HomeMy WebLinkAbout2009-00496 - add final �� �`— ' �j'�ATE TIME ✓
CITY OF ORONO`������ C%ALLED IN /„ � ��
INSPECTION �NOjT�IC�yE, �c �SCHEDULED 7yLc��� •y
PERMIT NO._�" 'LZL�=7�-�J"'COMPLETED
ADDRESS 9� , �GL�Lil/
OWNER TELEPHONE NO �71���Yn
CONTRACTOR
>; DESCRIPTION ���%'���0� _��`��"''�
�
� ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING
Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS
y ❑ FRAMING ❑ MECHANICAL FINAL
O ❑ TREE REMOVAL
Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION
Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS
� ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT
J ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP
_ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL
❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL
� WNE NTRACTOR TO MEET YOU:�YES_NO
� COMMENTS:
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� ❑CORRECT WORK 8 PROCEED C' ISSUE CERTIFICATE OF OCCUPANCY
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O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE COVERING PERMANENT
❑CORRECTUNSAFECONOITIONWITHIN HOURS. � pHOTOTAKEN
INSPECTOR W4LL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR � CITATION ISSUED
❑ INSPECTION REQUtRED.CALLTO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. �952� 249-46��
Owner/Contractor on site:
Inspector. W � � �
White Copylinspector's File Canary CopylSite Notice
CITY OF ORONO PERMIT NO.: 2009-00496
2750 KELLEY PARKWAY
� ; ORONO, MN 55356- �ATE �SSUED: 08/25/2009
952 249-4600 FAX: 952 249-4616
ADDRESS : 980 FERNDALE RD W
PIN : 02-117-23-44-0019
LEGAL DESC : COUNTRY CLUB ESTATES
: LOT 000 BLOCK 000
PERMIT TYPE : ADDITION/REMODEL/REPAIR
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR
ACTIVITY : 434-RESIDENTIAL
VALUATION : $ 60,000.00
NOTE: SGPERATG PERMITS REQUIRED: PLUMBING,MGCHANICAL,FIREPLACE,ELECTRICAL(STATF;)
ADVANCED PLAN REVIEW COLLECTED ON PERMIT 2009-00495 S/17/09$491.89
APPLICANT PERMIT FEE SCHEDULE 756.75
SAFAR,JACK
980 FERNDALE RD W PLAN REV[EW 0.00
WAYZATA, MN 55391- STATE SURCHARGE(VALUATION) 30.00
TOTAL 786.75
OWNER
SAFAR,JACK& PAMELA
980 FERNDALE RD W
WAYZATA, MN 55391-
AGREEMENT AIVD 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 Buiiding Code. This permit is for only[he work described and does
no[grant permission for additional or related work which requires separate
permits. All provisions of laws and ordinances governing this[ype of work
shall be compied with whether or not specified herein.This permit will
expire and become null and void if construction authorized is no[
commenced within 180 days of the date of issuance,or if construction is
suspended for a period of 180 ays at any time after work has commenced.
The applicant is responsibl .or assuring all required inspections are
requested in con anc ith the State Building Code.This permit may be
revoked at an im for ue cause. �\
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Applicant P m e ignature � Date ued By Signature Date
SEPARATE PERMITS REQUIRED FOR WO OTHER THAN DESCRIBED ABOVE.
� � City of Orono
Building Permit Application
for New Structures or Additions
Mailing Address: I! Permit number: �9- B D`{9�
�\ PO Box 66
� Crystal Bay, MN 55323-0066 Date received: �-/7-�
%; � �:, ��' �I�YJ
,' �'� !'' . Received by:
,� ��i :� �, Street Address: `�4�, 8 9� �-
�`;'�F, ' �,��;j� �ti�� 2750 Kelley Parkway Plan review fee: �
LyX,EgH04,�" Orono, MN 55356 �i r� �, o?D09-05�9
� t ��Fee: �:
Main: 952-249-4600 Fax: 952-249-4616 www.ci.orono.mn.us ✓ � �"(�- , ��J`�
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: �� �-�i'�i `�/-�� ��� �
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 su�cient on-srte parking is available. Non-permitted events will not be allowed.
CONTRACTOR/APPLICANT INFORMATION:
Name: '!y�c � S.� r�>''�
State License # Expiration Date:
Phone: yS� �/?/ �y 93 (office) �C�5 >�`/ Sl� / (cell)
Mailing Address: �� ��� ,,,o�� � City: _ ZIP_
Contact Person: �J7�/f�",�Fi4iL ;� �v,n,�,;y r�pplicant is: Contractor / Homeo� (Circle One)
Email and/or Fax:
PROPERTY OWNER INFORMATION:
Name: "��� lT S� ,�,�,-rc
Phone (day): �>s�- �/� I �yy 3
Address: �.Fr� �<,�,�p,�v �,L �,�.J City: t�'2 v it,v ZIP: S`�-3�j t
Email and/or Fax �s��l�,/7 i � Y �i S�
ARCHITECT/ ENGINEER INFORMATION:
Name: /7,��c� ��i �
Phone (day): �I S�� �'7�v �222
Add ress: �.2�> f�i�n�-,-a r}✓-� City: �-�✓��1 L .��t,� ZI P: j���'�
Email and/or Fax: �:� ,� ��z �C" C Z�-F
PROJECT INFORMATION:
1.Type of Project 2. Proposed Use 3. Structure Type 4. Sewage Disposal 8�
Water Supply
❑ New Construction •�&i�fe-F�r�i+y with �Residence �
�Addition attached garage ❑ Garage/Accessory Bldg. �Public Sewer I
❑ Accessory Building ❑ Single Family with ❑ Deck
❑ Relocation detached garage ❑ Office/Commercial ❑ Private Sewer '
❑ Other. (specify) ❑ Multiple Family/Condo ❑Warehouse i
❑ Public � ❑ Storage � ❑ Public Water �
"'Any earth movement may require ' ❑ Commercial ❑ Other(specify) �i
� MCWD review 8� permits. ❑ Industrial i ❑ Private Well ;
Minnehaha Creek Watershed District(MCWD) ❑ Other. (speCify) � '� I
� 18202 Minnetonka Blvd ! i I
Deephaven, MN 55391 �
I Phone: 952-471-0590 �
i Fax: 952-471-0682 I !
i www minnehahacreek or I I ''
Estimated Construction Valuation (excluding Iand) $ �Q ,p0� —
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Last Updated: 6/22/2009
- 19 -
STRUCTURE INFORMATION: t
, 1. Structure Dimensions i 1. Structure Dimensions (continued) ! 2. Type of Construction ;
I a. Length (ft.)= >L ! Number of bedrooms= I�' ❑Wood/Frame I
; � �,Masonry i
b.Width (ft.}= � � ; Number of garage stalls: ❑ Metal
j Attached = ❑ Pole Bldg. �
Areas in square feet ' Detached = I ❑ ICF
j ❑ On-site Prefab
c. Basement= � I� ❑ Off-site Prefab
d. 151 Story = I , ❑ Other(please specify):
G'. Z�d.StO � �
rY= I �
f. Yz Story = �
g.Total Area=
I
REQUIRED SUBMITTALS:
All of the information must be submitted in order for your application to be processed:
Not I
Enclosed Ap licable
� I ❑ I Permit A lication
❑ ❑ � Pro osed Buildin Plans
� � I MN State Ener Code Calculations and Mechanical Code Re uirements Form �
❑ I ❑ : Surve meetin all re uirements
❑ ❑ ' Stormwater Pollution Prevention Plan I
I � ❑ , Hardcover Calculation(s ;
❑ � ❑ { Se tic S stem Site Evaluation Re ort ;
❑ � I Access Permit
❑ ❑ i Wetland Buffer Im rovement Plan
❑ ❑ En ineered Plans for Retainin Walls 4 feet or above
❑ ❑ ; Plan Review Fee I
� _ ❑ i � j Other �
APPLICANT 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 ezcess of$500;
• Certifies that the information supplied is true and correct to the best of his/her knowledge. The appficant 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;
• 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. I
If you refuse to supply the information, the application may not be issued. ,
Applicant's Signature: Date: �� �� ��
i
Last Updated: 6/22/2009 �
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�
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�Plan Review Checklist for New Structures / Additions
Address/ PID / LegaL �� C� � �iL�n. c��� l P � � �,,f
Description of work: � /� �,,�' `� � �� y ?
Septic review by: Date Approved:
Zoning review by: �'�-�, '� Date Approved: Z- � '
Building review by: Date Approved: 8•ZY- �l
Grading review by: /� �j� Date Approved:
Zoning File#: lJ I" `TI Resolution #: Resolution Date:
Zonin District j Fire Department � Post Office School District '
� I
Zoning: Lot Are : 1y�7� SF /AC Width: j Depth:
a
Survey Submitted: Yes ❑ No Date of Survey: ��`L �
Pro osed Setbacks: �
� ,
Front (Lake) � Rear(Street) ( N S E W ) ( N S E W ) Other Buildings I Wetland
_ � Side Side ; , �
tuilding �efined Height: Quilding �eak Height:
l �
FOR A BUILDING WITH A BASEMENT OR CRAWL SPACE: FOR A BUILDING ON A SLAB FOUNDATION:
j START i the distance between the basement floor/ ' j START � the distance between the slab and the I
� WITH crawl space floor and the highest roof peak, � WITH i highest roof peak, the top of the cornice j
j the top of the comice of a flat roof, the deck ' � of a flat roof, the deck line of a mansard
; � line of a mansard roof, or the uppermost i i roof, or the uppermost point on a round or I
; ! point on a round or other arch-type roof ; � other arch-t e roof �
� SUBTRACT i half the distance between the highest � i SUBTRACT ' half the distance between the highest I�
window and highest roof peak of a pitched � � I, window and highest roof peak of a �
roof I I � pitched roof �
! SUBTRACT ' the distance between the basement floor/ ADD � the distance between the stab and the i
� � crawl space floor and the highest existing '� I� highest existing grade within the �
� grade within the foundation or 10 feet, I j � foundation
� whichever is less. � � EQUALS ' Defined buildin height ,
� EQUALS Defined building height 'i
Lot Coverage: �D1�L� SF � %
horeland District MCWD Permit Received i ra e Lakeshore Setback ' Blu
Yes ❑ No � � Yes ❑ No ❑ N/A �! Yes ❑ No ❑ N/A � Yes o ,
; Permit Number: I Setback: �
� HardcoverZones j Existin Proposed I Variance Required ; CUP�Re ired I
0-75' I ' l� 3 i Z,��l Yes ❑ No i ❑ Yes � N i
75-250' I I p� pa', , Pe(s)� z.- , YPe�s)�
� 250-500� � i ! C ���G��'��,.����,, , �� ����- �,
500-1000' ' � - �{'j�`Q-,� \,�a' I
REMARKS (in-house):
Updated: 07/01/2009
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Fees to be Charged YES NO
Permit �/ '
�
Plan Review �/
State Surchar e v-
Investigation Fee �/
SAC-Number of SAC Units
Sewer Connection
Water Connection
Park Fee
Site inspection
Other(specify)
Miscellaneous Fees
Calculated By:
UBC: Construction Type:
� Square Footage I j $ per Square Footage '� I
I
Basement ' X = �
I 15 Floor I X i = '� �
' 2" FIOor ' X j - $ !
Gara e I X ! _ ; � �
�_ ! I I
Estimated Construction Value: $ (��r�� °�
Orono Inspections Required Work Requirinq Separate Permits Required State Permits
❑ Site .�Plumbing 0 Grading / Filling ❑ Well
❑ Hardcover Removal ,� Mechanical ❑ Fire -0 Electrical
,0' Footing 0 Septic ❑ Water Connection
❑ Foundation Survey ❑ Fireplace ❑ Sewer Connection
� Framing ❑ Masonry ❑ Lawn Irrigation
,ef Insulation ❑ Mfg.
❑ Wall Board ❑ Other(specify)
❑ As-Built Survey
�Final
❑ Other specif )
REMARKS (in-house):
Other Review: Reviewed by: Date Approved:
Access:Existing: ❑ YES ❑ NO New: ❑ YES ❑ NO
REMARKS (TO BE NOTED ON PERMIT AND INITIALLED BY PERSON PULLING PERMIT)
S � I�- ��,� � S!�D c-r l c�( � l��s i� � l�� �v��.i1v -'�� � ��v: F � .�a �z � , <;.
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Updated: 07/01/2009
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I�. �` T TIME v
CITY OF ORONO �LLED IN v a
INSPECTION NOTICE SCHEDULED �
PERMIT NO. � -d0 COMPLETE
ADDRESS D � � �
OWNER C NTR.
TELEPHONE NO.�� 1 �41 �l�- �7 ���
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�ESCRIPTION � Q�G 1-C�1LO�I
FOOTING ❑ MECHANICAL RI ❑ EXCAV/GRADING/FILLING
Q ❑ FRAMING ❑ MECHANICAL FIN ❑ LAKESHORE/WETLANDS
� ❑ INSULATION ❑ WOOD BURNER/FIREPLACE
❑ TREE REMOVAL
Z ❑ WALL BD. ❑ WATER HOOK-UP ❑ SITE INSPECTION
Q ❑ FINAL ❑ SEWER HOOK-UP ❑ PROGRESS
� ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ COMPLAINT
Q ❑ DEMO-FINAL ❑ SEPTIC INSTALL. ❑ FO�LOW-UP
? ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ HARD COVER REMOVAL
J ❑ PLUMBING FINAL ❑ FOUNDATION/REMOVAL
Z OWNERICONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN
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. �95Z� Z49-460�
OwnerlContractor on site:
Inspector. �_�� l �
White Copyllnspector's File Canary CopylSite Notice
� DAT TIME
CITY OF ORONO CALLED IN ��
INSPECTION NOTICE y��(�/ SCHEDULED D Zl,� �
PERMIT N0.2��J9�(�CJ ! L S� COMPLETED
ADDRESS ��� �erndn.�.�e �C' LC�
OWNER n�a-� ���� CONTR.
TELEPHONE NO. SGO� �Pl o� lolCp ���QS
� DESCRIPTION ������
� ❑ FOOTING ❑ MECHANICAL RI ❑ EXCAV/GRADING/FILLING
Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ LAKESHORE/WETLANDS
� ❑ INSULATION ❑ WOOD BURNER/FIREPLACE
O ❑ TREE REMOVAL
Z ❑ WA�L BD. ❑ WATER HOOK-UP ❑ SITE INSPECTION
Q ❑ FINAL ❑ SEWER HOOK-UP ❑ PROGRESS
� ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ COMPLAINT
� ❑ DEMO-FINAL ❑ SEPTIC INSTALL. ❑ FO�LOW-UP
_ ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ HARD COVER REMOVAL
J ❑ PLUMBING FINAL ❑ FOUNDATION/REMOVAL
� OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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V BEFORECOVERING 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� 249-46QQ
Owner/Contractor on site:
Inspector. � 1 1,
White Copyllnspector's File Canary CopylSite Notice
02004- oo,�q(o
Q�OD�� DO(Q�� �DATF, TIME
CITY OF ORONO CALLED IN ��
INSPECTION NOTI�� SCHEDULED ���D ��
PERMIT NO. COMPLETED
ADDRESS 7�� � � �'
OWNER ���a� TELEPHONE NO. glz f17/ �Y��
CONTRACTOR
�; DESCRIPTION
�Yy� �
�
� ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING
Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS
y ❑ FRAMING ❑ MECHANICAL FINAL
O ❑ TREE REMOVAL
Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION
Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS
� ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT
J ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP
? ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL
J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL
� OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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❑ INSPECTION REQUIRED.CAL�TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (g52) 249-4600
OwnerlContractor on si� '�
Inspector. � —�
White Copyllnspector's File Canary CopylSite Notice
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� • • • •
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To: Finance Department � �
From: Christine Mattson, Planning Assistant (✓�` ' � 1A/�, V
� �i� -
CC: Street File
Date: 11/10/2010
Re: Building Permit Escrow Refund
Building Permit #2009-00496 pertaining to 980 Ferndale Road West is complete. The
Applicant, Jack& Pam Safar, has requested a refund of the escrow.
The following is attached:
• Escrow Refund Request
• Email from Bonestroo indicating no unbilled WIP on this project
• Email from Campbell Knutson indicating no unbilled WIP on this project
• Original signed escrow agreement
• Copy of cash register receipt showing escrow amount received
z:\forms�zoning standard forms\escrow agreement standard forms\escrow refund memo template.doc ��
.
Christine Mattson
From: Planning [Planning@ci.orono.mn.us]
Sent: Tuesday, November 02, 2010 8:37 PM
To: Christine Mattson
Subject: FW: 980 Ferndale Rd W
-------------------------------------------
From: Pam Safar[SMTP:PAMSAFAR(a�GMAIL.COM1
Sent: Tuesday, November 02, 2010 8:36:17 PM
To: Planning
Subject: 980 Ferndale Rd W
Auto forwarded by a Rule
Hello,
We had a final inspection in July (I think) on nn addition we put on our house last year. I need to follow up
to see if our deposit that we put down was refunded to us. Sorry we can't remember but we don't see a
record of having received it. Cnn you check for us?
Pam and Jnck Safar _�����;
980 Ferndnle Rd West �` �
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Building Permit # 2009-00496
Amount Escrowed $2500.00 l ,
_�:1 ��-��d�_ _ _ --- --- - - - -
Do you need nny other information? . ' ` '� � ° ----=. =
_ .�� _ .�-- -—
� .._____ _:�...�___� ��--
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Thnnks for your hetp. ° t� �m�� 1�l�h �-�Cl�!`�----'._._�--�._ _. • --
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___ .
Pam --�---���l..t'�U�,_`�L��� �--�r��.�.� - - --- _..
� (`16 CC�_-- _� _Y���U.�.�-?_� _._ __ _ ___ _-_
Pam Safar � -
pamsafar@�mail.com :,,�:: . ::. ..; 1 � = . ,. .� :::.. .. ::. . , :n. w„,..�
952.471.8468
a,..,� s � �
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Christine Mattson
From: Sherry Charboneau [SCharboneau@ck-law.comJ
Sent: Wednesday, November 10, 2010 2:38 PM
To: Christine Mattson
Subject: RE: WIP
Chris:
We have no unbilled WIP on the matters listed below.
Thanks.
Sherry
Sherry L. Charboneau, Legal Assisranr
CAMPBELL KNUTSON, P.A.
31 7 Eagandale Office Center
1380 Corporate Center Curve
Eagan, MN 55121
Direct Dial: 651-234-6230
Office: 651-452-5000
Fax: 651-452-5550
E-mail: scharboneau@ck-law.com
From: Christine Mattson Imailto:CMattson@ci.orono.mn.us]
Sent: Wednesday, November 10, 2010 2:22 PM
To: Sherry Charboneau; 'Amundsen, Darren T
Subject: WIP
Hello,
Do either of you have any unbilled WIP for the following:
Building Permit 2009-00496 Jack& Pam Safar 980 Ferndale Road W
Building Permit 2010-00079/2010-00523 Barbara Halper 3200 North Shore Drive
Thank you!
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
`� 952.249.4620 6 952.249.4616
� cmattson@ci.orono.mn.us ; www.ci.orono.mn.us
Office Hours: Monday- Friday 8:00 am to 4:30 pm
OUR OFFICE W/LL BE CLOSED:
Thursday, November 11,2010(Veterans Day)
1
Christine Mattson
From: Amundsen, Darren T [Darren.Amundsen@bonestroo.com]
Sent: Wednesday, November 10, 2010 2:44 PM
To: Christine Mattson
Subject: RE: WIP
No WIP from us
Darren Amundsen, PE
Associate
Direct 651-604-4894
Cell 651-775-5623
darren.amundsen@bonestroo.com
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Visit the re�v Bor�zstroo._com to sic,n-up for Sourc?ONE,
our upcominy newsletter.
From: Christine Mattson [mailto:CMattson@ci.orono.mn.usl
Sent: Wednesday, November 10, 2010 2:22 PM
To: 'Sherry Charboneau'; Amundsen, Darren T
Subject: WIP
Hello,
Do either of you have any unbilled WIP for the following:
Building Permit 2009-00496 Jack & Pam Safar 980 Ferndale Road W
Building Permit 2010-00079/2010-00523 Barbara Halper 3200 North Shore Drive
Thank you!
G..h.�i.a-f in,e M,A�{�{-,a�n,
Planning Assistant
City of Orono
2750 Kelly Parkway Orono MN 55356 (physical addressJ
PO Box 66 Crystal Bay MN 55323-0066 (mailing addressJ
`� 952.249.4620 = 952.249.4616
� cmattson@ci.orono.mn.us �� www.ci.orono.mn.us
Office Hours: Monday- Friday 8:00 am to 4:30 pm
OUR OFFICE WILL BE CLOSED:
Thursday, November 11, 2010(Veterans Day)
1
. /
BUILDING PERMIT ESCROW AGREEMENT
Orono Building Permit#2009-00496
AGREEMENT made this ���r� day of ���q�1Sf , 20�9, by and between the CITY OF ORONO,
a Minnesota municipal corporation ("City")and Jack Safar("Owner").
Recitals
1. Building permit applications have been filed for a ���{����'I ���f�� located at 980
Ferndale Road West the ("Subject Property"), also legally described as attached as Exhibit A.
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 Owner 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 the City has incurred (including planning, engineering, in excess of $500, or legal
consuitant review) or will incur in reviewing the plan. Eligible expenses shall be consistent with expenses the
Owner would be responsible for under a building permit application. The escrow wili 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 #2009-00496 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 Owner. Owner shall be responsible for payment to the City within 30 days of the Owner's receipt
of bill.
4. DISBURSEMENT FROM ESCROW ACCOUNT. In the event that the Owner does not make
payment to the City within the timeframe outlined in #3 above, the City may draw from the escrow account without
further approval of the Owner to reimburse the City for Eligible expenses the City has incurred. The City shall
notify the Owner the Owner of such draw and the nature of the expense for which the reimbursement is being
made. If the Escrow amount falls below 75% of the original escrow amount the Owner shall deposit additional
sums as directed by the City, or the City shall discontinue review and post a Stop Work Order.
4. CLOSING ESCROW. The Balance on deposit in the escrow, if any, shall be returned to the
Owner when the review has been completed and written notification is received from the Owner requesting the
funds.
5. CERTIFY UNPAID CHARGES. If the project is abandoned by Owner, 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.
�
CI : CIT F OWNER:
By: By:
Its: � ' ti By:
Escrow Aqreement
Exhibit A
Leqal Description of Premises
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CITY OF ORONO PERMIT NO.: 2009-00517
2750 KELLEY PARKWAY .
ORONO, MN 55356- DATE IssuED: 08/24/2009
952 249-4600 FAX: 952 249-4616
ADDRESS : 980 FERNDALE RD W
PIN : 02-ll 7-23-44-0019
LEGAL DESC : COUNTRY CLUB ESTATES
: LOT 000 BLOCK 000
PERMIT TYPE : ESCROW FEE-TIED TO BUILDING PERMIT
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ESCROW FEE-TIED TO BUILDTNG PERMIT
NOTE: ESCROW FEE FOR ADDITION/REMODEL PERMIT#2009-00496
4
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APPLICANT ESCROW FEE-BUILDING 2,500.00
SAFAR,JACK&PAMELA
980 FERNDALE RD W TOTAL 2,500.00
WAYZATA,MN 55391-
OWNER
SAFAR,JACK&PAMELA
980 FERNDALE RD W
WAYZATA,MN 55391-
AGREEMENT AND SWORN STATEMENT
The work for which this permit is issued shall be performed according to
the approved plans and specifications,applicable Ciry approvals,and the
State Building Code. This permit is for only the work described and does
not grant permission for additional or related work which requires sepazate
permiu. All provisions of laws and ordinances governing this type of work
shal]be compied with whether or not specified herein.This permit wiil
expire and become nul]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 aze
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.