HomeMy WebLinkAbout2016-00928 - demo � CITY OF ORONO * 2 PJ 1 6 - 0 0 9 2 8 *
. 2750 KELLEY PARKWAY DATE ISSUED: 08/25/2016
ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 345 SPRING HILL RD
PIN : 25-118-23-43-0008
LEGAL DESC : REG. LAND SURVEY NO. 1429
: LOT 000 BLOCK 000
PERMIT TYPE : DEMOLITION
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : DEMO-ACCESSORY STRUCTURE
ACTIVITY : 649-ALL OTHER BUILDING&STRUCTURES
NOTE:
1. FOUNDATIONS/ALL DEMO DEBRIS TO BE REMOVED FROM GROUND&DISPOSED OF OFF SITE,PER PCA REGULATIONS.
2. INSPECT[ONS DONE BEFORE BACKFILLING.
DEMO OF IN-GROUND POOL ONLY
APPLICAI�IT DEMOLITION-ACCESSORY STRUCTURE 50.00
STATE SURCHARGE DEMO 1.00
GENADEK TOTAL 51.00
716 THIRD AVE
MENDOTA HEIGHTS,MN 55118- Payment(s)
(612)369-4698 CHECK 51.00 51.00
OWNER
RILEY,ROGER
345 SPRING HILL 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 governing this type of work
shall be compied with whether or no[specified herein.This permit will
expire and become null and void if construction authorized is not
commenced within l80 ays of the date of issuance,or if construction is
suspended for a per' of 180 days at any time after work has commenced.
The applicant is ponsible for assuring all required inspections are
requested in c formance with the State Building Code.This permit may be
revoked at y time for due cause. /�r�
�_.__. ��L�� d
,..� � /s �� � - � j���� -{� �, � l z �5/ /�-
A ' ant Permitee Signature Date Issued By Signature Date
�O�T City of Orono FOR CTI'Y USE ONLY •Z�
�y P.O.Box 66 Date Received: _^�-r�Q Permit k �'i'�r r �
0 2750 Kelley Parkway ��,
Crystal Bay, MN 55323 Amount: $ S 1 - SAC Credit: � 1 /A
(952)249-4600 �� � � ` `�i
'� ,� Homeowner(s)Signed: ❑Yes }� �
y� �,� Resolutions(if any)Signed:❑Yes ❑None Required
lqK E S H��� Zonin Disclosure Si ned: ❑Yes ❑None Re uired
'` �y ; � ��.�-3/l(r�
CITY OF ORONO - DEMOLITION PERMIT
(All permits must be approved by the Building Official and/or Zoning Department)
Job Site ! Owner Information:
Type: esidential ❑ Commercial
�. 1
Site Address: � `� � r����''�� � � 1��-' ,
Ro�t,1''
Owner: !20 � �� Mailing Address: S°--�
City: U�''�-� � Zip: $S 3`� I
Phone: � L� �--�Z���- -7 7 � � Email:
Contractor/Applicant Information:
� �J� -,�F,� �;c=�`�--- ��N c��;r��•� �.�
Contractor/App.: � c_�-.�..�- Contact Person: ,S'i�
Address: '1 I 6 �ti,�l �.�-- State License#: �'`�U�-(
City: .��=^�7� �����( Zip: � Expiration Date: � r�
Phone: �r Z-���� ' �J�Cl � Email: �`.�'t•� `-I � /t'�°.-�-
la'1 �•Cmm
SPECIAL CONDITIONS 8� HOLD HARMLESS AGREEMENT
General I nstructions:
1. You may be required to obtain other permits, i.e.: well abandonment, sewer, etc.
2. Work must not begin unless the permit card is available on the job site.
3. A 24-48 hour notice is required for all inspections. Call (952) 249-4600.
4. Sewer must be discontinued at the City service by qualified contractor before demo permit is issued.
Demolition by means of: ❑ Manual Disassembly ❑ Heavy Equipment ❑ Other
Permit(s) Issued: [�Sewer Disconnection ❑Well Abandonment#' /�
In return for issuance of said Demolition Permit, the undersigned owner hereby agrees to:
1. Submit a survey, aerial photo or sketch showing all structures on the property. Note which structures are
to be demolished.
2. Submit a survey, aeriat photo or sketch showing proposed erosion control measures in accordance with
Chapter 79, Construction Site Runoff Control.
3. Submit a copy of permit approval from the Minnehaha Creek Watershed District (MCWD). The City will
not issue a demolition permit without a copy of the permit(s) from the MCWD or documentation stating
permit(s) are not required. ��, � �,�,�_ �„� _
�A'V�I1��
Form Last Updated: July 2015
150784 "
.
4. Submit a$2,500 escrow and an escrow agreement signed by the property owner(copy attached).
5. Keep all structure(s) enclosed and/or secured until such time as demolition is complete.
6. Keep all demolition debris off adjoining property and/or the public rights-of way unless specific prior
approval is obtained in writing for temporary use thereof.
7. Completely remove foundation(s) from the ground.
8. Completely dispose of all demolition debris off site in accordance with all applicable PCA requirements.
9. Abandon water wells in accordance with State Health Department regulations.
10. Call for an inspection when all debris has been removed, before backfilling.
11. Within 5 working days of superstructure removal, a final inspection shall be requested. The site shall be
left clean and clear of all debris, with any excavation filled with earth level with the adjacent ground
elevation (except when such excavation is to be used as part of a new building and such new building is
actually under construction).
12. Abandon septic systems per Minnesota Rules Chapter 7080. All septic tanks must be pumped, crushed
and filled with native soils. An inspection is required after the tanks are pumped and before the tanks are
crushed and filled.
13. The undersigned owner shall and hereby does indemnify and hold harmless the City of Orono, its agents,
employees and assigns from and against all claims, damages, losses or expenses, including attorney
fees, against the City, its agents, employees and assigns arising out of or resulting from the demolition
described herein as performed by the property owner, his employees, agents, subcontractors or assigns.
PERMIT TYPE AND FEE CALCULATION
�
❑ $75.00 — Principal Structure ����
$50.00 —Accessory Structure x�(how many) ����`
1. Subtotal of above permit requested $
2. State Surcharge 1.00
3. TOTAL PERMIT FEE (add lines 1-2 above) $
The undersigned herby applies to the City of Orono for issuance of a Demolition Permit, agrees to do
all the work in a strict accordance with the ordinances of the City and the regulations of the State of
Minnesota, and certifies that all statements made on this application are complete, true and correct.
Applicant's Signature: � Date: ��'� '���
Owner's Signature: Date: P'=� u'�
Approved By: l_,�,�� Date: g� � ' ��
(Building Official)
* Zoning Disclosure Required? ❑ YES �� NO
`This must be filled out by Zoning Department-For eit (er�wer, a Zoning Official must sign all applications.
* Approved By: Date:
(Zoning Official)
Form Last Updated: July 2015
150784
♦
�' Hennepin County Property Map NO C�p
0R ate: 8/16/2016
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Division in Process Comments:
The displayed parcel undary may not be the actual boundary
because this proper is in the process of being divided
or replatted.
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This data(i)is furnished'AS IS'with no
representation as to completeness or
r(� accuracy;(ii)is furnished with n o
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Hen nepin County shall not be I iable fo r a ny
damage,injury or loss resulting from this data.
��� �� Sv��, � ( � e� COPYRIGHT OO HENNEPIN
� / �`��U' • COUNTY 2016
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Christine Mattson
From: Heidi Quinn <hquinn@minnehahacreek.org>
Sent: Monday,August 22, 2016 10:17 AM
To: Melanie Curtis;Christine Mattson
Cc: Stanley Genadek
Subject: No MCWD permit Needed: 345 Spring Hill Rd, Orono
Good Morning Melanie&Christine,
After review of the proposed pool removal (approx.47 cy)at 345 Spring Hill Road, MCWD staff have determined that no
Erosion Control permit is needed.
Please contact me with questions.
Thank you,
Heidi
Heidi Quinn � Permitting Technician � Minnehaha Creek Watershed District
15320 Minnetonka Boulevard � Minnetonka, MN 55345 � Office:952-641-4504
1
�0��
C ITY OF ORONO
.1 ,y, Street Address: I Mailing Address: Telephone(952)249-4600
��n Gti 2750 Kelley Parkway P.O.Box 66 I Fax (952)249-4676
tqkESH��� Orono,MN 55356 Crystal Bay,MN 55323 www.ci.orono.mn.us
August 11,2016
Stan Genadek
Genadek Landscaping&Excavating
716 Third Avenue
Mendota Heights, MN 55118
Re: Demolition Permit Application#2016-00928
345 Spring Hill Road
On August 5, 2016 the City received a demolition permit application for an in-ground pool. Staff conducted a
preliminary review and find items 1 through 4 of the demolition permit application(copy attached)were not submitted.
Please submit the following in order for your application to be considered complete and for the plan review to continue:
1. Submit a survey,aerial photo or sketch showing all structures on the property. Note which structures are to
be demolished.
2. Submit a survey, aerial photo or sketch showing proposed erosion control measures in accordance with
Chapter 79,Construc[ion Site Runoff Control
3. Minnehaha Creek Watershed District (MCWD). Your project may trigger the Minnehaha Creek Watershed
District's (MCWDs) permitting requirements; please contact the MCWD directly at 952-471-0590 regarding
your project. Please note,the City of Orono will not issue a building permit without a copy of the MCWD permit
or documentation stating the proposed project does not trigger any of their permitting requirements.
4. Escrow&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
enclosed agreement and submit a check for$2,500.
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,
CITY OF ORONO
�
hti ���
Christine Mattson
Planning Assistant
c Stan Genadek,via email
Roger Riley;345 Spring Hill Road;Wayzata, MN 55391
Roger Peitso, Building Official
enclosures
' Hennepin County Property Map
Da te: 8/11/2016
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PARCEL ID: 2511823430008 Comments:
OWNER NAME: Roger Riley
PARCELADDRESS: 345 Spring Hill Rd, Orono MN 55391
PARCELAREA: 1.99 acres, 86,746 sq ft
A-T-B: Torrens
SALE PRICE: $679,900
SALE DATA: 03/2016
SALE CODE: Other— See Certificate Of This data(i)is furnished�As is��cn�o
Real Estate Value (Crv) representation asto completeness or
accuracy;(ii)is furnished with no
ASSESSED 2015, PAYABLE 2016 warrantyofanykind;and(iii)is notsuitable
for legal,engineering or surveying purposes.
PROPERTY TYPE: Residential Hennepin County shall not beliable forany
HOM ESTEAD: Homestead damage,injury or loss resulting from this data.
MARKET VALUE: $683,000
TAX TOTAL: $8,735.66 COPYRIGHT �OHENNEPIN
COUNTY 2016
ASSESSED 2016, PAYABLE 2017
PROPERTY TYPE: Residential
HOMESTEAD: Homestead
MARKET VALU E: $734,000
�i� /
�_/ �!/ DATE TIME
CITY OF ORONO CA�LED IN �
INSPECTION NOTIC SCHEDULED {���
PERMIT NO. ' COMPLETED
ADDRESS r � ���
OWNER TELEP ON N . Z �� T ��c�
CONTRACTOR ��Q �'
� DESCRIPTION . d'� �� / �+.-�'�
l� ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL
Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING
O ❑ 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 OWNERICONTRACTOR TO MEET YO •_YES_NO
y COMMENTS:
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� /�C�IWBRI�ATISFACTORY:PROCEED ❑ PROJECT COMPLEfE
W O CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFOREC0IIERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pHOTO TAKEN
INSPECTOR WILL REfURN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Ca11 ' pection 2a hour�in advance. (g52) 249-4600
Ow IContractor on ' . � ��"'t�
Inspector 'Y"�
White Copylinspector's Ffle Canary CopylSite Notice
` �
� DATE TIME
��
CITY OF ORONO CALLED IN ��
INSPECTION NOTIC SCHEDULED , ��
PERMIT NO. �' ' "�Z COMPLETED
ADDRESS � �
OWNER TELEPH E NO. '� � - g�
CONTRACTOR �
� DESCRIPTION �� � � �(�r
ty ❑ FOOTWG ❑ DEMO-FINAL , ❑ SEPTIC FINAL D/�
� ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADIN /FILLING
O ❑ 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
41 ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL
_
J ❑ DEMO-SITE ❑ S TIC INSTALL
2 OWNERICONTMCTOR TO MEET YOU�YES_NO
v�i COMMENTS:
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W ❑CORRECT WORK 6 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE COVERING PERMANENT
❑CORRECTUNSAFECONDITIONWRHIN HOURS. ❑ PHOTOTAKEN
INSPECTOR WFLL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (952) 249-46��
OwnerlContractor on site:
Inspector:� �h^- �
White Copyflnspector's Fite Cenary CopylSit�Notics
�� DATE TIME
CITY OF ORONO cnLLED IN
INSPECTION O CE SCHEDULED � _��
PERMIT NO. COMPLETED _
AD�tESS "�
OWNER TELEP NE .
CONTRACTOR L-'�,/��'_
� DESCRIPTION �� 4���o-�C��
t1� ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL
Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING
Q ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL
2 ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION
Q �] FRAMING ❑ MECHANICAL FINAL ❑ RATED WALLS
� ❑,INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT
v NAL ❑ WATER HOOK-UP ❑ FOLLOW-UP
_ ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAk
v ❑ DEMO-SITE ❑ SEPTIC I ALL ��d
2 OWNERICOI�TRACTOR TO MEET Y�OU:_YE$�NO ��`��'�'�
� COMMENTS: (.r � [�2 ��2 ih �' � lC �
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� ❑WORK SATISFACTORY:PROCEED �ROJECT COMPLETE
W ❑CORRECT WORK 8 PROCEED ❑ISSUE CERTIFICATE OF OCCUP/1NCY
O ❑CORRECT WOFIIC,CALL FOR REINSPECTION TEMPORARY
V BEFORE COVERINO PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HWRS. p pHpTOTAKEN
INSPECTOR WILL RETURN
❑STOP OROER POSTED.CALL INSPECTOR �GTATION ISSUED
❑INSPECTION REWIRED.CALL TO ARRANGE ACCESS. '
Call for the next inspectfon 24 hours in advanoe. (952) 249-4600
Owr�erlContractor on site:
Inspecto��
WINte CopyAnspactors FII� C�nary CopyISIN Notfa
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� • � • � •
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emo
To: Finance Department
From: Christine Mattson, Planning Assistant (�
CC: Street File
Date: October 3, 2016
G/L: 101-22205
Re: Escrow Refund
Demolition Permit#2016-00928 pertaining to 345 Spring Hill Road is complete. Please refund
$2,500 to the property owner, Roger Riley.
The following is attached:
• Original signed escrow agreement
• Copy of cash register receipt showing escrow amount received
Mail to: Roger Riley
345 Spring Hill Road
Wayzata, MN 55391
w:�,street files�,spring hill road�345�escrow refund form 2016-00928.doac
. �
ESCROW AGREEMENT
DEMOLITION PERMIT#2016-00928 .
AGREEMENT made this�day of , 20�, by and between the CITY OF ORONO, a
Minnesota municipal corporation("City")and R er Riley("Owners").
Recitals
1. An applic�tion for a demolition permit has been filed for an in-ground pool located at 345 Spring Hill
Road ��� �("S bje�� Property°) legally described as
� , Hennepin County,
Minnesota.
2. In conjunction with the demolition, erosion control measures are required as shown on attached Exhibit
,�A�
NOW,THEREOFRE,THE PARTIES AGREE AS FOLLOWS:
1. DEPOSIT OF ESCROW FUNDS. Contemporaneously with the execution of this Escrow Agreement,
the Owners shall deposit$2,500 with the City. All accrued interest, if any, shall be paid to the City to reimburse the City
for its cost in administering the escrow account.
2. PURPOSE OF ESCROW. The purpose of the escrow is to guarantee reimbursement to the City for all
out-of-pocket costs (including planning, engineering, or legal consultant review)the City has incurred to assure that the
erosion control measures are installed and maintained so the property complies with the provisions of Orono City Code
Chapter 79. The financial securiry 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. If compliance with the
approved Land Disturbance Permit is not accomplished within the allowable time period, the City may bring the project
into compliance by use of the security.
3. RIGHT OF ENTRY. The Owners hereby grant the City, its agents, employees, officers and contractors
the right to enter the property to perform all work and inspections deemed appropriate by the City in conjunction with the
required erosion control measures, including but not limited to constructing or completing any and all of the agreed upon
improvements should the Owners'contractor not complete those improvements by the date specified herein.
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. Any remaining amount of the financial security deposited with the City for faithful
performance of the plans and specifications and any related remedial work will be released after the completion and
inspection of all such measures and the establishment of final stabilization for the Subject Property.City Staff shall review
the terms of this escrow agreement finro 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.
CITY: ITY OF RONO OWNERS:
By: � / � ��ir l�, Za1 b
�ts: r
�
150784
���� ho� ���
�u��c� - c�o R �
c�- �iov�
�,l � �
,
��n�� ot �.y:
I h�eraby certi!'y� thQt this is a Lrue and correct repreeentntion of a eur�nsT of
the bonndaries of t,hat part of the Nort.l�reat quarter of the Southeast quart�er and
oP Govrr�s�nt Lot t,, Ssction 25, Tc�vnship �].8, Range 23, IYinB Uorth Qf the porth
line of �ct �� �g#.a�erad Laad Survey Na. 1�83, Pilea oP Regiatrsr af Titlsa,
Connty of Henn+�pin, �nd l�ria8 8e�3� of a 2ia� �eacriD�d ae begia�ng a.t.tbe 3ou'kb-
�+�est sor'n�er o� seid .Sec�� 25, �aone�e� !lat�► slong tb� 1Jeot li�a t�e►reof, 1�5a.0
Peet; thence 8aatorl�r dat'le¢ting .'t� � �'l,�t.93°15' a dist�anae o! 2289.7 fee�;
t�hsnas detl*c�1.ng to '�h�s ri.�t along s 2° ettrve (d+slta a�gls 28°35� , u�l t�ngent
� di*� 729.8 t'i�t) a distan� of 1t„29.2 feet; thea� Sou�.hesater�jr� taa�nt t,o
; said �nr�e a diafi�aac� ot 252.O .feet; thsnc�s detlecZing 't�o ti�e lei't along a lo3pr
� cm•rs (delta anQle 14°3g' , �+►ad �a�sIIt diatance 490.5 �'eet} a dis�nce of 975.5
� fiet; t�ence So�eattarly, tangent to eaid laet dea�ri.bed curre, a disteaCe oP
: 53g.5 !'�at; t�ienee d�tlsatiug to the left along a 3°30� cm�re (delts anglo 34°50'
4nd tangsnt dis�an@e 313.6 Fset) to its Sat.�rsaction xith t�e B�st line of snid
3ection 25, ar�d �here eadiag. It does �t purport ta� ahoM i�prcr�►enents:or en-
croa�ant.s, but doea ipclicate t�e proPosed location of a proposed house.
., . •� .
Hennepin County Property Map
Date: 8/16/2016
1 inch =50 feet
Division in Process Comments:
The displayed parcel undary may not be the actual boundary
because this proper is in the process of being divided
or replatted.
�,� �� !
� `r� �c� �ncxa5�o
This data(i)is furnished'AS IS'with no
representation as to complelaness or
aacuracy;(ii)is fumished with no
warranty of any kind;and(iii)is notsuitable
for legal,engineering or surveying purposes.
Hennepin County shall not be liable forany
damage,injury or loss resulting from this data.
COPYRIGHT�HENNEPIN
COUNTY 2016
, , • .
ROGfR RILEY 61rJ6
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�2A�Yo ►rnti, 5539 I A�tC�t.� f� Zd�o sse,rns�z
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ORDEROF�4 OG �Z.�
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06
City of Orono
2750 Kelley Parkway -
• Orono MN 55356 952-249-4600
Receipt No: 3.016234 Aug 18, 2016
Roger Riley '
Previous Balance: .00
, Permits .
' 345 Spring Hill Rd 2,500.00
101-22205
Deferred Rev-Developer Deposit
---------------
Total: 2,500.00
---------------
---------------
Check
Check No: 6156 2,500.00
Payor:
Roger Riley
Total Applied: 2,500.00
� ---------------
Change Tendered: .00
---------------
- ---------------
08/18/2016 11:59AM
' ' � • CITY OF ORONO
2750 KELLEY PARKWAY * 2 0 1 6 — 0 0 9 9 9 *
DATE ISSUED: 08/18/2016
ORONO,MN 55356-
952 249-4600 FAX: (952)249-4616
ADDRESS : 345 SPRING HILL RD
PIN : 25-118-23-43-0008
LEGAL DESC : REG.LAND SURVEY NO. 1429
: LOT 000 BLOCK 000
PERMIT TYPE : ESCROW FEE-TIED TO BUILDING PERMIT
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ESCROW FEE-TIED TO BUILDING PERMIT
NOT'E: THIS$2500 ESCROW IS TIED TO BUILDING PERMIT 2016-00928
APPLICANT ESCROW FEE-BUILDING 2,500.00
TOTAL 2,500.00
RILEY,ROGER Payment(s)
345 SPRING HILL RD CHECK 6156 2,500.00
WAYZATA,MN 55391-
OWNER
RILEY,ROGER
345 SPRING HILL 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 Ciry approvals,and the
State Buiiding Code. This permit is for only the work described and does
not grant permission for additional or related work which requ'ves 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 t6e date of issuance,or if construction is
suspended for a period of 180 days at any time after work has commenced.
The applicant is responsible for assuring all required inspections are
requested in conformance with the State Building Code.This permit may be
revoked at any time for due cause.
/ /
Applicant Permitee Signature Date Issued By Signature Date