HomeMy WebLinkAbout2013-00660 - new structure CITY OF ORONO * 2 0 1 3 - 0 0 6 6 0
2750 KELLEY PARKWAY DATE ISSUED: 08/23/2013
ORONO, MN 55356-
(952) 249-4600 FAX: (952)249-4616
ADDRESS 760 TONKAWA RD
PIN 05-117-23-34-0007
LEGAL DESC PARTENS POINT 1 ST DIV
LOT 013 BLOCK 000
PERMIT TYPE NEW STRUCTURE
PROPERTY TYPE RESIDENTIAL
CONSTRUCTION TYPE SINGLE FAMILY
ACTIVITY 101-SINGLE FAMILY HOUSES,DETACHED
VALUATION $ 650,000.00
NOTE: SEPARATE PERMITS REQUIRED:PLUMBING, MECHANICAL,SEPTIC,FIREPLACE,SEWER CONNECTION,LAWN
IRRIGATION, WELL(STATE),ELECTRICAL(STATE)
*948.T COUNTOUR SHOULD BE SHOWN ON AS BUILT
*NO PERMANENT LANDSCAPING IMPORVEMENTS ARE TO BE PERMITTED WITHIN THE UTILITY EASEMENT
NOTE: AN APPROVED AS BUILT SURVEY IS REQUIRED PRIOR TO CERTIFICATE OF OCCUPANCY ISSUANCE. INITIAL:
NOTE: BE AWARE,IN THE EVENT WEATHER OR OTHER CONDITIONS PREVENT THE COMPLETION OF AN AS-BUILT SURVEY AT
THE TIME THE CERTIFICATE OF OCCUPANCY IS REQUESTED,A TEMPORARY CERTIFICATE OF OCCUPANCY MAY BE ISSUED
UPON REC T F A$10,000 ESCROW TO ENSURE COMPLETION OF THE AS-BUILT SURVEY AND ALL SITE IMPROVEMENTS.
INITIAL:
NOTE: PR RTO THE START OF FRAMING AN AS-BUIL�DATION SURVEY MUST BE SUBMITTED AND APPROVED BY CITY
OR A STOP WORK ORDER WILL BE ISSUED. INITIAL:
APPLICANT PERMIT FEE SCHEDULE 4,206.75
SCHRADER&COMPANIES STATE SURCHARGE(VALUATION) 325.00
4725 EXCELSIOR BLVD#300
ST LOUIS PARK,MN 55416- TOTAL 4,531.75
(952)465-3582
Minnesota State License#: BC592473
OWNER
BORDSON,BRENT&NANCY
760 TONKAWA RD
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 are
requested in conformance with the State B ilding Code.This permit may be
revok t any ' e PE-40e c se.
b -
Q
Applicami Permitee Signature Date Issued By S' ature 7KTate
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOV .
&X-
tq
City of Orono
Building pp Permit Application
for New Structures or Additions
Mailing Address: Permit number:
PO Box 66
Q ` Crystal Bay, MN 55323-0066 Date received: —/ --1
Street Address:' Received by: Wj �-
/ 2750 Kelley Parkway Plan review fee: 7 3 3
t�F� Orono,MN 55356
k t H oR� Main: 952-259-4600 Total IF
Fax: 952-249-4616 . 1�
This application form must be completed in full and all required information must be submitte
Incomplete applications will be returned. (Please print)
GENERAL INFORMATION: -�-�^
Job Site Address: 70 e; ,eoolx ko. LeA✓G 2-xAe&7,
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/APPLICANT INFORMATION:
Name: � S
State License# S Expiration Date: 319"
Phone: cell • office S • 35,T
Mailing Address: 2 � t.0 03ao City: S •LOl4K ek ZIP: SO y
Contact Person: ^VC!% OA Z R6V!f Applicant is: o ac or / Homeowner (circle One)
Email and/or Fax: Cora bb#f if TCM11ADdr?LCdP7J019A119S.COM
PROPERTY OWNER INFORMATION:
Name: frWCy J;6)t6A,1r SyIROSoN
Phone (day): 6I4 • 94b • Q76 2
Address: 76o "A-DNA WA 12n City.ZcAIA LA$a ZIP: <53 Ski
Email and/or Fax /VAA/C y& AM 00 etz • t'1/
ARCHITECT/ENGINEER INFORMATION:
Name: .5'Ay►lar �4 S C649MA C-f s14i4,S C649MA C-f&2.
Phone(day):
Address: City: ZIP:
Email and/or Fax:
PROJECT INFORMATION: Description of project:
1.Type of Project 2.Proposed Use 3.Structure Type 4.Sewage Disposal&
Water Supply
XNew Construction Single Family with WResidence
❑Addition attached garage Ef Garage/Accessory Bldg. Public Sewer
❑Accessory Building ❑ Single Family with ❑Deck
❑Relocation detached garage ❑Office/Commercial
El Other: (specify) El Private Sewer
( p fy) ❑Multiple Family/Condo ❑Warehouse
❑Public ❑Storage ❑Public Water
**Any earth movement may require ElCommercial ElOther(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.m innehahacreek.o
Estimated Construction Valuation(excluding land) $ 400 GOO.
Packet Last Updated: 04119/2013
Page 22 of 23
STRUCTURE INFORMATION:
1.Structure Dimensions t.Structure Dimensions(continued) 2.Type of Construction
a.Length(B.)= 56 Number of bedrooms= Wood/Frame
b.Width(fl)_ _ Number of garage slags: ❑Masonry
Areas in snuare feet Attached= O Metal
C.Basement= IZ90 UNCI N ❑Pole Bldg.
• Detached=� [:3 ICF
d.id Story = 15-41
❑On-site Prefab
e.2"0 Story= ❑Off-site Prefab
f. %Story = ❑Other(please specify):
g.Total Area=
REQUIRED SUBMITTALS:
All of the Information must be submitted In order foryour application to beprocessed:
Not
Enclosed Applicable
O Permit Application
❑ Propused Building Plans
❑ MN State Energy Code Calculations and Mechanical Code Requirements Form
❑ ❑ Survey(meeting all iternents
❑ O Stormwater Pollution Prevention Plan
❑ ❑ Hardcover Calculation(s)
O X Septic System Site Evaluation Report
❑ iff, Access Permit
❑ Weiland Buffer Improvement Plan
❑ o En veered Plans for Retainina Welts 4 feet or above
❑ Minnehahe Creek Watershed District Permit(t)
❑ Plan Review Fee
❑ ❑ Other.
APPLICANVOWNER 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$S00;
• Certifies that the Information supplied Is true and correct to the best of hieArer knowledge. The applicant recognizes that they
are solely responsible for suhmitifng a complete application being aware that upon failure to do so,the staff has no alternative
but to reject it until it Is complete;
• Acknowledges the Escrow Agreement Is completed and signed;
• Understands some or all of the information that you are asked to provide on this application Is classified by State law as either
private or confidential. Private data Is Information which generally cannot be given to the public but can be given to the subject
of the data. Confidential data is information which generally cannot be given to either the public or the subject of the date. Our
purpose and intended use of this Information Is to annually update our records and records of other governmental agencies
required by law. If you refuse to supply the information,the application may not be issued.
Agrees that in the event that weather or other conditions prevent the completion of an as-built survey at the time the
Certificate of Occupancy Is requested,a temporary Certificate of Occupancy may be Issued upon receipt of a S1o,000
escrow to ensure completion of the as-built survey and ail site improvements.
Applicant's Signature: Date:
:M Owner's Signature: Date:
L
Packet Last Updated.- 0411WO13
Page 23 of 23
'PLAN REVIEW CHECKLIST FOR NEW STRUCTURES / ADDITIONS
Address/Permit Number: .T�)n- � 1.J,4
Description of work: J t-,�
Septic review by: I Date Approved: '- (2
Zoning review by: IMILtDate Approved:
Building review by: Date Approved: ` S
Grading review by: bate Approved:
Zoning District: Zoning File#: Reso#: Reso Date:
Zoning: Lot Area: Zit(� S /AC Width: Lot Coverage: SF _%
Survey Submitted: Yes 0 No Date of Survey: 7 -15-15 Revised date(?): 7'2-� i
Proposed Setbacks:
Front ake Rear((!tree ) ( N S E W ) ( NE W ) Other Buildings Wetland
Side lide
Defined Height: 2��� Peak Height: FFE: ,1b 00rminus 6 feet= (Existing Contour)
Perimeter(linear feet) = OTS 60%= z,2 #of Stories - Ok? t L4 n,1 VtV 6
" ►O(Q r�'1 ; 5-Z fa1 �1 V/ej�1� y
FOR A BUILDING'MTH A BASEMENT OR CRAWL SPACE: ,�^ „
The distance between the lowest W v �w ��
START WITH proposed floor(of the basement or crawl FOR A BUILDING ON A SLAB FOUNDATION:
space and the highest The distance between the to of slab and
) g point of the roof. START WITH the highest point of the roof.p
If you have a... If you have a...
• GABLE OR HIPPED ROOF(no GABLE OR HIPPED ROOF(no
windows): Subtract half the windows): Subtract half the distance
distance between the highest point between the highest point of the roof
of the roof to the low point of the to the low point of the corresponding
SUBTRACTION corresponding gable or hipped roof SUBTRACTION gable or hipped roof
(BASED ON ROOF GABLE OR HIPPED ROOF(with (BASED ON GABLE OR HIPPED ROOF(with
TYPE) windows): Subtract half the ROOF TYPE) windows): Subtract half the distance
distance between the top of the between the top of the highest
highest window and the highest window and the highest point of the
point of the roof roof
•
ALL OTHER ROOF TYPES(flat, ALL OTHER ROOF TYPES(flat,
• mansard,etc):No subtraction.
mansard,etc):No subtraction. ADDITION Add the distance between the top of slab
SUBTRACTION Subtract the distance between the (BASED ON and the highest existing grade adjacent to
(� (BASED ON EXISTING basemenUcrawl space floor and the EXISTING the foundation.
l v GRADES) highest existing grade adjacent to the I GRADES
foundation OR 10 feet(whichever is less). EQUALS Defined building height
r EQUALS Defined building height
2q-I�
Shoreland District MCWD Permit Received Average Lakeshore Setback Met? Bluff
Yes 0 No
Yes 0 No 0 N/A 0 Yes oYes 0 No 0 N/A
Permit Number: 13 -L� Setback:
Stormwater Quality Existing Proposed Variance Required CUP Required
Overlay District Tier Hardcover Hardcover
�j0 Yes NO 0 Yes o
I Z -,� � Z 3 "10 Type(s) TYPe(s)
Updated: January 2013
v:\forms\plan review checklist 2013.docx l
REMARKS (in-house):
Fees to be Char ed YES , NO
Plan Review
Investigation Fee
Other(specify)
Square Foote e $per Square Footage
Basement X = $
1st Floor X = $
2nd Floor X = $
Garage X = $
Estimated Construction Value: $
Orono Inspections Required Work Requiring Separate Permits Required State Permits
0 Site ePlumbing 0 Grading/Filling Well
0 Hardcover Removal Mechanical 0 Fire Electrical
Footing 0 Septic 0 Water Connection
Poured Wall Fireplace Sewer Connection
Foundation Survey Masonry Lawn Irrigation
,'Radon Rock Bed 0 Mfg.
Framing 0 Other(specify)
tA
sulation
s-Built Survey
final
0 Wetland Buffer
0 Other(specify)
REMARKS (in-house):
Other Review: Reviewed by: Date Approved:
Access: Existing: 0 YES 0 NO New: 0 YES 0 NO
OFFICIAL REMARKS-TO BE NOTED ON PERMIT AND INITIALLED
No r•,
Updated: January 2013
Oforms\plan review checklist 2013.docx
WALL BRACED PANELS SHALL BE IN
ACCORDANCE TO IRC SECTION 8602.10 BY
USING OPTION S }"GYP. BD ON STUDS SPACED
16" O.C. FASTENED AT -t" O.G. ON THE INTERIOR
IN ADDITION, ON THE EXTERIOR, OPTION "3 Y2"
PLYWOOD PANEL SHEATHING ON STUDS
SPACED 16" O.C. PANELS SHALL BE
INSTALLED IN ACCORDANCE WITH TABLE
R6023(3).
760 TONKAWA RD
WALL BRACING SECTION
8/19/13 SCALE: 1/4"=l'-0"
SCHRADER
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wrihiSOft MOM9 . Load Short Form Job: OM BORDSON
Date: 0s,0e,2013
Entire House By: C.Thompson
Goodin Company
i
2700 2nd street north,MirmeepolK MN 55411 Phone:812.586-7811 Fac 812-5888132 Ematk cadrlc.thompson@goodinco.com Web:www.goodnco corn
Project I • • •
For: BORDSON RESIDENCE, LEWIS HTG&AIR
160 T60k*WA Ro.
LOA [.RKY', P"d S5 354
Design
Htg Clg Infiltration
Outside db(°F) -16 88 Method Simplified
Inside db(°F) 72 75 Construction quality Average
Design TD(°F) 88 13 Fireplaces 1 (Average)
Daily range - M
Inside humidity 5 50
Moisture difference(gr/Ib) 4 24
HEATING EQUIPMENT COOLING EQUIPMENT
Make Make
Trade Trade
Model Cond
AHRI ref no. Coil
AHRI ref no.
Efficiency 90 AFUE Efficiency 0 SEER
Heating input 0 Btuh Sensible cooling 0 Btuh
Heating output 0 Btuh Latent cooling 0 Btuh
Temperature rise 0 OF Total cooling 0 Btuh
Actual air flow 2266 cfm Actual air flow 2266. cfm
Air flow factor 0.019 cfm/Btuh Air flow factor 0.053 cfm/Btuh
Static pressure 0 In H2O Static pressure 0 in H2O
Space thermostat Load sensible heat ratio 0.89
ROOM NAME Area Htg load Cig toad Htg AVF Cig AVF
(ft2) (Btuh) (Btuh) (cfm) (cfm)
BASEMENT 1904 32036 11888 610 636
MAIN FLOOR 1535 51837 19322 987 1033
UPPER FLOOR 1263 26630 7330 507 392
BONUS ROOM 550 8485 3835 162 205
i
Entire House d 5252 118988 42374 2266 2266
Other equip loads 0 0
Equip. @ 0.93 RSM 39366
Latent coding 5326
TOTALS 5252 118988 44692 2266 2266
Calculations approved by ACCA to meet all requirements of Manual J 7th Ed.
it htsoft' 2013-Jun-2410:01:50
wr
9 R1WSu8e®U1&.e18.0.24 RSU75012 Page 1
Z:1Wdghtson HVAC%Project%Cedric1h080613 LEW HTOt.rup Calc=MJ7 Front Door faces: N
City of Orono
Hardcover Calculation Worksheet
Property Address: 760 Tonkawa Drive (our survey 140395)
Prepared by: James H. Parker P.E. & P.L.S. No. 9235 Date: 6/29/2014
`�'rfSHOQ'E
Stormwater Quality Overlay District Tier: (Circle one) Tier 1 Tier 2 Tier 3 Tier 4 Tier 5
Step 1: ASBUILT HARDCOVER
In the following table identify all items of existing hardcover on the property, keyed by letter to
Certificate of Survey (survey must accompany this form). Use as many lines as necessary to
accurately depict existing hardcover status of the property.
Key to
Survey Hardcover Item (Describe) Length x Width Total (Square Feet)
(Example) (Garage) (24'x 30') (720) S.F.
A House 2,926 S.F.
B Bitumnious Driveway 1459 S.F.
C Concrete 52 S.F.
D Bou er Retaining Was 253 S.F.
E Pavers 635 S.F.
F Dec 97 S.F.
G Stone areas 214 S.F.
H S.F.
I .F.
J
S.F.
K S.F.
L S.F.
M S.F.
N S.F.
0 S.F.
P S.F.
Q S.F.
R S.F.
S S.F.
T S.F.
U S.F.
V S.F.
W S.F.
X S.F.
Y S.F.
1 Total Existing Hardcover 5 636 S.F.
Excludable Hardcover See City Code Sec 78-1684
Deck 97 S.F.
Boulder Retaining Walls 253 S.F.
S.F.
S.F.
S.F.
2 Total Excludable Hardcover 350 S.F.
3 Net Existing Hardcover 5 286 S.F.
4 Total Lot Area 23,643 S.F.
Asbuilt Hardcover Percentage [(3)/(4)) 22.36%
IUD lbhwwoL Kos
Zo 13- bo�ocQo
/-S-1211
E)tk(14"
i
ADVANCE SURVEYING & ENGINEERING CO.
I hereby certify that this report was prepared by me or under my direct supervision and
that I am a licensed professional engineer and a professional land surveyor under the
laws of the State of Minnesota.
James H. Parker P.E. & P.L.S. No. 9235
ADVANCE SURVEYING & LNGINEEKIN COPY
I hereby certify that this report was prepared by me or under my direct supervise n
that I am a licensed professional engineer and a professional land surveyor under the
laws of the State of Minnesota.
James H. Parker P.E. & P.L.S. No. 9235
Step 2: PROPOSED HARDCOVER
In the following table identify all items of existing hardcover on the property, keyed by letter to
Certificate of Survey (survey must accompany this form). Use as many lines as necessary to
accurately depict existing hardcover status of the property.
Key to
Survey Hardcover Item (Describe) Length x Width Total (Square Feet)
(Example) (Garage) (24' x 30') (720) S.F.
A House 2,996 S.F.
B Driveway 1,297 S.F.
C Patio Northeast 423 S.F.
D Patio Southeast Flagstones w. 5' to 7between 66 S.F.
E Dec &Steps 81 S.F.
F Wal &steps, drive to main entrance 242 S.F.
G Stairs N. side house 49 S.F.
H Steps rom SE Patio 9 S.F.
I Stepping stones to lake 99 S.F.
J Steps on lake bluff 80 S.F.
K Stepping stones N. o ome 35 S.F.
L Garage stoop 44 S.F.
M Retaining walls on S.E. side home 25 S.F.
N Retaining wa s on N. side home 163 S.F.
O Lift Sta. NW 7 S.F.
P Li t Sta. NE 20 S.F.
Q S.F.
R S.F.
S S.F.
T S.F.
U S.F.
V S.F.
W S.F.
X S.F.
y S.F.
1 Total Proposed Hardcover 5,636 S.F.
Excludable Hardcover See City Code Sec 78-1684
Space between stepping stones not counted 42 S.F.
50% of flagstone patio SE of home ? 55 S.F.
S.F.
S.F.
S.F.
(2) Total Excludable Hardcover 97 S.F.
3 Net Proposed Hardcover Subtract line 2 from line 1 ] 5 539 S.F.
4 Total Lot Area 23,643 S.F.
Proposed Hardcover Percentage [(3)/(4)] 23.43%
City of Orono 0R0N0 Copi
Hardcover Calculation Worksheet
ddress: 760 Tonkawa Road (our survey 130216)
yF GA, )y: James H. Parker P.E. & P.L.S. No. 9235 Date: 7/15/2013
k
`qFSH��
Stormwater Quality Overlay District Tier: (Circle one) Tier 1 Tier 2 Tier 3 Tier 4 Tier 5
Step 1: EXISTING HARDCOVER
In the following table identify all items of existing hardcover on the property, keyed by letter to
Certificate of Survey (survey must accompany this form). Use as many lines as necessary to
accurately depict existing hardcover status of the property.
Key to
Survey Hardcover Item (Describe) Length x Width Total (Square Feet)
(Example) (Garage) (24' x 30') (720) S.F.
A House 733 S.F.
B Garage 884 S.F.
C Drive 2986 S.F.
D Concrete 607 S.F.
E Sheds 67 S.F.
F Steps 18 S.F.
G Stepping stones 25 S.F.
H S.F.
S.F.
J
S.F.
K S.F.
L S.F.
M S.F.
N S.F.
p S.F.
P S.F.
Q S.F.
R S.F.
S S.F.
T S.F.
U S.F.
V S.F.
W S.F.
X S.F.
Y S.F.
1 Total Ex-isting Hardcover 5,320 S.F.
Excludable Hardcover See City Code Sec 78-1684
S.F.
S.F.
S.F.
S.F.
S.F.
2 Total Excludable Hardcover 0 S.F.
3 Net Existing Hardcover 5 320 S.F.
4 Total Lot Area 23 643 S.F.
Existing Hardcover Percentage [(3)/(4)] 22.50%
sr /
�! ) DATE t7U v
CITY OF ORONO CALLEDIN
INSPECTION ICE off SCHEDULED
PERMIT NO. 3 �COMPLETED
ADDRESS « -TO l"��A .
OWNER TELEP E NO. &CZ- .39,Y--CAG3
CONTRACTOR
a DE.SCRIPT ON `
❑ FOOTING ❑ PLUMBING I L ❑ EXCAWGRADING/FILLING
Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS
y ❑ FRAMING ❑ MECHANICAL FINAL
Q [j 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 ❑ FOUNDATION/REMOVAL
Z OWNERICONTRACTOR TO MEET YOU:_YES_NO
cam., COMMENTS:
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LURK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE
W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
C.1 BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTOTAKEN
INSPECTOR WILL RETURN ❑CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (952) 249-4600
Owner/Contractor on sits
Inspector. `
White Copy/Inspector's File Canary Copy/Site Notice
V/
CCITY OF ORONO CALLED IN TIN{�+�--
INSPECTIO OTICE SCHEDULED
PERMIT NO 3 C-'f�)Q:Q COMPLETED
ADDRESS Ito 0 -Tb�<<RsJ�,
OWNER SCI"Ir'a&-V' TELEPHONE NO. 1. 3_4
CONTRACTOR K L --r-:
ti
DESCRIPTION �
tai ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING
RED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS
G ❑ MECHANICAL FINAL ❑ TREE REMOVAL
Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION
Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS
❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT
v ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP
i ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL
v ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUWATION/REMOVAL
Z OWNERICONTRACTOR TO MEET YOU:_YES_NO
0 COMMENTS:
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LU ~K SATISFACTORY.PROCEED El PROJECT COMPLETE
W ❑CORRECT WORK&PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY
❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑PHOTO TAKEN
INSPECTOR WILL RETURN ❑CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (952) 249-4600
Owner/Contractor on site- -0 oft e2aft
Inspector.
White Copyllnspector's File Canary CopylSite Notice
5e 6 -TIME L-
CITY OF ORONO CALLED IN x7y, �—
INSPECTION—NOTICE SCHEDULED !/-/.S�-/3
PERMIT NO B � COMPLETED
ADDRESS -76 3�IEA-zO4
OWNER TELEPHONE NO.60l2 910-6-0&
CONTRACTOR S C44aG-g-(
3Z DESCRIPTION Ka
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I-
❑ FOOTING ❑ PLUMBI NAL LlEXCAV/GRADING/FILLING
Q ❑ POURED WALL ElMECHANI RI ❑ LAKESHORE/WETLANDS
y ❑ FRAMING ❑ MECHANICAL FINAL
O El TREE REMOVAL
Z ❑ INSULATION ❑ WOOD BURNERIFIREPLACE ❑ 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 ❑ FOUNDATION/REMOVAL
2 OWNEWCONTRACTOR TO MEET YOU:_YES_NO
COMMENTS:
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❑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
Owner/Contractor on site:
Inspector.
White Copy/Inspector's File Canary CopylSite Notice
<;eT D TIME
CITY OF ORONO CALLEDIN
INSPECTION NOTICE SCHEDULED
PERMIT 10 COMPLETED
ADDRESS7/0d / Q
OWNER - �J- TELEPHONE NO. 5ZD
CONTRACTOR OCkIR�c ¢ `-CJ
DESCRIPTION 1 nsstaa �6-y`--
❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAWGRADING/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 ElSEWER HOOK-UP ❑ COMPLAINT
v ❑ DEMO-SITE ❑ SEPTIC MAINT ❑ FOLLOW-UP
❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL
v ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL
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❑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
Owner/Contractor on site:
r.
Inspecto �-
White Copylinspector's File Canary Copy/Site Notice
DATE TIME
�{ CITY OF ORONO CALLED IN q p Gam•
INSPECTIO OTI�,J E SCHEDULED I( ��,(3 - ��
PERMIT NO. � _ (COMPLETED
ADDRESS ,,
OWNER <4__1_0&a4_ TELEPHONE NO.`r9'M 3._Jle
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DESCRIPTION v 0�
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Q Ll 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 ❑ FOUNDATION/REMOVAL
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INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR ❑CITATION ISSUED
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (952) 249-4600
Owner/Contractor on site:
Inspector. rt
White Copylinspector's File Canary Copy/Site Notice
DATE TIME
CITY OF ORONO CALLED IN
INSPECTION NQjICE SCHEDULED
PERM T NO. _-920A40 COMPLETED
ADDRESS 7(!5 n -' 4 e.0(_
OWNER TELEPHON NO.
CONTRACTOR
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Z ❑ INSULATION ❑ WOOD BURNERIFIREPLACE ❑ SITE INSPECTION
Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS
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v ❑ DEMO-SITE ❑ SEPTIC MAINT ❑ FOLLOW-UP
i ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL
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INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR ❑CITATION ISSUED
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (952) 249-4600
OwwlContractor on site: 45L
Inspector. Iv—
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White Copylinspectoes File Canary Copy/Site Notice
DAT TIME
CITY OF ORONO CALLED IN
INSPECTION NOTICE SCHEDULED — — _�
PERMIT NO. COMPLETED
ADDRESS 7 (PoO
OWNER TEL P NE NO.k;���D"�POL3
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DESCRIPTIONLI/(. � ✓�G�z-oYcS
❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILUNG
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❑STOP ORDER POSTED.CALL INSPECTOR
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (952) -4600
Ownerr,ontractor on site:
Inspector.
White Copyllnspectoes File Canary CopyWo Notice
S DATE TIME `/
CITY OF ORONO CALLED IN �e2=�o�Ady
INSPECTION OTICE SCHEDULED Is - Z/:Od
PERMIT NO. -AW29WCOMPLETED
ADDRESS
OWNER TFLFPJ40NE NO. kO?_�7/0�1,
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3: DESCRIPTION
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ti ❑ FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL
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❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL
v ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL
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Call for the next inspection 24 hours in advance. (952) 249-4600
OwnedContractor on site: ®reAS,
Inspector. I:..
White Copyllnspector's File Canary Copylsite Notice
C —5 s,—t DATE TIME J
CITY OF ORONO CALLED IN
INSPECTION NOTICIESCHEDULED
PERMIT NQ="/ �OMPLETED
ADDRESS //
OWNER TELEP I-19t�E NO& 8'lD
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v ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL
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❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (952) 249-4600
Owner/Contractor on site: �a
Inspector.
White Cop nspector's File Canary Copy/Site Notice
DA E / TIME V
CITY OF ORONO CALLED IN +` ,/
INSPECTION OTICE SCHEDULED -7- 10-146 _2 =
PERMIT NO.4ZQ COMPLETED
ADDRESS V� TdYLIC atdlaL
OWNER TTEL"HONE NO /2-9/0-(000
CONTRACTOR C�-O LY
DESCRIPTION
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Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION
Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS
❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT
v ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP
Uq ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL
v ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL
2 OWNERICONTRACTOR TO MEET YOU:_YES_NO
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❑CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next InspectionA4 hours in advance. (952) 249-4600
OwnerlContractor on site-
Inspector F..
White Copyllnapector's File Canary CopylSite Notice
DATE I TIME
CITY OF ORONO-?"(3 —�Q&&o CALLED IN 7'
INSPECTION NOTI SCHEDULED
PERMIT NO '� COMPLETED
ADDRESS
OWNER TEL HONE NO&I -*1D-�
CONTRACTOR
DESCRIPT
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NSLAB ❑ WATER HOOK-UP ❑ PROGRESS
❑ SEWER HOOK-UP ❑ COMPLAINT
-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP
❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL
❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL
OWNEWCONTRACTOR TO MEET YOU:_YES_NO
COMMENTS:
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❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTO TAKEN
INSPECTOR WILL RETURN
❑CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours i advance. (9 49-4600
Owner/Contractor on site:
Inspector.
White CopylInspector's File �' Canary Copy/Site Notice
Planning & Zoning
Department
Me o
To: Finance Department
From: Christine Mattson, Planning Assistant `
CC: Street File
Date: July 28, 2014
G/L: 101-22205
Re: Escrow Refund
Bldg Permit#2013-00660/760 Tonkawa Road
Building Permit Application #2013-00660 pertaining to 760 Tonkawa Road is complete.
Please refund $10,000 to the applicant, Brent&Nancy Bordson.
The following is attached:
• Original signed escrow agreement
• Copy of cash register receipt showing escrow amount received
Mail to: Brent& Nancy Bordson
760 Tonkawa Road
Long Lake, MN 55356
wAstreet filesVonkawa road\760\escrow refund memo 20134X)660.docx
1 I
TEMPORARY CERTIFICATE OF OCCUPANCY
ESCRCriV AGREEMENT
Orono BuOding Permit#M3
AGREEMENT made Ihb 5 day of 20j8L by and between Oe CfTY OF
ORONO,a Mlnnasolm municipal corpmalleon(may")Ad Brant iii Nancy So dsont(-Ow an-),
Regilleft
1. Coratruclion of the now nmMence located at 760 Tonkawm Road the subject
Property,. Itchy described as Lot 13. Porten's Point 1" Division in Orono, Hem s&
County Minnesota, Is the subject of buikRtg per"application nurnber 2013-00980 has
been completed.
2. Waiter cendilions urrenty pmhbk oompletion of exterior bnproesrnents, final gmcl%
and vegetation eshblisftent. An awbuilt survey carrot be accurately conducied at this
time.
3. Owners request the City Issue a temporary re "llcMs of ocupency ('TCO') to the
Owners so that the Owners may occupy tits new reslderroe.
4. The CRY w8 Issue a TCO only N the Owners establish an escrow to ensure oanpletion of
extafor k proverttenb,oonl meliort of erosion conbol and subm ilml of an am4xM survey
to the City.
NOW THEREFORE.THE PARTES AGREE AS FOLLO1118:
1. DEPOSIT OF ESCROW FUNDS. Conternponnsously with the execullon of this Escrow
Agraernent,the Owners shall deposit=10,000 with the City. AN accrued interest,N eny,shall be paid to
Via City is reirnbur a On City for Ils cost In administering Ore escrow account.
Z PURPOSE OF ESCROW. The purpose of the am= Is to assure compiedon of any
exterior bnprovements.final gmdhtg, selablishment of vegnlatlon as wall as guaranine raimbursernerrt lo
On City for all out-ot:podat costs the City has incurred NdLWinB platting, errgineerbng, In ercoess of
3500,or legal consultant revlat or alp Ir ur In reviewRtg the pian.E ible expenses shall be consistent
wb expenses to Owners would be responsible for under a bolding Permit applicattlorh.The escrow will
also guarantee reimbursement io to City for all ouW-pocket costs Ots City las Incurred io assure Oat
the work is compleied in accordmtoe wilh the Sk m vdw PcOullon Preven*m Plat and to povidone of
Orono City Code Chapter 79. The fUarcdal seurfly may also be used by the City to aftkafs any
hasaudow condillom associated with the waft and to repair any damage to public property or
iMrasructun that Is caused by the work PmIuding plennUtg, engirteering, or legal coretdmmt reviaw)
associmied with building penMt M13.00690 N complonce vAh the approved bullddtg permit Is not
8. MOMHLY MUM. As the City receives cormuliont bib for incurred costs,Oa City will
In tum sand a bill to the Owners. Owners Shap be responsible for payment to the City Wddn 30 days of
the Owners'receipt of bill.
4. DlilSUROMMENT FROM NO==ACCOUNT. In Ow event that Oe Owners do not make
payment lo to City wilMrt the thnsi . ou linsd In 83 above,shell issue a Slop Weak Order until the Owners
pay ail s pensee invoiced pwaumht to$3. The City msy draw from the esaow acca ttwillhohd further approval
of tie Owners to reirnbtsse the City for eligible a,;l sea rte Cir hes incurred.
L ANG ESCROW. The Bohm on deposit in to escrow,N any.shell be ratumed to
the Owners when tie review has been compleiad and wrllben notillellon Is received tram to Owners
regtaeetlng One funds.
tee4r�
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IL CERTIFY UNPAID CHARGES. S the project IB abandoned by Owners,or I the eligible
eocpana a Icuccxred by the City exceed the amount In escrow, the City shall have the right to cwft the
unpdid balance to,the subject property ptmRot to Minn.Stat.§1415.01 and 305.012.
7. ACCESS TO SUBJECT PROPERTY. The Owners hereby grant to the City,Its agents,
employees,often and cordraclors,the ftM to enter upon the subject property for the opec aft purpose
of inapedq and compladng any exbdor Improvements,final grading, asteblidanert of vegetation and
Me restoration of tie subject property should the Owners not complele the work by the specified dales.
CRY: CITY OF ORONO OWNERS:
k 16
Isailwl-110 0dr. 0 Q%W to III aWrse Dgputraa t 0 0oN to llb e d lIlle
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11111111 Rill 111111111 oil 111111111111111
CITY OF ORONO * 2014 - 00330, *
2750 KELLEY PARKWAY DATE ISSUED: 04/17/2014
ORONO, MN 55356-
952) 249-4600 FAX: 952) 249-4616
ADDRESS 760 TONKAWA RD
PIN 05-117-23-34-0007
LEGAL DESC PARTENS POINT 1ST DIV
LOT 013 BLOCK 000
PERMIT TYPE ESCROW FEE-OTHER
PROPERTY TYPE RESIDENTIAL
CONSTRUCTION TYPE ESCROW FEE-OTHER
NOTE: ESCROW FOR TEMPORARY CO 2013-00660
APPLICANT ESCROW FEE-OTHER 7,500.00
TOTAL 7,500.00
BORDSON, BRENT&NANCY Payment(s)
760 TONKAWA RD CHECK 5705 7,500.00
LONG LAKE, MN 55356-
OWNER
BORDSON, BRENT&NANCY
760 TONKAWA RD
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 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
SWLOMNO PERMIT ESCROW AGREEMENT
Oros 9uMM Perink tfM3MM
DEMOLITION PERMIT
OM34MM
t
AGREEMENT made this day of 20_by and between the CITY OF ORONO.
a Mimesota munidPW corporation
CCW)Nancy Boidedn rOenr we).
geywal
1. A demolition permit application and building permit applicallon has been tiled for demolition and
construction of a raw sinole famlly residence located at 760 Tonk we Road the (Subject PropW, legally
described as Lot 13.Panner's Point 1"Division.Hennepin County Minnesota.
2. Owners request the City to review this application.
3. The City will commence its review of the application and Irms costa associated with sold review
only H the Owner establishes an escrow to ensure,reimbursement to the City of Its coats.
NOW THEREFORE,THE PARTIES AGREE AS FOLLOWS:
1. D1:POa;IT OF ESCROW FUNDS. Cotemporansasly with the exacution of this Escrow
Agreement.tae Owners shah deposit$2.500 with the City. AM accrued Intsrest,If any,sisals be paid to the City to
near nbwss tins City for its cost in adminisloft tins escrow account.
2. PURPOSE OF ESCROW.The purpose of the escrow ls to guarantee reimbursement to the City
for al out of-pocket coats tis City has Incurred (Including plemft enalnearlogi. in a wass of$500, or legsi
consultant revlow) or wit Intra in reviewing the plan. Ellobla openew shall be consistent with mWerses the
Owners would be rospa ellb- for under a bu lift penMt epploation. The escrow SMI also guarertes
rolmbursament to the City for allout-cRpocdost oats the City has incurred to sown Unat tine work is completed In
a000rina with the Stormvaler Pollution Prevention Plan and the provh(as of Orono City Code Chapter 79.
The financial security may also be used by the City loeMmInde any hazardous conditions associatsd with the
work and to rapek any damW to public property or hfrasbuctu m Dat Is caused by the wok(Including plawft,
treview)associsladwith demollillonrmNSM34MM and building 011113411116111111 If iplim with l approved buft permit a sit
n
3. MONTHLY SN.LING. As tit City receives consultant bills for li oil v costs,the City YM In tum
send a bill to the Owners. Owners sisals be responsible for payment to to City within 30 days of tis Owners'
receipt of bill.
4. Dili MRSEMENT FROM ESCROW ACCOUNT. In the event tat the Owners do not make payment
to tie City w iddn the tlrnefimrus outlined In 63 above.Mall issue a Stop Work Order until the Owners pay all expsr ses
Irnotced pursuant lo 43. The City may draw from to escrow account without furrier approtiel of the Owners to
mimbures to City for olgitnls experees tie City has Incurred.
5. CLOSMIG ESCROW. The Balance an deposit In One secrow, it any, shell be returned to the
Owners when the review has been completed and written nWation ls reostved from the Owners requesting the
funds,
R CERTIF1f UNPAID CHARGES. VV*projectle abandoned by Owners.or latae abuts expenses
Incurred by the qty m,,r a d to amount In escrow,the City dM have the dqM to arfity the unpaid balernce lo the
subject property pursuant to Minn.Stat.§§415.01 and 308.012.
CITY: ITY OF Oi�N OWNER:
BY• VAJ -�
its:
DEMOLITION PERMIT 2013-00530
ESCROW AGREEMENT
AGREEMENT made this 2.4�day of , 20_L3 , by and between the CITY OF ORONO,
Minnesota municipal corporation ("City")and Nancy Bordson ("Owners").
Recitals
1. An application for a demolition permit has been filed for the principal structure located at
760 Tonkawa Road ("Subject Property") legally described as Lot 13, Parten's Point 1st Division, 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 thatthe
erosion control measures are installed and maintained so the property complies with 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. 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 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.
S. 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.
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: C Y OF ORONO OWNERS:
By: �+�
Its:
Internal Use Only: 0 Original to Finance Department 0 Copy to Street File
. Receipt += &W90
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CITY OF ORONO * Z 0 1 3 - 0 0 5 5 1
2750 KELLEY PARKWAY DATE ISSUED: 06/24/2013
ORONO, MN 55356-
(952) 249-4600 FAX: (952)249-4616
ADDRESS 760 TONKAWA RD
PIN 05-117-23-34-0007
LEGAL DESC PARTENS POINT 1ST DIV
LOT 013 BLOCK 000
PERMIT TYPE ESCROW FEE-TIED TO BUILDING PERMIT
PROPERTY TYPE RESIDENTIAL
CONSTRUCTION TYPE ESCROW FEE-TIED TO BUILDING PERMIT
NOTE: THIS$2500 ESCROW IS TIED TO DEMO PERMIT-2013-00530-PD CHECK#6149
APPLICANT ESCROW FEE-BUILDING 2,500.00
BORDSON,BRENT&NANCY ESCROW FEE-EROSION CONTROL 0.00
760 TONKAWA RD
LONG LAKE,MN 55356- ESCROW FEE-GRADING 0.00
TOTAL 2,500.00
OWNER
BORDSON,BRENT&NANCY
760 TONKAWA RD
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 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.
-101- Permit
—ILA] PIN
-W--j
Update Address
Permit#: 12013-00660
r- Main PIN Address
Permit Address: 1760 Tonkawa Rd r Additional PIN Address
Parcel Issue
F Permit Issue
General I Fees Inspections(14) 1 Notes Applicant Detail I CO Detail
Seq Inspection Type Inspector Date Status H Fee Rec
1 Radon Prevention Inspection WGIB 10/30/2013 P Y 0
,12 Footing WGIB 8/27/2013 P 0
3 Poured Wall WGIB 8129/2013 P Y 0
4 Foundation Survey B/4 Framing CMAT 9/9/2013 P 0
5 Framing v WGIB 11/15/2013 P
6 Insulation WGIB 11/20/2013 P Y 0
- 17 Escrow Refund Requested
8 Escrow Refunded
19 Final
j10 Final REINSPECTION METJ 419/2014 F Y 0
METJ 6127/2014 F Y 0
11 Final REINSPECTION METJ 6Q7/2014 P Y 0
_ IM
12 Final REINSPECTION CMAT 7/21/2014 P Y 0
13 Final REINSPECTION I CMAT 17/211t2014 P Y 0
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