: �2n^,�e,l - N� C 0 � Email CK & Bonestroo to see if there is any unbilled WIP. Date email sent: 10 •?�f� I l ❑ Prepare memo for Finance Department ❑ Note amount refunded in program. z:\forms�zoning standard fortns�checklist for refunding building permft escrows.doc December 23,2010 Christine Mattson From: Darren Amundsen [Darren.Amundsen@bonestroo.com] Sent: Monday, October 24, 2011 1:40 PM To: Christine Mattson Subject: RE: Unbilled WIP See below Darren Amundsen, PE Associate Bonestroo, now Stantec Tel 651-604-4894 Cell 651-775-5623 darren.amundsenCa�stantec.com stantec.com Bonestroo has joined Stantec. a professional services consulting fi►m recognized for its leadership in sustainability, depth and diversity of talent, and technical expertise. The content of this email is the confidential property of Stantec and should not be copied, modified, retransmitted,or used for any purpose except with Stantec's written authorization. If you are not the intended recipient,please delete all copies and notify us immediately. � Please consider the environment before printing this email. From: Christine Mattson jmailto:CMattson@ci.orono.mn.usl Sent: Monday, October 24, 2011 9:08 AM To: Darren Amundsen; 'Sherry Charboneau' Subject: Unbilled WIP Good Morning, Do either of you have any unbilled WIP for the following? 2010-00044 915 Partenwood Mary Safar NO 2010-01042 1980 Sixth Avenue James Pierpont NO 2011-00021 2256 Shadywood Road Forrest & Renee Burke NO 2011-00428 2330 Glendale Cove Lane James Rhodes October we have 1.5 hrs at $164/hr= $246 Thanks! Christine Mattson Planning Assistant City of Orono 2750 Kelly Parkway ; Orono ; MN i 55356(physical addressJ PO Box 66 ; Crystal Bay ; MN 55323-0066 (mailing address) 'S 952.249.4620 � 8 952.249.4616 � cmattson@ci.orono.mn.us � www.ci.orono.mn.us � Christine Mattson From: Sherry Charboneau [SCharboneau@ck-law.com] Sent: Monday, October 24, 2011 12:02 PM To: Christine Mattson Subject: RE: Unbilled WIP Christine: We do not have any unbilled WIP for the items listed below. Happy Monday! Sherry Sherry L. Charboneau Legal Assistant CAMPBELL KNUTSON P.A. 1380 Corporate Center Curve•Suite 317•Eagan,MN 55121 �'(651)234-6230•Fax:(651)452-5550 �scharboneauC�Dck-law.com•www,ck-law,com From: Christine Mattson jmailto:CMattson@ci.orono.mn.usl Sent: Monday, October 24, 2011 9:08 AM To: Darren Amundsen (darren.AmundsenCa�bonestroo.com); Sherry Charboneau Subject: Unbilled WIP Good Morning, Do either of you have any unbilled WIP for the following? 2010-00044 915 Partenwood Mary Safar 2010-01042 1980 Sixth Avenue James Pierpont 2011-00021 2256 Shadywood Road Forrest& Renee Burke 2011-00428 2330 Glendale Cove Lane James Rhodes Thanks! Christine Mattson Planning Assistant City of Orono 2750 Kelly Parkway ; Orono : MN , 55356(physical addressJ PO Box 66 ; Crystal Bay : MN i 55323-0066(mailing addressJ '�i' 952.249.4620 6 952.249.4616 � cmattson@ci.orono.mn.us ; ;www.ci.orono.mn.us Office Hours: Monday- Friday 8 am to 4:30 pm 1 � ' Y BUILDING PERMIT ESCROW AGREEMENT � Orono Building Permit#2010-01042 AGREEMENT made this � day of � , 20 l 0, by and befinreen the CITY OF ORONO, a Minnesota municipal corporation "City") and �f,q�n•rr_5 ��aa� ("Owners"). Recitals 1. A building permit application has been filed for an addition to the home located at 1980 Sixth Avenue, the ("Subject Property"), legally described as attached as Exhibit A. 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 ESCR�3W- DS. Contemporaneously with the execution of this Escrow Agreement, the Owners shall dep if$2,500 w h the City. All accrued interest, if any, shall be paid to the City to reimburse the City for its cost in min ' ' e 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 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 building permit #2010-001042 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 property pursuant to Minn. Stat. §§415.01 and 366.012. CITY: CITY OF ORONO OWNER: , By: (� �.��,�5 c'1��v i-- —' �--._.. Its: �-� U r,.,�a t.��:cc��cv r / a --�._ � — - .,,�,�.�o _�. �,�,,..��. '., _ -;, ' � .� .� �.w� � '��# ��, � �°��C�p��to�ree`t��.e � ' � CITY OF ORONO PERMIT NO.: 2oiaoii2i 2750 KELLEY PARKWAY ORONO, MN 55356- DATE ISSUED: 1 U16/2010 952 249-4600 FAX: 952 249-4616 ADDRESS : 1980 SIXTH AVE N PIN : 27-118-23-42-0004 LEGAL DESC : LJNPLATTED 27 118 23 : LOT 000 BLOCK 000 PERMIT TYPE : ESCROW FEE-TIED TO BUILDING PERMIT PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ESCROW FEE-TIED TO BUILDING PERMIT NOTE: THIS$2500.00 ESCROW PAYMENT IS TIED TO BLDG PERMIT 2010-01042 APPLICANT ESCROW FEE-BUILDING 2,500.00 PIERPONT,NDY&JIM TOTAL 2,500.00 1980 SIXTH AVE N LONG LAKE,MN 55356- OWNER PIERPONT,NDY&JIM 1980 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 sepazate 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 aRer 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. 1 � Christine Mattson From: jwpierpont@cs.com Sent: Monday, October 10, 2011 10:37 AM To: Christine Mattson Subject: Escrow deposit for permit number 2010-01042/Addition/construction at 1980 Sixth Ave. North Thank you for your quick return of my phone call inquiry. As I indicated today we received our final inspection approval from Willie Gibbs, Inspector, for the project we have had underway at 1980 Sixth Ave. North under Building Permit number 2010-01042. Please close out the construction escrow by refunding to me the deposit placed with the city for $2500. If there is any interest accrued on the funds we would appreciate that as well. Please mail the check to the address 1980 Sixth Ave. North, Orono, Mn. 55356. Thank you for your assistance. James Pierpont 1980 Sixth Ave. North Orono, Mn. 55356 (952) 334-3035 1 . . �� n1 ME ORANDUM . 2 November 2011 TO: Ron Olson, Finance Director FROM: Melanie Curtis, Planning &Zoning Coordinator RE: Escrow Refund—Pierpont Please process the refund of the building permit escrow for permit number#2011-01042. This refund should have been processed through the Council's October 24th Accounts Payable approvals. The check should be mailed to: James Pierpont 1980 Sixth Ave N r�' Long Lake, MN 55356 �V�L�� (�� Z�� , C�-