HomeMy WebLinkAbout2012-00365 - land alteration • • , CITY OF ORONO * Z 0 1 2 - 0 0 3 6 5 *
2750 KELLEY PARKWAY DATE ISSUED: OS/14/2012
ORONO, MN 55356-
952 249-4600 FAX: 952 249-4616
REPRINTED ON 5/16/2012
ADDRESS : 3409 EASTLAKE ST
PIN : OS-117-23-13-0036
LEGAL DESC : BAYSIDE ADDN TO LAKE MINNETONK
: LOT 000 BLOCK 008
PERMIT TYPE : ZONING PERMIT
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : LAND ALTERATION(0-500 CU YDS)
NOTE: DRIVEWAY REPLACEMENT
LAND ALTERATION-MINOR
FORM INSPEC"1'ION PRIOR TO POURING CONCRE"I'E
*CONTACT MINNEHAHA CREEK WATERSHED D[STRUCT FOR ANY PERMITS THA'1�MAY BG REQUIRED
*SEE ATTACHED COMMENTS FROM CITY ENGINEER
ESCROW COLLECTED$2000.00 PERMIT 2012-00400
APPLICANT MINOR LAND ALTERATION 50.00
OVSYANNIKOVA, MIKHAIL& ELENA
3409 EASTLAKE ST ENGINEERING REVIEW COSTS
LONG LAKE, MN 55356- TOTAL 50.00
OWNER
OVSYANNIKOVA, MIKHA[L& ELENA
3409 EASTLAKE ST
LONG LAKE, MN 55356-
AGREEMENT AND SWORN STATEMENT
I hc��ork 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 scparate
permits. All provisions of laws and ordinances governing this type of work
shall be compied with whether or not specified herein.This permi[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.
�e� Gt�� l l l l
Applicant Pennitee Signature Date Issued By Signature Date
SEPARATE PERM[TS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
� . �. CITY OF ORONO * Z B 1 2 - PJ 0 3 6 5 *
, �T. 2750 KELLEY PARKWAY DATE ISSUED: OS/14/2012
ORONO, MN 55356-
952 249-4600 FAX: 952 249-4616
ADDRESS : 3409 EASTLAKE ST
PIN : OS-117-23-13-0036
LEGAL DESC : BAYSIDE ADDN TO LAKE MINNETONK
: LOT 000 BLOCK 008
PERMIT TYPE : ZONING PERM[T
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : LAND ALTERATION(0-500 CU YDS)
�Fr/-si��-
NOTE: DRIVEWAY REPI,ACEMEN"I'
LAND ALTERATION-MINOR
ESCROW COLLECTED$2000.00 PERMIT 2012-00400
APPLICANT MINOR LAND ALTERATION 50.00
OVSYANNIKOVA, MIKHAIL&ELENA
3409 EASTLAKE ST ENGINEERING REVIEW COSTS
LONG LAKE, MN 55356- TOTAL 50.00
OWNER
OVSYANN[KOVA, MIKHA[L& ELENA
3409 EASTLAKE ST
LONG LAKE,MN 55356-
AGREEMENT AND SWORN STATEMENT
The work for which this permit is issucd shall be performed according to
the approved plans and specifications,applicable City approvals,and the
State E3uilding Code. This perniit is for only the work described and does
not grant permission for additional or rela[ed 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.
� iFr//! O�l��(cLv�h'�kc.;�-} �� 5 �I`f/ i � ^ 0/�'1�-'� � �
npplicant Permitee ' nature Date Issued By S� ature ate
SEPARATE PERM[TS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
� � �O�f o�
. . � Plan Re�6ew Checkl�st �o� �o�ing Perr�it /�pplicatior�s
_ � �°� �
Address: � ���
Description of work: ��� 1�f �
Type of permit:
Zoning review by: ' !`�-� Date Approved: 6 �....
Grading review by: ,.�``f' Date Approved: ��� /�
Other Review, Reviewed by: Date �pproved:
Zonin : �
Zoning File#: Resolution #: � Resolution Date:
�.
Lot Area: SF/AC Width: Depth:
Survey Submitted? Yes � No Date of Survey:
� o -a -o8'
Existin Setbacks:
Front(Lake) Rear(Street) ( N S E W ) ( N S E 4'V ) Other Buildings Wetland
Side Side
Pro osed Setbacks:
Front(Lake) Rear(Street} ( N S E W ) ( N S E IN ) Other Buildings Wetland
Side Side
Shoreland D'ostrict MCWD Permit Received Average Lakeshore Setback Met? Bluff
� Yes 0 No /A C7 Yes o
Yes a No 0 Yes 0 No N/A
Permit Number: Setback:
liardcover Zones Existin Pro osed Variance Re uireci CUP Re uirec�
0-75' 0 Yes o ❑ Yes No
�
75-250' Type(s): Type(s):
250-500' Zoning File#: Zoning File#:
500-1000' esolution#: Resolution#:
. �i
�
Created: March 29,2011
z:\forms\plan review checklist for zoning permit applications.docx
Planni�g Review Checklist for Zoning Permit Applications
Page 2 of2
Cubic Yards
In Out Total
Haul Route? ? � Yes � No
Explain haul route in detail:
Fees to be Char ed Amount Orono Inspections Required
Perrnit Amount
� Site
Escrow Amount � Hardcover Removal
� Footing
Signed escrow received? � Poured Wall
� As-Built Survey
� Yes � No 0 Planting Plan
0 Wetland
Escrow amount received? inal
0 Yes 0 No �Other(specify)
�ornn ►�°�o� prt �'
Engineering review needed? � �{�1 ��
� Yes � No
REMARKS (in-house):
Other Review: Reviewed by: Date Approvecl:
REMARKS (TO BE NOTED ON PERMIT AND INITIALLED BY PERSON PULLING ERMIT)
' � � � � �
.
Created: March 29,2011
z:\forms�plan review checklist for zoning permit applications.docx
� Ci#y of �ronq
Zaning Permit A ticat�on
Msi�ing Addres� Permit number. � � "v b,3�O S
�,��.� PO Box 66 Date received: J�— - f �--
Crystal Bay,MN 55323-0066
t � � Escrow#and
�C ti} � Strset Add�ess: amount;
�'�, � �=� � 2750 Kelley Parkway Parmil Fee:
�' �,� Orono,fJIN 55356
��'SIiOSL4' Appraved 6y:
�--�_�' Fax: 952-2�49-4618 No�:
Main' 952-249-0604 �'"^�+-ci.orono.mn,us
This application form must be completed in fup and all required information must be submitted. (P�ease print.)
Job Sita Add ress: 3� o� P S f � ,�y�j � � � �r^�
CONTRACTOR!AP_,I,.JCAN7 INFORMATtON:.
N ame: � P.��} 1/_�yR NN��p vF}
Phone: � �J�-�},�E - ��j 3 Fax: /v
_ '�t�'.:��
Address: �• S• Cit ; .s.1� ZIP: � 5. �
Contact Person: iv � ; fJ,v�+.. ontact's phone number � , � �c - -
Email ' t7V� !, Cc�-�pp��cant is: Contractor Homeowner {CircleOns)
PROPERTY OWNER INEORMATIOH:
Name_ = �N t�VS Y/�i+l�� 1�JV/�
Phone(daY7: � c h � �v i S �_��/� .✓a �2- - �{�• _
Mailing Address: Q S1 -- 5C; ZIP; - ;� .�
Email andlor Fax Ov nJ C�A;f. ` :�i L� �} Z�fi z a,� ,,
Overall Project Description: �: �DLs��.. C�����✓�'�2c=- � ' .�:� C'.Xis���lr_., y v��•rJ�
�G�'t N✓��t� h c-.' - - �._� —
� CI��S� .�GilE' r�-t�t� .SG'�C ,/2/�•v
Soxk TYPE OF P�RMIT COST*
Dock,Residential—Permanent dock on any lake or initial seasonal dock nat on $50+engineering review costs
Lake Minnetonka ermanent dock re uires CUP
Dock,Commercial $50+engineering review costs
Escrow for erosion control and en ineerin review costs $2,400
� �ewa ermit(IVew eplacemer�t No charge
so re uired is a Minor ar Ma'or and Alteration Permit
Land Afteration, Major(grading,filling, or excavating) more 500 cubic yards or $5d
more than 1 p cubic yards in lakeshore setback (also requires CUP)
Escrow for erosion control and en ineerin review costs As determiner!b CUP
XLand Alteratlan, Mi�or�grading,filling or excavating)—500 or less cubic yards $50+engineering review costs
autside of lakeshore setback ar less than 10 yards in lakeshore setback
Escrow for erosion control and en ineerin review r,osts S2,U00
Retaining Wall measuring under four feet require a zoning permit, 550�engineering review costs
Retaining walls measuring mp�lhan four feet(from bottam of footings to tvp of
wa�[)require a bui[ding permit. (Tisr�ed retaining walls are considered one wall
unless the walls are separated by twice the height of the lower wall.)
Escrow for erosion control and en ineerin review costs $2,500
Stalrway to Lake(New or Replacement) �50+engineering review costs
Escraw for erosion cantrol and en ineenng review costs $2,Opp
Structure Pormit for other slructures not requiring a building permit but SSb+engineering review costs
regulated bythe zoning code(including, but not limited io accessory building of
less than 120 square feei,detached deck or platForm and sport courtS
Escrow for erosion control and en ineerin review costs $2,500
Tree Remo�al or othor vegotatfon removal in 0 to 75 foot zane No�har e,
{aver)
*Permlt fee will be cofl@cted at
the tlme the permtt�s Iss�ed.
updated: Fy,ri�z3,2o�z
. � APPLIGANTIOWNER ACKNOWLEDGEMENT: '
• Applican#lOwner agrees to provide all information required or requested by the Pfanning Department;
• Owner agrees to pay the City of Orano for engineerEr�g consuttant review costs where applicable;
• ApplicanVOwner certifies that the infarmatian supplied is true and oorrect to tt�e best of hislher knowledge_ The
appticant recognizes that they are solely responsibfe for submitting a complete appl"rcation being aware lhat upon failure
to do so,the staff has no afterrtative but fo reject it until it is oomplete;
• Appticant acknowledges the attacned Escrow Agreement is comp�eted and signetl by awner;
• AppJicanUOwner undersiands their project may require an initial and as-built survey per City Code Sectian 86-68.
• Some or al! of the informativn that you are askQd to pro�ide on this application is classified by State law as either
private or oonfidential. 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 informaEion which generalfy cannot be given to either t�he public or the su6ject
of the da�a. Our purpose and intended use af this infnrmation is to annually update our records �nd records of other
ovemmental agencies required by law_ If you_refuse to supply the infprmation,ti�e application may not be issued
The undersigned certify that the infprmation supplied is true and correct to the best of their knowtedge.
Applicant's Signature: • p�t�: 5� 3 �;�OJ�,
Property Owr�e►'s Signalure: Date: _5� � ��p��
TYPE OF PERMIT: ��B�ISSION REQUIREMENTS• Except for tree remo�al permits, all permits
require a completed appllcation forrn, escrow agreement(signed by the property
owner} and eserpw check from owner, two copies of all plans, and three copies
of all grading plans or surveyslsite plarts
Dack, Resldential Seasonal Dock-�ur�ey showing proposed dock
Permanent Dock-plans as approved by CUP and copy of LMCD permit
Dack,Cornmercial 1. Slructural plans tor the dock
2. Survey showing the propased location of the dack
3. Gopy af LMCD permit
1]ri�eway Permit 1, All Minor or Major Land Alter,�tion Permit ret�uirements
2. Hardcaver calculations, existing and proposed
3_ priueway plans
Land Alteratlan,Major 7. Pfans as approved by Conditional Use Permit
2. Erasion control plan or copy of MCWD Erosion Control Permit
Land A[teration, Minar �. Grading plan including existing and proposed oontours
(less then 90 cu.yds_within 75'of 2. Amaunt of fill to be imported andlor exported and haul route
lake ar less than 507 cu.yds 3. Amount of earth to be maved around on site
elsewhere.) 4. Erasion control p]an or copy of MCWD Erosian Control Permit
Retafning Wall 1. Plans for wall(s}
2. Unless repair or exact replacement of existing wail, submit an updated survey wit�
grading plan including existing and proposed contours
3. Hardcover ealculation workshsets'rf in shoreland district
d, Erosion control lan ar co of MCWD Erosion Control Permit
Stairway to Lake 7. Constructian plans iar stairway, inclutting footings
2. Topographical survey of property with proposed stairs shown
3, Erosion cantrol plan or copy of MCWD Erosion Control Permit
StructUre Permit 1. Plans for structure.
2. Survey of property with proposed structure shown and with sotba�ks to pro�erty
lines, other struc#ures on property and the septic system indicated.The general
focation af any sewer arod water servi�s shoutd be si�own if applicable.
3. Grading plan if grading is required
4. Hardoover calculation worksheets if in shoreland district
5, Erosion control lan or co of MCWQ Erosion Contro!Permit
Tree Removal Call: 95z-249-4640 to scheduie a single tr�e remaval inspection, A re-planSng p�an�
mana ement fan re uired for clear cuttin ,buckthom or other intensive ve etation removal.
Updated; /rpril 23,Z412
,
Jesse Struve
From: Jesse Struve �
Sent: Friday, May 11, 2012 8:42 AM
To: Christine Mattson
Subject: 20120511 3409 East Lake St
Christine,
I have reviewed the permit application to upgrade the existing gravel driveway to concrete for 3409 East Lake St and
have the foliowing comments:
• The driveway can be upgraded, but the resulting driveway cannot be any larger than what is existing.
• The survey indicates there is potential for runoff from the neighboring property to the east which crosses the
property. The resulting driveway cannot impede or stop drainage from the neighboring property. The new
driveway cannot result in drainage issues for the neighboring property.
• If the driveway results in drainage issues for the neighboring property,the applicant will be required to correct
the issue.
Feel free to contact me with any questions or concerns. The applicant may want to schedule a form inspection with me
prior to pouring the concrete driveway for review of potential grading issues.
lesse Struve, PE
Director of Public Works/City Engineer
City of Orono
(952) 249-4661 - Direct
(952) 249-4616- Fax
www.ci.orono.mn.us
i
Ci�ristine Mattson
From: Christine Mattson
Sent: Friday, May 11, 2012 9:49 AM
To: 'Anna O'
Subject: 3409 East Lake St/Zoning Permit Application #2012-00365
Attachments: Escrow Agreement-Zoning Permit w Erosion Control 2012-00365.pdf;
admin@ci.orono.mn.us_20120511_094249.pdf
Hi Anna,
The City Engineering has reviewed your application and has the following comments below:
Christine,
I have reviewed the permit application to upgrade the existing gravel driveway to concrete for 3409 East Lake St and
have the following comments:
• The driveway can be upgraded, but the resulting driveway cannot be any larger than what is existing.
• The survey indicates there is potential for runoff from the neighboring property to the east which crosses the
property. The resulting driveway cannot impede or stop drainage from the neighboring property. The new
driveway cannot result in drainage issues for the neighboring property.
• If the driveway results in drainage issues for the neighboring property,the applicant will be required to correct
the issue.
Feel free to contact me with any questions or concerns. The applicant may want to schedule a form inspection with me
prior to pouring the concrete driveway for review of potential grading issues.
Jesse Struve, PE
Director of Public Works/City Engineer
City of Orono
(952) 249-4661 - Direct
(952) 249-4616- Fax
www.ci.orono.mn.us
In conjunction with a driveway replacement permit, it also requires a minor land alteration permit and therefore
requires a $2,000 escrow. Attached is a copy of the application for your reference. Please have your mother
sign the attached escrow. When you come to pick up the permit, bring the signed escrow agreement along
with a check. The application fee is $50 and both the escrow and application fee can be paid with one check.
Once the project is complete and it has passed the inspections you can request a refund of the money in
escrow.
If you have any questions, please don't hesitate to contact me.
Christine Mattson
Planning Assistant
City of Orono
2750 Kelly Parkway Orono MN 55356 (physical addressJ
PO Box 66 Crystal Bay MN 55323-0066 (mailing addressJ
'�i 952.249.4620 8 952.249.4616
1
� cmatt�on@ci.orono.mn.us � www.ci.orono.mn.us
Office Hours: Monday- Friday 8 am to 4:30 pm
Summer Office Hours begin Monday, May 21,2012
Monday-Thursday: 7:30 am to 5 pm/ Friday 7:30 am to 11:30 am
OUR OFFICE WILL BE CLOSED: Monday, May 28,2012 (Memorial DayJ
2
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Christine Mattson
From: Lyle Oman
Sent: Wednesday, May 16, 2012 9:38 AM
To: Christine Mattson
Subject: FW: 3409 East Lake Street- New Driveway
From: rebecca holzem [rlholzem@yahoo.com]
Sent: Wednesday, May 16, 2012 7:35 AM
To: Lyle Oman; Melanie Curtis
Cc: Jessica Loftus
Subject: 3409 East Lake Street - New Driveway
Good morning Lyle and Melanie.
I would like to bring to your attention that the residents at 3409 East Lake Street are installing a new cement
driveway today.
My question are: Did they obtain a permit? And... Are driveways supposed to be installed so that the top
meets grade or is the entire driveway to be installed/poured above grade as they are doing? Also, is the
driveway to be poured directly on the lot line? (Should you look at a pile of dirt that they scraped off where the
driveway is being installed --the pile of dirt has been dumped in their back yard --, you will see grass that was
at one time located on the east edge of there driveway, providing a 2'foot boarder of grass on their yard along
the property line. With the widening of the actual driveway, are they not creating even more hardcover on this
property?)
Also...
Melanie:
During our meeting on July 7, 2011 you informed me that you told the residents at this address that they could
not install a wall, etc. in their back yard as they requested in a meeting that you had with them. If you or Lyle
inspect their back yard when you are inspecting their new driveway, you will see that they installed a 4' to 5'
long by approximatly 3' to 4' high wall along our propertly line surrounded by a shorter perimeter wall along the
entire area formerly known as their garage - surrounding the broken up concrete that you allowed them to retain
when the walls and roof of the garage was torn down last year.
I am requesting that you inspect the wark that is taking place at this address. Also, I would like to know if you
have addressed the issue of the unsitely blue tarp that is covering something in they front yard. Ths eyesore has
been sitting there for months. Is there something that can be done -- can this be removed?
Thank you.
Rebecca L. Holzem
3407 East Lake Street
Orono, MN 55356
Phone: 612.801.1140
i
,
. •
• . • .
� •
emo
To: Finance Department
From: Christine Mattson, Planning Assistant
CC: Street File
Date: 6/6/2012
G/L: 101-22205
Re: Building Permit Escrow Refund
Building Permit#2012-00365 pertaining to 3409 Eastlake Street is complete. The Applicant,
Elena Ovsyann�kova, has requested a refund of her$2,000 escrow.
The following is attached:
• Copy of escrow refund request
• All engineering review and inspections performed by Jesse Struve
• Original signed escrow agreement
• Copy of cash register receipt showing escrow amount received
Mail to: Elena Ovsyannikova
3409 Eastlake Street
Long Lake, MN 55356
w:�street files\eastlake street\3409\escrow refund memo 2012-00400.doc
Christine Mattson
From: Anna O [anikova1@gmail.com]
Sent: Thursday, May 31, 2012 9:16 AM
To: Christine Mattson
Subject: RE: ESCROW, FLAT ROOF CARPET and RAILING RE: 3409 East Lake St/Zoning Permit
Application#2012-00365
Hello Christine,
We have completed our project and inspector signed off everything yesterday. Please advise when the refund for the
escrow will be issued as we have to pay off the loan asap.
Please let me know if you have any questions.
Thank you!
Anna
From: Christine Mattson [mailto:CMattson@ci.orono.mn.us]
Sent: Friday, May li, 2012 3:39 PM
To: 'Anna 0'
Subject: RE; ESCROW, FLAT ROOF CARPET and RAILING RE: 3409 East Lake St/ Zoning Permit Application #2012-
00365
Anna,
I believe you are referring to the escrow agreement, which is attached. You can come up anytime between
8:00 am and 4:30 pm Monday-Thursday to give us the escrow & check, pay the permit fee and leave with all
the paperwork necessary to start the project.
Have a great weekend.
Christine�
From: Anna 0 [mailto:anikovalCc�clmail.com]
Sent: Friday, May 11, 2012 3:32 PM
To: Christine Mattson
Subject: RE: ESCROW, FLAT ROOF CARPET and RAILING RE: 3409 East Lake St/ Zoning Permit Application #2012-
00365
Hello Christine,
I just got off the phone with MCWD. I spoke with Kathrine Bac (not sure of spelling).
18202 Minnetonka Boulevard Wayzata, MN 55391
(952) 471-0590
She said that we do not need a permit since the driveway is less than 5,000 sq ft and there are no erosion
issues.
However, placing the stones in the creek requires a permit and escrow. She suggested us to plant some native
shrubs and flowers to keep the soil in place. Then we don't need a permit.
So, what time can my mom come on Monday with a check for escrow?
Can you send me the permit form pls? So I can help her fill it out right away, and my mom will bring it too.
i
ZONING PERMlT ESCROW AGREEMENT
Permit#2012-00365
AGREEMENT made this � �T day of m��-� 20�Z by and between the CITY OF ORONO,
a Minnesota municipal corporation ("City")and Elena Ovsy'2fnnikova ("Owners").
Recitals
1. A zoning permit application has been�led for in-kind replacement of gravel driveway to cement at
the property located at 3409 Eastlake Street the ("Subject Property°), legally described as the West 6.00 feet of
Lot 1, and the East 50.00 feet of Lot 2, Block 8, Bayside Addition to Lake Minnetonka, Hennepin County
Minnesota.
2. Owner requests the City to review this application.
3. The City will commence its review of the application and incur costs associated with said review
only if the Owner establishes an escrow to ensure reimbursement to the City of its costs.
NOW THEREFORE,THE PARTIES AGREE AS FOLLOWS:
1. DEPOSIT OF ESCROW FUNDS. Contemporaneously with the execution of this Escrow
Agreement, the Owners shall deposit$2,000 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 incu►red (including planning, engineering or legal consuftant review) or will
incur in reviewing the plan. Eligible expenses shall be consistent with expenses the Owners would be responsible
for under a zoning permit application. The escrow will also guarantee reimbursement to the City for all out-ofi-
pocket costs the City has incurred to assure that the work is completed in accordance with the 5tormwater
Pollution Prevention P1an and the provisions of Orono City Code Chapter 79. The financial security may also be
used by the City to eliminate any hazardous conditions associated with the work and to repair any damage to
public property or infrestructure that is caused by the work (including planning, engineering, or tegal consultant
review)associated with permit#2012-00365 if compliance with the approved zoning perm'st is not accomplished.
3. MONTHLY BIL�ING. 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 ACCOUIVT. In the event that the Owners do not make payment
to the City within the timeframe outlined in#3 above, shall issue a Stop Work Order until the Owners pay all expenses
invoiced pursuant to #3. The City may draw from the escrow account without further approval of the Owners to
reimburse the City for eligible expenses the City has incurred.
5. CLOSING ESCROW. The Balance on deposit in the escrow, if any, shall be returned to the
Owners when the review has been completed and written notifi�ation is received from the Owners requesting the
funds.
6. CERTIFY UNPAID CHARGES. If the project is abandoned by Owners, or if the eligible expenses
incurred by the City exceed the amount in escrow, the City shall have the right to certify the unpaid balance to the
subje rop y pursuant to Minn. Stat. §§415.01 and 366.012.
CITY: CI ONO OWMER:
BY: � i - E1E�l�1 �� � �.�c�. v� h � +r��'A
�
Its:
Internal Use Only: p Original to Planning Department q Copy to Street File
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