Loading...
HomeMy WebLinkAbout2015-00511 - land alteration CITY OF ORONO * 2 0 1 5 - 0 0 5 1 1 * 2750 KELLEY PARKWAY DATE ISSUED: 08/06/2015 • ORONO,MN 55356- 952 249-4600 FAX: 952 249-4616 ADDRESS : 2687 WAYZATA BLVD W PIN : 33-118-23-13-0002 LEGAL DESC : UNPLATTED 33 118 23 : LOT 000 BLOCK 000 PERMIT TYPE ZONING PERMIT PROPERTY TYPE COMMERCIAL-BUSINESS CONSTRUCTION TYPE LAND ALTERATION(0-500 CU YDS) NOTE: $2,000 SB COLLECTED IN ESCROW FEE ACTUAL ESCROW FEE AMOUNT COLLECTED $2,000.00 HOW DID THEY PAY?CK#3561 &WHO PAID?LONG LAKE PROPERTIES LLC ESCROW PERMIT#:(DON'T FORGET TO ENTER) MINOR LAND ALTERATION ESCROW FEE FOR:EROSION CONTROL&ENGINEERING REVIEW COSTS NOTE:PARKING LOT TO BE STRIPED AND AS-BUILT SURVEY SUBMITTED AND APPROVED PRIOR TO RELEASE OF ESCROW. INITIAL: APPLICANT MINOR LAND ALTERATION 50.00 TOTAL 50.00 SPENSA MANAGEMENT GROUP LLV Payment(s) 350 HIGHWAY 7 CHECK 3564 50.00 EXCELSIOR,MN 55331- (952)404-3381 OWNER Long Lake Properties LLC 8525 E PINNACLE PEAK RD SCOTTSDALE,AZ 85255- 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 111111111 1111111111 CITY OF ORONO * 2 0 1 5 - 0 0 5 1 1 t 2750 KELLEY PARKWAY DATE ISSUED: 08/06/2015 ORONO,MN 55356- 952 249-4600 FAX: 952 249-4616 ADDRESS 2687 WAYZATA BLVD W PIN 33-118-23-13-0002 LEGAL DESC UNPLATTED 33 118 23 LOT 000 BLOCK 000 PERMIT TYPE ZONING PERMIT PROPERTY TYPE : COMMERCIAL-BUSINESS CONSTRUCTION TYPE : LAND ALTERATION(0-500 CU YDS) NOTE: $2,000 SB COLLECTED IN ESCROW FEE ACTUAL ESCROW FEE AMOUNT COLLECTED $2,000.00 HOW DID THEY PAY?CK#3561 &WHO PAID?LONG LAKE PROPERTIES LLC ESCROW PERMIT#:(DONT FORGET TO ENTER) MINOR LAND ALTERATION ESCROW FEE FOR:EROSION CONTROL&ENGINEERING REVIEW COSTS NOTE:P LOT TO BE STRIPED AND AS-BUILT SURVEY SUBMITTED AND APPROVED PRIOR TO RELEASE OF ESCROW. INITIAL: APPLICANT MINOR LAND ALTERATION 50.00 TOTAL 50.00 SPENSA MANAGEMENT GROUP LLV Payment(s) 350 HIGHWAY 7 CHECK 3564 50.00 EXCELSIOR,MN 55331- (952)404-3381 OWNER Long Lake Properties LLC _ny 601 CARLSON PKWY�;O 50 ` MINNETONKA, 55305- 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 confibruance with the S to Building Code.This permit may be revoked at ft ti Ar due cause. An b i () ---Fso JS Applicant Pefiniteoignatdri Date Issued By Sign tore Date City of Orono Zoning Permit Application / Mailing Address: Permit number: Q�T PO Box 66 s VO Date received: �� Crystal Bay, MN 55323-0066 T' r�5 Escrow#and Street Address: amount: J �o 2750 Kelley Parkway y S. Orono, MN 55356 Permit Fee: PP Y ESHO Ot-� Fax: 952-249-4616 Approved b : Main: 952-249-4600 Notes: www.ci.orono.mn.us This application form must be completed in full and all required information must be submitted. (Please print.) Job Site Address: 26,97 Wayzata Blvd CONTRACTOR/APPLICANT INFORMATION: Name: Spensa Management Group, LLV Phone: Fax: Address: _- City: 952-404-q113 P: Contact Person: Contact's p Gre wn e�r tAcelsiol 55331 95e Email n.o„��„�SpJai��n�.%Om�oMc'tor Homeowner (Circle One) r PROPERTY OWNER INFORMATION: F� Name: Lonq I nkP PropPrtiPs, LLC Phone(day): Mailing Address: 8525 E Pinnacle Peak ft, Scuttsdale, A2! ZIP: 85255 Email and/or Fax Overall Project Description: ADD CURB, OVERLAY DRIVE, PAVE GRAVELAREA,ADD SOILAMENDED SWALI CBoxk TYPE OF PERMIT COST* Dock, Commercial $50+ engineering review costs Escrow for erosion control and engineering review costs $2,000 Dock, Residential—Permanent dock on any lake or initial seasonal dock not $50 + engineering review costs on Lake Minnetonka (permanent dock requires CUP) Hardcover Permit: Driveway, Patio, Sidewalk, etc. (New or Replacement) No charge Also requires is a Minor or Major Land Alteration Permit Land Alteration, Major(grading, filling, or excavating) more 500 cubic yards $50 or more than 10 cubic yards in lakeshore setback(also requires CUP) Escrow for erosion control and engineering review costs As determined by CUP Land Alteration, Minor(grading, filling or excavating)—500 or less cubic $50+ engineering review costs yards outside of lakeshore setback or less than 10 yards in lakeshore setback Escrow for erosion control and engineering review costs $2,000 Retaining Wall measuring under four feet require a zoning permit. $50+ engineering review costs Retaining walls measuring more than four feet(from bottom of footings to top of wall) require a building permit. (Tiered retaining walls are considered one wall unless the walls are separated by twice the height of the lower wall.) Escrow for erosion control and engineering review costs $2,500 Stairway or Lifts to Lake(New or Replacement) $50+ engineering review costs Escrow for erosion control and engineering review costs $2,000 Structure Permit for other structures not requiring a building permit but $50+ engineering review costs regulated by the zoning code (including, but not limited to accessory building of less than 120 square feet, detached deck or platform and sport court) Escrow for erosion control and engineering review costs $2,500 Tree Removal or other vegetation removal in 0 to 75 foot zone No charge. Pre-inspection required. Temporary Construction Office/Trailer associated with building permit) $30 (over) *Permit fee will be collected when the permit is issued. Updated: January 2015 APPLICANT/OWNER ACKNOWLEDGEMENT: • Applicant/Owner agrees to provide all information required or requested by the Planning Department; • Owner agrees to pay the City of Orono for engineering consultant review costs where applicable; • Applicant/Owner 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; • Applicant acknowledges the attached Escrow Agreement is completed and signed by Owner; • Applicant/Owner understands their project may require an initial and as-built survey per City Code Section 86-68. • Some or all of the information that you are asked to provide on this application is classified by State law as either private or confidential. Private data is information which generally cannot be given to the public but can be given to the subject of the data. Confidential data is information which generally cannot be given to either the public or the subject of the data. Our purpose and intended use of this information is to annually update our records and records of other governmental agencies required by law. If you refuse to supply the information,the application may not be issued. The undersigned certify that the inform 'on pplied ' true and correct to the best of their knowled e. Applicant's Signature: / 71t Date: Z �6 Property Owner's Signature: VL=_4 Date: �2Z//S- " SUBMISSION REQUIREMENTS: Except for tree removal permits, all permits require a completed TYPE OF PERMIT: application form, escrow agreement (signed by the property owner) and escrow check from owner, two copies of all plans,and three copies of all grading plans or surveys/site plans Dock,Commercial 1. Structural plans for the dock 2. Survey showing the proposed location of the dock 3. Copy of LMCD permit Dock, Residential Seasonal Dock—survey showing proposed dock Permanent Dock—plans as approved by CUP and copy of LMCD permit(if applicable) Hardcover Permit 1. All Minor or Major Land Alteration Permit requirements apply as appropriate 2. Hardcover calculations,existing and proposed 3. Survey Land Alteration, Major 1. Survey/grading plan including existing and proposed contours as approved by Conditional Use Permit 2. Erosion control plan. 3. A copy of Minnehaha Creek Watershed District(MCWD)permits or documentation from the MCWD stating the proposed project does not trigger any of their permitting requirements. Please note,the City will not issue a building permit without information from the MCWD. Land Alteration, Minor 1. Survey/grading plan including existing and proposed contours (Less than 10 cu.yds. 2• Amount of fill to be imported and/or exported and haul route within 75'of lake or less 3. Amount of earth to be moved around on site than 501 cu.yds 4. Erosion control plan. elsewhere.) 5. A copy of Minnehaha Creek Watershed District(MCWD)permits or documentation from the MCWD stating the proposed project does not trigger any of their permitting requirements. Please note,the City will not issue a building permit without information from the MCWD. Retaining Wall 1. Plans for wall(s) 2. Unless repair or exact replacement of existing wall,submit an updated survey with grading plan including existing and proposed contours 3. Hardcover calculation worksheets if in shoreland district 4. Erosion control plan 5. A copy of Minnehaha Creek Watershed District(MCWD)permits or documentation from the MCWD stating the proposed project does not trigger any of their permitting requirements. Please note,the City will not issue a building permit without information from the MCWD. Stairway or Lifts to 1. Construction plans for stairway or lift, including footings Lake 2. Topographical survey of property with proposed stairs or lift shown 3. Erosion control plan 4. A copy of Minnehaha Creek Watershed District(MCWD)permits or documentation from the MCWD stating the proposed project does not trigger any of their permitting requirements. Please note,the City will not issue a building permit without information from the MCWD. Structure Permit 1. Construction plans. 2. Survey of property with proposed structure shown and with setbacks to property lines,other structures on property and the septic system indicated.The general location of any sewer and water services should be shown if applicable. 3. Grading plan if grading is proposed. 4. Hardcover calculation worksheets 5. Erosion control plan. 6. A copy of Minnehaha Creek Watershed District(MCWD)permits or documentation from the MCWD stating the proposed project does not trigger any of their permitting requirements. Please note,the City will not issue a building permit without information from the MCWD. Tree Removal Call: 952-249-4600 to schedule a single tree removal inspection. A re-planting plan/erosion control/management plan required for clear cutting,buckthorn or other intensive vegetation removal. Updated: January 2015 PLAN REVIEW CHECKLIST FOR ZONING PERMIT APPLICATIONS Address: 2�60 7 Wrx 2zoi L 'JW Description of work: (t9 �R'✓I Ham/, 4l,U14'je (v effilPP-Ieo] Type of permit: Z-61wrnl . W6Jeou0 Al ( uvJ ru (i.4' Zoning review by: Date Approved: 5 Grading review by: Date Approved: ly mlj-41/ Other Review, Reviewed by: Date Approved: Zoning Information: Zoning File#: Resolution#: Resolution Date: Lot Area: '51 0©0 SF/AC Width: Z 2.7. 3 Depth: Survey Submitted? 0 Yes JZNo Dat of Survey: Revision date: Existing Setbacks: Front(Lake) Rear(Street) ( N S E W ) ( N S E W ) Other Buildings Wetland Side Side Proposed Setbacks: Front(Lake) Rear(Street) ( N S E W ) ( N S E W ) Other Buildings Wetland Side Aide Shoreland District MCWD Permit ReceivA Nverage Lakeshore Setback Met? Bluff Yes 0 No 0 N/A0 Yes 0 No 0 Yes 0 No 0 Yes 0 No N/A Permit Number: 5 Ct 3 Setback: Stormwater Quality Existing Proposed Variance Required CUP Required Overlay District Tier Hardcover Hardcover Q ) 0 Yes J� No 0 Yes ,f�i. No �{� �,S/ Type(s): Type(s): ✓ File# File# Updated:January 2013 z:\forms\old stuff\plan review checklist for zoning permit applications 2013.docx Earth M r� u l 5 Out Total �s es Haul Rc rL��� Explair U� C -- iount Orono Inspections Required Perrr 0 Site Escrow Hardcover Removal 0 Footing Escrow Agreement received? 0 Poured Wall fit—As-Built Survey ld Yes 0 No 0 Planting Plan 0 Wetland Buffer Escrow Money received? 0 Final 0 Yes No 0 Other(specify) Engineering review needed? 0 Yes 0 No REMARKS (in-house): Other Review: Reviewed by: Date Approved: REMARKS (TO BE NOTED ON PERMIT AND INITIALLED BY PERSON PULLING PERMIT) dh W-bta' + SUIry '50LbMIRCO rAwnrycd Updated:January 2013 z:\forms\old stuff\plan review checklist for zoning permit applications 2013.docx MINNEHAHA CREEKWATERSHED DISTRICT QUALITY OF WATER OQUAIITY OF LIFE Pursuant to Minnesota Statutes Chapter 103D, and on the basis of statements and information contained in the permit application, correspondence, plans, The Minnehaha Creek maps, and all other supporting data submitted by the applicant, and made a part hereof by reference, PERMISSION IS HEREBY GRANTED to the applicant Watershed District is named below for use and development of land in the Minnehaha Creek committed to a leadership Watershed District. role in protecting, improving and managing Issued to: Lonq Lake Properties LLC Permit No: 15-193 the surface waters and Location: 2687 Wayzata Blvd Orono affihabed groundwater Purpose: Erosion Control, Stormwater Management - Commercial resources within the Date of Issuance: 08/03/2015 Date of Expiration: 08/03/2016 District,including their By Order of the Board of Managers relationships to the ecosystems of which Thomas Dietrich they are an integral part. District Technician We achieve our mission This permit is not transferable without District approval, and is valid to the date of through regulation expiration. No activity is authorized beyond the expiration date. If the permittee requires more time to complete the project, an application for renewal of the capital projects, permit must be received by the District at least 30 days before expiration. education,cooperative The applicant is responsible for compliance with all District Rules and for the endeavors,and other action of their representatives, contractors, and employees. programs based on Stipulations: Project to be completed as described in plans submitted to the MCWD office on May 12, 2015 according to the provisions of this sound science, permit. innovative thinking,an • Properly install and maintain all required erosion control measures until the disturbed areas are re-stabilized informed and engaged . When the site is re-stabilized and the MCWD staff has constituency,and the performed a final inspection, all silt fences must be removed cost effective use of public funds. (Statement concerning fees for inspections, violations, etc... on following page) 15320 Minnetonka Boulevard, Minnetonka, MN 55345 • Office: (952)471-0590 0 Fax: (952)471-0682 0 www.minnehahacreek.org MINNEHAHA CREEK WATERSHED DISTRICT QUALITY OF WATER QUALITY OF LIFE Inspection/Analysis/Monitoring Fees The Minnehaha Creek Watershed District is A site inspection and monitoring by District staff will be performed where the activity involves: committed to a leadership a a commercial/industrial/multi-family residential development role in protecting, ® a single family residential development greater than 5 acres or of any size if improving and managing within the Minnehaha Creek subwatershed • any alteration of a floodplain or wetland the surface waters and ® dredging within the beds, banks or shores of any protected water or wetland affiliated groundwater • a violation • any project which in the judgment of the District staff should be inspected resources within the due to project location, scope, or construction techniques District,including their relationships to the In these cases, the applicant shall pay to the District a fee equal to the actual costs of field inspection of the work, including investigation of the area affected ecosystems of which by the work, analysis of the work, and any subsequent monitoring of the work, they are an integral part. which in the case of a violation shall be at least $35. We achieve our mission through regulation, Standard Fee Schedule capital projects, District professional staff $ 65.51* education,cooperative District interns $ 40.35* District clerical staff $ 46.69* endeavors,and other Consulting Senior Engineer $ contracted rate programs based on Consulting Engineer/Technician $ contracted rate District Counsel $ contracted rate sound science, Application fee $ 10.00 Copy costs $ .25 + actual staff time innovative thinking,an Color copy costs $ 1.00 + actual staff time informed and engaged constituency,and the * cost effective use of Hourly public funds. 15320 Minnetonka Boulevard, Minnetonka, MN 55345 • Office: (952)471-0590 9 Fax: (952)471-0682 •www.minnehahacreek.org Melanie Curtis From: Theresa Zerby[TZerby@minnehahacreek.org] Sent: Wednesday, June 03, 2015 1:05 PM To: aberenberg@ae-mn.com Cc: greg@aspengroup.com; Melanie Curtis; Christine Mattson Subject: permit 15-193 documents Attachments: 15-193 draft maintenance plan and schedule.docx; 15-193 invoice.pdf; 15-193 maintenance declaration 10-21-13.docx; 15-193 Conditional Approval.pdf; declaration instructions 10-21-13.docx Hi Andy, Tom Dietrich asked me to contact you and give you copies of the conditional approval letter for permit 15-193 (2687 Wayzata blvd) along with the declaration template and instructions on how to record the declaration. • You will need to attach to the declaration a copy of the survey,clearly showing the location of the vegetated Swale this will be labeled attachment A. • The maintenance plan which I also attached to this email is Attachment B and will need to be included in the declaration. • 1 have also included a copy of the invoice for$720.60 for the engineering fees and the cost of the public notice mailing. Please let me know if you have any questions on these documents. I would also suggest you have me review the declaration for completeness before you take it to be recorded at Hennepin county property records. Thank you, Theresa Zerby Regulatory Clerk Minnehaha Creek Watershed District 15320 Minnetonka Blvd Minnetonka, MN 55345 Phone 952-641-4519 Tzerbv@minnehahacreek.org MINNENANA CREEK WATERSHEO 01$TRICT i MINNEHAHA CREEK WATERSHED DISTRICT QUALITY OF WATER QUALITY OF LIFE June 2,2015 Long Lake Properties, LLC The Minnehaha Creek 8525 E Pinnacle Peak Rd. Scottsdale,AZ 85255 Wotershed District is committed to a RE: Notice of Conditional Approval for MCWD Permit Application No.15-193, leadership role in 2687 Wayzata Blvd.,Orono Protecting, improving Dear Applicant: and managing the The review of this application and 14-day public comment period has concluded and the Minnehaha Creek surface waters and Watershed District has determined the above mentioned permit application to be complete. Therefore,the affiliated groundwater application is approved with the following conditions: resources within the o Submission of reimbursement for fees in the amount of$720.60; o Submission of a recorded declaration for:vegetated swales. District, including their relationships to the Once the above mentioned materials have been submitted and all permit conditions have been met staff will issue the permit. You are reminded that work on the project cannot begin until the permit has been issued. ecosystems of which they The approval expires one year from the date of this letter. If final municipal approval of the project results in are an integral part. changes to the project you must submit revised plans to the MCWD for review. We achieve our mission Please contact me at(952)641-4518 or tdietrich@minnehahacreek.ore if you have any questions or concerns. through regulation, capital projects, Respectfully, education, cooperative endeavors, and other �--- .� • programs based on sound science, Tom Dietrich Permit&Compliance Coordinator innovative thinking, an informed and engaged constituency,and the cost effective use of public funds. Cc: Andy Berenberg,Anderson Engineering 6/3/2015 MCWD irwoicefor permit 15-193 MINNEHAHA CREEK WATERSHED DISTRICT OUAUTY OF WATER,QUALITY OF LIFE INVOICE Minnehaha Creek Watershed District 15320 Minnetonka Blvd March 20,0015 Minnetonka,MN 55345 952-471-0590 952-471-o682 TO: Long Lake Properties LLC 8525 E Pinnacle Peak Rd Scottsdale,AZ 85255 DISTRICT REPRESENTATIVE JOB PAYMENT TERMS DUE DATE Permit 15-193 Check only Upon receipt FEES DESCRIPTION UNIT PRICE LINE TOTAL Mail Cost Mail cost $ 33.10 $ 33.10 Engineering Fees Engineering fees $ 687.50 $ 687.50 SUBTOTAL $ 72o.6o SALES TAX $ 0.00 TOTAL $ 720.6o Make all checks payable to MCWD hfp://10,1.1.15.8080/PERM ITTING/reportsfirivoice.php?permitmimber=15.193&recipierrt=Long+Lake+Properties+LLC&address=8525+E+Pinnacle+Peak+Rd... 1/1 Planning ♦ Zoning Department Memo To: Finance Department From: Christine Mattson, Planning Assistant CC: Street File Date: December 8, 2015 GIL: 101-22205 Re: Escrow Refund Building Permit#2015-00511 to 2687 Wayzata Blvd W is complete. Please refund $2,000 to the property owner, Long Lake Properties LLC. The following is attached: • Original signed escrow agreement • Copy of cash register receipt showing escrow amount received Mail to: Long Lake Properties LLC 10446 N 74"' Street#150 Scottsdale,AZ 85258 wAstreet files\wayzata blvd\2687(geffre intedors)\escrow refund form 2015-00511.doac LAND USE APPLICATION ESCROW AGREEMENT Application#7011-OKI( AGREEMENT made this ILOAF day of �`'`c���f 20 (_§ by and between the CITY OF ORONO, a Minnesota municipal corporation ("City") and Lor.1E„ c w u� t�2onE;�Ti ESw L_LC a N� +w)ni�sr« Liwii9'izE-� Lkw-ZLu-t1 Cyt-�-P,"-ksi [a corporation-optional) ("Owners"). Recitals 1. Owners have filed Land Use Application (5 �( formally requesting the City to review plans for the property addressed: .261-7 WAy2Af-A- 19LyAc G2GNb (the "Subject Property") legally described as 2. Owners request the City to review said plans which requires City approval and may require I consulting legal and/or engineering review. ` J 3. The City is willing to commence its review of the application and incur costs associated with said review only if the Owners establish an escrow to ensure reimbursement to the City of its costs. NOW THEREFORE,THE PARTIES AGREE AS FOLLOWS: 1. DEPOSIT OF ESCROW FUNDS. Contemporaneously with the execution of this Escrow Agreement, the Owners shall deposit$ 2ZM with the City. All accrued interest, if any, shall be paid to the City to reimburse the City for its cost in administering the escrow account. 2. PURPOSE OF ESCROW. The purpose of the escrow is to guarantee reimbursement to the City for all out-of-pocket costs the City has incurred (including planning, engineering, or legal consultant review) or will incur in meeting with the Owner�evi wing the plans, and preparing agenda packet material for City Council review of Land Use Application# rJ 1 Eligible expenses shall be consistent with expenses the Owners would be responsible for under a land use application. 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 cease all reviews 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 all requirements related to the project are complete. City Staff shall review the terms of this escrow agreement two times per year to determine whether the requirements of the project have been successfully completed and whether it is appropriate to return 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: CITY OF ORONO OWNERS: BY: BY : Its: P I Its: GV1 e7Vfh!E�� b 0,1 00 , , Updated: January 2015 Long Lake Properties, LLC P.O.BOX 66 MUTUAL OF OMAHA BANK CTYORO—CITY OF ORONO CRYSTAL BAY,MN 55323 LL-Mutual 6890 NK Print As:CITY OF ORONO Date:06/18/2.015 06/18/2015 2015 CapX 2015 CapX $2,000.00 $2,00081111 .00 Page 1 of 1 Long Lake Properties, LLC 10446 N.74th Street,Suite 150 MUTUAL OF OMAHA BANK 3561 Scottsdale,AZ 85258 Date: 06/18/2015 The order of CITY OF ORONO ***Two Thousand Dollars*** $**2,000.00** CITY OF ORONO P.O.BOX 66 CRYSTAL BAY,MN 55323 United States atures riquifed over$10,000 1 o n o ;r N � 1 O 11 O O I O II C6 I O 11 O O 1 II N CIOO I O 11 O O I II N N I N II N N I 1t m Q 41 1 II 1 it CL I 11 U II d (.� m N J II N J 4, J J m L N M T LO W >, Q O m O O tT 1p O 4,,, t2> N W 0 03 CU ED O d IIS cl; O N LO O O N O N 1 M 11 L O •ai Z Z m m OO .- O O Y � W C O O -0 Z .. J d HCD O- J •C O 3 N L_ U IT C lf) 'O 1 O cp O t f0 O f0 !_ UN O J d N Cfl h0 L U d J 0 L U U CITY OF ORONO * 2015 - 01004 2750 KELLEY PARKWAY DATE ISSUED: 08/06/2015 ORONO,MN 55356- 952 249-4600 FAX: 952 249-4616 ADDRESS : 2687 WAYZATA BLVD W PIN : 33-118-23-13-0002 LEGAL DESC : UNPLATTED 33 118 23 : LOT 000 BLOCK 000 PERMIT TYPE : ESCROW FEE-APPLICANT PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ESCROW FEE-APPLICANT NOTE: ESCROW TIED TO ZONING PERMIT#2015-00511 FOR LAND ALTERATION-PD CK#3561-$2,000,PD BY:LONG LAKE PROPERTIES APPLICANT ESCROW FEE-APPLICANT 2,000.00 Long Lake Properties LLC Payment(s) TOTAL 2,000.00 601 CARLSON PKWY#350 CHECK 3561 2,000.00 MINNETONKA,MN 55305- (952)449-5755 OWNER Long Lake Properties LLC 601 CARLSON PKWY#350 MINNETONKA,MN 55305- 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 conf ance with the State Building Code.This permit may be revoked any m for due ca e. ail�l (E- Applici ftrqffe Si atu a 13ate Issued By Signature Date