HomeMy WebLinkAbout2014-00856 - shed ' CITYOFORONO * 2014 — PJPJ856 *
, _ 2750 KELLEY PARKWAY pATE �SSUE�: 08/14/2014
ORONO, MN 55356-
(952) 249-4600 FAX: (952) 2�19-4616
ADDRESS : 75 FERNDALE RD N
PIN : 36-118-23-44-0006
LEGAL DESC : ALLO-RAE TERRACE
: LOT 002 BLOCK 001
PERMIT TYPE : ACCESSORY STRUCTURE
VROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : SHED> 120 SQ FT
r��.� ��,�-��� �-�-�� —�.< �_ ��:
VALUATION : $ 5,500.00
N01�1�:: SHI:D- 12 X 12
APPLICANT PERMIT FEE SC}�EDULE 132.75
STATE SURCHARGE(VALUATION) 2.75
KNABENSHUE, PAUL& ALYC[A
TOTAL 135.50
75 FERNDALE RD. N
WAYZATA, MN 55391- Payment(s)
Cl2EDIT'CARD 9594 135.50
OWNER
KNABENSHUE, PAUL&ALYCIA
75 FERNDALE RD. N
WAYZATA, MN 55391-
AGREEMENT AND SWORN STATEMENT
Che work for which this permit is issued shall be perlormed accordins to
the approved plans and specifications,applicable City approvals,and the
State E3uilding Code. "I-his permit is for only the work describcd 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 I 80 days of the date of issuance,or if construction is
suspended for a period of 180 days at any time after work has commenced.
I�he applicant is responsible for assuring all required inspections are
requested in conf�ormance with the State[3uilding Code.This permit may be
revoked at an �time for due cause.
�-�- v � / �"�� , �
Applican Permitee Signature Date Issued By , nature Datc
1
,
� CITY OF ORONO
�
BUILDING PERMIT APPLICATION
� FOR NEW STRUCTURES OR ADDITIONS
/ � Mailing Address: ,�;/c./--�:G h���(F,
1 �D�I� PO Box 66 Permit number: ' I
%� Crystal Bay, MN 55323-0066 Date received:
� �� StreetAddress:' Received b :
`�`� � ��f' 2750 Kelley Parkway �� � J Plan review fee: � .. '� !.<-' �i� 5�1 f�
F� Orono, MN 55356 �G gf ,l
'k�sHo�� �'g`" � q
___ Total Fee: �� �1
Main: 952-249-4600 Fax: 952-249-4616
This application form must be completed in full and all required information must be submitted.
Incomplete applications will be returned. (Please print)
GENERAL INFORMATION:
Job Site Address: � � �L� �^c���� ` ;� �� .: � /v� � ✓c'Y�c� '�'�J % % j � �
Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes 0 No
If yes,a specia/event permit is required with Police Department and City Council approva/60 days pnor to the event. Shuttle bus service will be
required unless applicant demonstrates su�cient on-site parking is available. Non-permitted events will not be allowed.
CONTRACTOR/APPLICANT INFORMATION:
Name: �e��y� �L/l/fl/'��^�SN��'
State License# Expiration Date:
Phone: (ce11) (� �Z - 2`�� — y 1 S (office)
Mailing Address: Ci : ZIP:
Contact Person: Applicant is: Contractor / eowne �c�«ie o�e�
Email and/or Fax:
PROPERTY OWNER INFORMATION:
Name: �/-i�?l� 1�' �A��/Il5 d+11 E
Phone(day): j; � � - ��J -��
Address: �].� ��✓ri d h� � (Z� /�J. . �«na CitY� �� d✓�o ZIP: �j 3 ��
Email and/or Fax f�,�1 i>L<�j�/���4 r3��15 ft UE- E_ �v�t��r4�3� , �or°vr
n �,�,.>.-.�...�
ARCHITECT/ENGINEER INFORMATION:
Name:
Phone(day):
Address: City: ZIP:
Email and/or Fax:
PROJECT INFORMATION: Description of ro�ect:
1.Type of Project 2.Proposed Use 3.Structure Type 4.Sewage Disposal 8�
Water Supply
❑New Construction ❑Single Family with ❑ Residence
❑Addition attached garage ❑Garage/Accessory Bldg. � Public Sewer
�Accessory Building ❑ Single Family with ❑ Deck
'Relocation detached garage ❑Office/Commercial ❑ Private Sewer
❑Other: (specify) ❑ Multiple Family/Condo ❑Warehouse
❑Public Storage � Public Water
'"`Any earth movement may also require ❑Commercial Other(specify)
MCWD review 8�permits. ❑ Industrial ❑ Private Well
Minnehaha Creek Watershed District(MCWD) �Other: (speCi
18202 Minnetonka Blvd �;���� Q,
Deephaven,MN 55391
Phone: 952-471-0590
Fau: 952-471-0682
Estimated Construction Valuation (excluding land) $ �15 ���
. �1,,�c�;� . 5`1 •� C� s w e`/ �M�ti t� �'L �d✓5`. 5�'►c c� �c.�� (��
� � �`k'1-� L� �U
. �� r 1/1�1,��¢ G �/� �o l/ 5 c?
�' STRUCTURE INFORMATION: � ',�1. I � ��v�v� c� c d re�t�L � ,� � � �
('" c � d vV{�'1 -
1.Structure Dimensions 1.Structure Dimensions(continued) 2.Type of Construction
a. Length (ft.)= _� Number of bedrooms=
❑Wood/Frame
b.Width(ft.)= ��� Number of garage stalls: ❑ Masonry
Areas in sauare feet Attached= ❑ Metal _ 5 �.,,��N�c C ( �'2 -�j0�
❑ Pole Bidg. j��-�
c. Basement= Detached= ❑ ICF f�
d. 1�Story = ,�On-site Prefab �` �""', R 5 s�m���
e.2"d Story= -�Off-site Prefab �h � t�
f. '/z Story = ( ��� �Ja hn�l.�� �
' ❑Other(please specify): � �
g.Total Area= ��
�
C er'�l/Q' « r���
REQUIRED SUBMITTALS:
All of the information must be submitted in order for your application to be processed:
Not
Enclosed A licable
❑ Permit A lication
❑ Pro sed Buildin Plans
� � MN State Ener Code Calculations and Mechanical Code Re uirements Form
❑ Surve meetin all re uirements
❑ Stormwater Pollution Prevention Plan
� � Hardcover Calculation s
❑ Cd Se tic S stem Site Evaluation Re ort
❑ Cd Access Permit
❑ �1 Wetland Buffer Im rovement Plan
� 0 En ineered Plans for Retainin Walls 4 feet or above
� � Minnehaha Creek Watershed District Permit s
� ❑ Plan Review Fee
� ❑ Application Escrow&Agreement
❑ ❑ Other:
APPLICANT/OWNER ACKNOWLEDGEMENT:
• Agrees to provide all information required or requested by the Building Department;
• Agrees to pay the City of Orono for engineering consultant review costs in excess of$500;
• Certifies that the information supplied is true and correct to the best of his/her knowledge. The applicant recognizes that they
are solely responsible for submitting a complete application being aware that upon failure to do so, the staff has no alternative
but to reject it until it is complete;
• Acknowledges the Escrow Agreement is completed and signed;
• 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 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.
• Agrees that in the event that weather or other condifions 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$10,000
escrow to ensure completion of the as-built survey and all site improvements.
� �,� / �I
ApplicanYs Signature: � � �%!� Date: � ��/ �v�
� /
Owner's Signature: �'� �� ---�— Date: �i' g ��� ( �G'/ `�
—�
' PLAN RE\/IEW CHECKLIST FOI� ��1rV STR CTUf�ES / AQaI�ION�
Address/Permit Number: ll�..�
�,;
� � �- L =
Description of work: S
�;
Septic r�view by: �����; Date �pproved:
Zoning review by: Date Approved:
�
Building review by: � �'`�-�—� Date Approved: � `8�- ���
� Grading review by: `�� Date Approved:
�:.
�orrinc� District: ` � Zoning File#: Reso#: Re�o �ate:
; Zaning: Lot�4rea: SF/AC Width: Lot Coverage: SF %
� —
Sunrey Submitted: �es 0 No Date of Survey: Revised date(?):
�i: Pro osed Setbacks:
�: Front(�L ce)��` Rear(�) ( N S E� 1llf� ( �G S E �) Qther Buildin s� We�land
(� Side Side �. -��
�2 ' �' I OL-' 14-' -� ��
Defined Height: Reak Height: FFE: FFE minus 6 feet= (Existing Contour)
�;� Perimeter(linear feet) = 50% _ #of Sfiories Ok? 0 YES
�
- FOR A BUILDING 1MITH A BASEMENT OR CRAWL SPACE:
The distance between the lowest FOR A BUILDING ON A SLQB FOUPIDATION:
START WITH proposed floor(of the basement or crawl
space)and the highest point of the roof. START WITH The distance between the top of slab and
If you have a...
the highest point of the roof.
If you have a...
• GABLE OR HIPPED ROOF(no . GABLE OR HIPPED ROOF(no
' windows): Subtract half the windows): Subtrect half the distance
�,; distance between the highest point between the hi point of the roof
of the roof to the low point of the to the lo int of the corresponding
SUBTRACTION corresponding gable or hi r of SUBTRACTION g or hipped roof
(BASED ON ROOF . GABLE OR HIPP OOF(with (BASED ON . /GABLE OR HIPPED ROOF(with
? TYPE) windows): tract half the ROOF TYPE) windows): Subtract half the distance
distan etween the top of the between the top of the highest
hi st window and the highest window and the highest point of the
oint of the roof roof
ALL OTHER ROOF TYPES(flat, • ALL OTHER ROOF TYPES(flat,
� mansard,etc):No subtraction. mansard,etc:Mo subtraction.
Subtract the distance between the ADDITION Add the distance between the top of slab
SUBTRACTI �� (BASED ON and the highest existing grade adjacent to
(BASED EXISTING basemenVcrawl space floor and the EXISTING the foundation.
�� � highest existing grade adjacent to the GRADES
foundation OR 10 feet(whichever is less). EQURLS Defined building height
EQUALS Qefined building height
�
u>>
Shoreland Distri I�C1ND Fermit I�eceiveci l�vera e Lakeshor� Setback Met? BiufF '
0 Yes � No � N/A � Yes No ,
� � Yes No 0 Yes 0 No A
Permit Number: � Setback:
Stormwater Quality Existing Prop�sec! �ariance I�equired CUP Required
O�verla District Tier Hardcover Fiarcfcover
� Yes No Q Yes No
� � Type(s): Type(s):
Updated: January 2013
v:lforms\plan review checklist 2013.docx
i, s a ��� �.�'� �9:t t � f��'" q .. a _ -,�r' ,,,!'� �•��d"n�" t:'�S' rh�way.�� a ='�',k.u� �'�-'•• �.;w �'� r ua ; �y ��a'Na
« F' ,�'e�"�r r a� �� i �%w
��� �",2t;�������'' '������ p�.�"t������ � �, �
��'' 3 ., .. .- . . _ ..
�`:
REMARKS (in-house):
�'
� Fees to be Char ed YES NO
�
e P@('111i� 6�'"r,
� Plan Review � '
State Surch�rge �-'
Investig�tion Fee
�; S�IC—Number of SAC Units
Other(specify}
S uare Foota e $ er S uare Foota e
Basement X - $
� 15i Floor � _ $
2nd Floo� X - $
Garage X - $
Estimated Gonstruction Va{ue: $ • � ��� �
� Orono Inspections Required Work Requiring Separate Permits Required State Permits
a Site 0 Plumbing 0 Grading / Filling � Well
� 0 Hardcover Removal a Mechanical � Fire 0 Electrical
� � Footing � Septic 0 Water Connection
� 0 Poured Wall � Fireplace 0 Sewer Connection
0 Foundation Survey � Masonry 0 Lawn lrrigation
0 Radon Rock Bed � Mfg.
0 Framing 0 Other(specify)
� � Insulation
�: � As-Built Survey �
inal
0 Wetland Buffer
Q Other(specify)
�
�—�_
,
r
{;;:
�
REMARKS (in-house):
�.
�
�'
�
� �
� Other Review: Reviewed by: �ate Approved:
�:
�, Access: Existing: � YES � NO New: � YES 0 NO
�
�;
� OFFICIAL REMARK3 -TO BE NOTED ON PERMIT AND tNtTIAl.LE�
�
i
�
F Updated: January 2013
v:\forms�plan review checklist 2013.docx
' Christine Mattson
From: Christine Mattson
Sent: Tuesday, August 12, 2014 3:03 PM
To: 'Paul Knabenshue'
Subject: RE: 75 Ferndale Road N /#2014-00856
Pa u I,
Your permit is ready. Please bring in the signed escrow agreement and check for$700 when you come in. We are open
7:30 am to 5 pm Monday through Thursday and 7:30 to 11:30 am on Friday.
Please don't hesitate to contact me with any questions.
Christine�
From: Paul Knabenshue [mailto:paul knabenshue@hotmail.com]
Sent: Tuesday, August 12, 2014 11:48 AM
To: Christine Mattson
Subject: Re: 75 Ferndale Road N / #2014-00856
Thanks Christine!
Sent from my Verizon Wireless 4G LTE DROID
Christine Mattson <CMattson(a�ci.oronamn.us> wrote:
Good Morning Paul,
I have passed your permit application along to the building official. He will contact you if he has any questions. We will
call you when the permit is ready to be picked up. Also, attached is the escrow agreement we talked about. When you
come in, please bring the signed escrow agreement with you along with a check for$700.
If you have any questions, please don't hesitate to contact us.
Christine Mattson
Planning Assistant
City of Orono
2750 Kelley Parkway Orono MN 55356 (physical addressJ
PO Box 66 Crystal Bay MN 55323-0066 (mailing address)
`la' 952.249.4620 �3 952.249.4616
� cmattson@ci.orono.mn.us � www.ci.orono.mn.us
Summer Office Hours: (Monday, May 19 through Friday,August 29,2014)
Monday-Thursday: 7:30 am to 5 pm
Friday: 7:30 am to 11:30 am
OUR OFFICE WILL BE CLOSED: Monday,September 1, 2014
1
Christine Mattson
From: Christine Mattson
Sent: Tuesday, August 12, 2014 9:40 AM
To: 'paul_knabenshue@hotmail.com'
Cc: Lyle Oman
Subject: 75 Ferndale Road N /#2014-00856
Attachments: Escrow Agreement- Building Permit w Erosion Control 2014-00856.pdf
Good Morning Paul,
I have passed your permit application along to the building official. He will contact you if he has any questions. We will
call you when the permit is ready to be picked up. Also, attached is the escrow agreement we talked about. When you
come in, please bring the signed escrow agreement with you along with a check for$700.
If you have any questions, please don't hesitate to contact us.
Christine Mattson
Planning Assistant
City of Orono
2750 Kelley Parkway Orono MN 55356 (physical addressJ
PO Box 66 Crystal Bay MN 55323-0066 (mailing addressJ
`ld' 952.249.4620 � 952.249.4616
� cmattson@ci.orono.mn.us �!" www.ci.orono.mn.us
Summer Office Hours: (Monday, May 19 through Friday,August 29,2014)
Monday-Thursday: 7:30 am to 5 pm
Friday: 7:30 am to 11:30 am
OUR OFFICE WILL BE CLOSED: Monday, September 1, 2014
1
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Parcel 36-118-23-44-0006 A-T-B: Torrens Map Scale: 1"= 100 ft. N
ID: Print Date: 7/9/2014 �
Owner P Knabenshue/A Knabenshue Market $244,000
Name: TotaL• � I�� _ ( Q(��
1�
Parcel 75 Ferndale Rd N Tax $3,084.18 `/ ;
Address: Orono, MN 55391 TotaL• (Payable: 2014) ` IO1�Il-�� (LY�L"
Property Residential Sale $304,000
Type: P1'iC@: This map is a compilation of data from various
sources and is fumished"AS IS"with no
HOm2- Sal@ representation or warranty expressed or
Non-Homestead 03/2014 implied,including fitness of any particular
stead: Date:
purpose,merchantability,or the accuracy and
completeness of the information shown.
Parcel 0.56 8Cf2S Sale WaffBflty D22d COPYRIGHT OO HENNEPIN COUNTY 2014
Area: 24,271 sq ft Code:
� Think�reen:
http://gis.co.hennepin.mn.us/Property/print/default.aspx?C=458788.63878759415,4980840.... 7/9/2014
Christine Mattson
From: Paul Knabenshue [paul_knabenshue@hotmail.com]
Sent: Wednesday, July 09, 2014 9:37 AM
To: Christine Mattson
Subject: Survey
Hi Christine,
I talked to Myles regarding pulling a permit for a shed construction project. He said I needed a survey
completed. I talked to a survey company and after they looked at the Orono web site they said they needed
to understand what kind of survey is needded. I am assuming it needs to be just to establish property lines? If
you can provide further clarification on the type of survey- much appreciated. And - if you have the name of
a survey company you recommend -that would be useful.
Thanks and Regards,
Paul Knabenshue
75 Ferndale Rd North
Orono
612-281-9958
1
. •
. . • .
1 •
emo
To: Finance Department
From: Christine Mattson, Planning Assistant
CC: Street File � \ ��l`
Date: November 24, 2014
G/L: 101-22205
Re: Escrow Refund
Building Permit #2014-00856 pertaining to 75 Ferndale Road N is complete. Please refund
�700 to the applicant, Paul Knabenshuer.
The following is attached:
• Original signed escrow agreement
• Copy of cash register receipt showing escrow amount received
Mail to: Paul Knabenshue
75 Ferndale Road N
Wayzata, MN 55391
w:lstreet files\femdale road n\75\escrow refund 2014-00856.docx
• � BUILDING PERMIT ESCROW AGREEMENT
Orono Building Permit#2014-00856
AGREEMENT made this � 't' day of , 20_, by and between the CITY OF ORONO,
a Minnesota municipal corporation ("City") Paul Knabe hue ("Owners").
Recitals
1. A building permit application has been filed for a 12' x 12' accessory structure located at
75 Ferndale Road N the ("Subject Property"), legally described as Lot 2, Block 1, Alio-Rae Terrace, Hennepin
County, Minnesota.
2. Owners request the City to review this appiication.
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 $700 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, in excess of $500, or legal
consultant review) or will incur in reviewing the plan. Eligible expenses shall be consistent with expenses the
Owners would be responsible for under a building permit application. The escrow will also guarantee
reimbursement to the City for all out-of-pocket costs the City has incurred to assure that the work is completed in
accordance with the Stormwater Pollution Prevention Plan and the provisions of Orono City Code Chapter 79.
The financial security may also be used by the City to eliminate any hazardous conditions associated with the
work and to repair any damage to public property or infrastructure that is caused by the work (including planning,
engineering, or legal consultant review) associated with building permit #2014-00856 if compliance with the
approved building permit is not accomplished.
3. MONTHLY BILLING. As the City receives consultant bills for incurred costs, the City will in turn
send a bill to the Owners. Owners shall be responsible for payment to the City within 30 days of the Owners'
receipt of bill.
4. DISBURSEMENT FROM ESCROW ACCOUNT. In the event that the Owners do not make payment
to the City within the timeframe outlined in #3 above, shall issue a Stop Work Order until the Owners pay all expenses
invoiced pursuant to #3. The City may draw from the escrow account without further approval of the Owners to
reimburse the City for eligible expenses the City has incurred.
5. CLOSING ESCROW. The Balance on deposit in the escrow, if any, shall be returned to the
Owners when 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 shalf 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 OWNER:
BY� ' �—°'
Its: ��+s o�n►v��<<c�o.�
i Infernal Use Only: �Original fio Pianning 0 Gopy to Property Owner Q Copy to Street File
City oT Orono
275U Kelley Parkway
Orono MN 5535E 952-249-46UG
Receipt No: 3.011565 Aug 14, 2U14
Paul Knabenshue
Previous Balance: .00
Permits
2014-00832 75 Ferndale Rd 700.00
N
101-22205
Deferred Rev-Developer Deposit
--------------
Tatal: 700.00
______�=_______
Check
Check No: 4206 700.00
Payor:
Faul Knabenshue
Total Applied: 700.00
---------------
Change Tendered: .00
---------------
----------
08/14/2014 11:54AM
� ' CITY OF ORONO * z 0 1 4 - 0 0 8 g z *
2750 KELLEY PARKWAY �ATE 1SSUED: 08/14/2014
ORONO, MN 55356-
(952) 249-4600 FA�i: (9�2) 249-4616
ADDRESS : 75 FERNDALE RD N
PIN : 36-118-23-44-0006
LEGAL DESC : ALLO-RAE TERRACE
: LOT 002 BLOCK 001
PERMIT TYPE : ESCROW FEE-TIED TO BUILDING PERMIT
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ESCROW FEE-TIED TO BUILDING PERMIT
NUTE: TIED"TO BUILDING PERMIT 2014-00856
APPLICANT ESCROW FEE-BUILDING 700.00
TOTAL 700.00
KNABENSHUE, PAUL&ALYCIA Payment(s)
75 FERNDALE RD.N CHECK 4206 700.00
WAYZATA, MN 55391-
OWNER
KNABENS�-IUE, PAUL&ALYCIA
7�FERNDALE RD.N
WAYZATA, MN 55391-
AGREEMENT AND SWORN STATEMENT
The work for wl�ich this permit is issued shall bc performed according to
[he 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 separatc
permits. All provisions of laws and ordinances goveming this type oS 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 18G 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 assurina alf required inspections are
requested in conformance with the State Building Code.This permit may bc
revoked at any timc for due cause.
�� � ��-^�' O �( �`f�I l - � �
Applicant Permitce Signature Date lssued Bv � ature Date �
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Pertnft Address: 7�Femdal�Rd N � .- - � . I
` Parcellssue
i Pertnit Issue
Generei�Fees Irwpections(1}�µ��j poaiicent netail 1 co oetnii�
Seq Inspedion Type Inspedor Date Status H Fee Rec
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Christine Mattson
From: Paul Knabenshue [paul_knabenshue@hotmail.com]
Sent: Wednesday, November 12, 2014 11:02 AM
To: Christine Mattson
Subject: escrow funds release
Hi1en,
I live at 75 Ferndale Rd North.
I had to put funds in escrow when I applied for a permit to have a shed built. The project is complete, and the
permit has been signed off by the inspector. Can I get the escrow funds returned?
Permit number: 2014-0856
Thanks,
Paul Knabenshue
612-281-9958
1
� V
L TIME
CITY O ORONO CALLED IN �
INSPECTION NOTIC,El SCHEDULED _���
PERMIT NO. ���`� _� �S�COMPLETED
ADDRESS
OWNER TELEPHON NO. ^ ""�
CONTRACTOR
�; DESCRIPTION _T�__\1(tq,�,r�h,.Q,�
�
ly ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING
� ❑ POURED WALL ❑ MECHANICAL RI � IAKESHORFJWETLANDS
ti
Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL
Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION
Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS
� �INAL ❑ SEWER HOOK-UP ❑ COMPLAINT
� ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP
_ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL
� ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
� CGMMENTS:
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GW ❑WORKSATISFACTORY:PROCEED �''ROJECTCOMPLEfE
� ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
W
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. U PHOTO TAKEN
INSPECTOR WILL REfURN
❑CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Cail for the next inspection 24 hours in advance. (952� 249-46�0
OwnerfContractor on site:
Inspector.���
White Copyflnspector's File Canary CopylSite Notice