HomeMy WebLinkAbout2016-01183 - boulder retaining wall CITY OF ORONO * z 0 1 6 — 0 1 1 s 3 *
2750 KELLEY PARKWAY DATE ISSUED: 1U10/2016
ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 1225 DICKENSON ST
PIN : 02-117-23-31-0048
LEGAL DESC : MINNETONKA BLUFFS
: LOT 000 BLOCK 016
PERMIT TYPE : ACCESSORY STRUCTURE
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : RETAINING WALL>4 FEET
VALUATION : $ 30,000.00
NOTE: BOULDER RETAINING WALL>4'
NOTE: PR(OR TO RELEASE OF ESCROW MONEY AN AS-BUILT SURVEY MUST I3E SUBMITTF?D AND APPROVED. INITIAL:
APPLICANT PERMIT FEE SCHEDULE 490.12
STATE SURCHARGE(VALUATION) 15.00
BOULDER IMAGES
1225 D[CKENSON TOTAL 505.12
WAYZATA, MN 55391- 1'ayment(s)
(651)322-7499 CHECK 10662 505.l2
OWNER
GIEL, TOM&SARAH
1225 DICKENSON STREET
WAYZATA, MN 55391-
AGREEMENT AND SWORN STATEMENT
The work for tifiich this permit is issued shall be performed according to
the approved plans and specitications,applicable City approvals,and the
State[3uilding Code. This permit is for only the work described and does
not grant pennission for additional or related work which requires separate
pennits. 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 wnstruction authorized is not
commenced within I RO days of the date of issuance,or if construction is
suspendcd 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 Quilding Code.This permit may be
revoked at any time for due cause.
� / � 7i� � �_ /� l /v � /�
'cant rmitee Signawre Date Issued B ignature Date
�—.
CITY OF ORONO �� ����� ���'�
BUILDING PERMIT APPLICA I N ��- �U��y �
--
FOR NEW STRUCTURES OR ADDITIONS
A, Mailing Address: Permit number. ��C�l�G' '�l l0
��j V �� �� PO Box 66
O ( � �( C ry s t a l B a y, M N 5 5 3 2 3-0 0 6 6 Date received: o� �
,� ,, \/�/ StreetAddress:' ��--� 1 Received by: /ri�T"
y�, � 2750 Kelley Park y �pl(� --Cl.�7 lan review fee: � 's� �`
�qK �ti�' Orono, MN 55356� y--�'`Y°� �C�C�,_,- _ __ ,
£5Ho Main: 952-249-4600 � �
Total Fee:
Fax: 952-249-4616 www.ci.orono.mn.us
This application form must be completed in full and all required information must be submi�d. (� 1
Incomplete applications will be returned. (Please print) �bJ�
GENERAL INFORMATION.
.lob Site Address: 1225 C)I�K �1 STREET ORONO MN 55356
Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes ❑ No
If yes,a special event permit is required with Police Department and City Council approval 60 days prior to the event. Shuttle bus service will be
required unless applicant demonstrates sufficient on-site parking is available. Non-permitted events will not be allowed.
CONTRACTOR/APPLICANT INFORMATION:
Name: BOULDER IMAGES INCORPORATED
State License# NA Expiration Date:
Phone: (cell)651-260-2337 (office) 651-322-7499
Mailing Address: 14555 S ROBERT TRAIL SUITE #11 City: ROSEMOUNT ZIP: 55068
Contact Person: TODD MONTREUIL Applicant is: Contractor / Homeowner (CircleOne)
Email and/or Fax: todd@boulderimages.com
PROPERTY OWNER INFORMATION:
Name: TOM GIEL �+- SQrah GI�� ��L ' 1Q'j ' 27� 3
Phone (day): p
Address: 1225 DICKENSON STREET Cit : R� Z,P: 55356
Email and/or Fax ��0�j C Q Q,1�•LPlY1�
ARCHITECT/ENGINEER INFORMATION:
Name:
Phone (day):
Address: City: ZIP:
Email and/or Fax:
PROJECT INFORMATION: Description of pro�ect:
1.Type of Project 2. Proposed Use 3.Structure Type 4.Sewage Disposal &
Water Supply
❑ New Construction ❑ Single Family with ❑Accessory Bldg./Garage
❑Addition attached garage ❑ Deck ❑ Public Sewer
❑Accessory Building ❑ Single Family with ❑ Office/Commercial
❑ Relocation detached garage ❑ Residence ❑ Private Sewer
� Other: (specify) ❑ Multiple Family/Condo ❑ Retaining Wall(s)
Boulder re ain�n� wall ❑ Public 4-feetorgreater ❑ PublicWater
**Any earth movement may als require ❑ Commercial ❑ Storage
MCWD review&permits. ❑ Industrial ❑Warehouse ❑ Private Well
Minnehaha Creek Watershed District(MCWD) ❑ Other: (SpeCify) ❑ Other(Specify)
15320 Minnetonka Blvd
Minnetonka,MN 55345
Phone: 952-471-0590
Fax: 952-471-0682
www.minnehahacreek.or
Estimated Construction Valuation (excluding land) $ 30�000
Last Updated: January 2016
STRUCTURE INFORMATION:
1.Structure Dimensions 1. Structure Dimensions(continued)
a. Length (ft.)= Number of bedrooms= 2. Occupancy:
b.Width (ft.)= Number of garage stalis:
3. Occupant Load:
Areas in square feet Attached =
c. Basement= Detached = 4. Type of Construction:
d. 15t Story =
e. 2"d Story- 5. Code Edition:
f. 'h Story =
g. Total Area=
REQUIRED SUBMITTALS:
All of the information must be submitted in order for your application to be processed:
Not
Enclosed A licable
❑ ❑ Buildin Permit Escrow A reement and Fees
❑ ❑ Plan Review Fee
❑ ❑ Com leted A lication Form
❑ ❑ Pro osed Buildin Plans-2 full size sets,to scale and 1 reduced 11 x 17 or 8'/�x 11 set
❑ ❑ Minnesota State Ener Code Calculations and Mechanical Code Re uirements
❑ ❑ Surve -2 full size,to scale meetin ALL surve requirements
❑ ❑ Hardcover Calculations
❑ ❑ Se tic S stem Certification
❑ ❑ Minnehaha Creek Watershed District(MCWD) Permit or
Documentation from MCWD statin no ermit is re uired
a ❑ Landsca e Walls and/or Retainin Wail Plans
❑ ❑ Stormwater Pollution Prevention Plan SWPPP
❑ ❑ Access Permit
❑ ❑ Data Privacy Advisory Form
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 conditions prevent the completion of an as-built survey at the time the
Certificate of Occupancy is requested, a temporary Certificate of Occupancy may be issued upon receipt of a $10,000
escrow to ensure completion of the as-buiit survey and atl site improvements.
�
Applicant's Signature: � Date: , , ,�, ' 9�Z 1�lG
Owner's Signature: Date:
Last Updated: January 2016
PLAN REVIEW CHECKLIST FOR NEW STRUCTURES / ADDITIONS
Address: 42� ����J�,��1'L �al(� Permit No.: ZIJ��t! �U/� b�''
Description of work: �e�11'1��u(a(� Date Rec'd: '7'�'��Q
Septic review by: ����vv �,I '�- w�C,tJ�-- Date Approved: -'"`�—
Zoning review by: ' Date Approved:_ ��' �• � �
Building review by: y D�te Approved: �r ���
Grading review by: Date Approved: � '�'�
Zoning District: �(� , ,Zoning File#: Reso#: Reso Date:
Zoning: Lot Area: �� S IAC Width: Lot Coverage: SF %
Survey Submitted: �Yes 0 No Date of Survey: ��•Z7• �� Revised date(?):
J \
Landscape plan submit�ed? 0 Yes ��Io Landscaper: �V�� ��
/ `
Proposed Setbacks:
Front (L e) Rear(St t) ( N �S E W ) ( N S E W ) Other Buildings Wetland
'�Ide S�
l �
D fined Height: PeaJs..k�a' ; FFE: ee - o
.
Peri eter(linear feet) = 50 0 - L.F. below grade
Baseme � � Yes � No, Stories
FOR A BUILDING WITH A BASEMENT OR CRAWL SPACE: FOR A BUILDING ON A SLAB FOUNDATION:
The distance between the lowest proposed , Slab at or above grade—
START WITH floor(of the basement or crawl space)and measure from hiahest existinq
the highest point of the roof. START WITH ra ade to the highest point of the
, � . roof even if fill was brought in to
� , elevate home.
If you have a... � * �
SUBTRACTION • GABLE OR PED ROOF(no Slab below grade—measure
(BASED ON windows• ubtract half the distance from highest existing grade to the
ROOF TYPE) betwe the highest point of the roof hi hest oint o the roof.
to t low point of the corresponding If you hav '
le or hipped roof SUBTR,4CTION ' BLE OR HIPPED ROOF
GABLE OR HIPPED ROOF(with (BASED ON (no windows): Subtract half
windows): Subtract half the distance ROOF TYPE) the distance between the
between the top of the highest highest point of the roof to
window and the highest point of the the low point of the
roof corresponding gable or
hipped roof
• ALL OTHER ROOF TYPES(flat, . GABLE OR HIPPED ROOF
mansard,etc):No subtraction. (with windows): Subtract
S TRACTION Subtract the distance between the half the distance between
ASED ON basemenUcrawl space floor and the the top of the highest
EXISTING highest existing grade adjacent to the window and the highest
GRADES) foundation OR 10 feet(whichever is less). point of the roof
• ALL OTHER ROOF TYPES
(flat,mansard,etc):No
EQUALS Defined building height subtraction.
Defined building height
EQUALS
Updated: May 2016
z:\forms\plan review checklist 5-2016.docx
Shoreland District MCWD Permit Average Lakeshore Setback Bluff
M et?
Permit Number: � - 0 Yes ❑ No N/A � Yes
�Yes � No ��—��� No
{/ � � N/A—see attached Setback:
Stormwater Quality Existing Proposed
Overlay District Tier Hardcover Hardcover Variance Required CUP Required
circle one % and sf % and sf
0 Yes No 0 Yes o
1 2 � . 3Q 4 5 � �`►(� TYPe�S):., TYPe�s)�
Fees to be Char ed YES NO
Permit t/
Plan Review r/
State Surcharge �—
Investigation Fee �,
SAC— Number of SAC Units �,
Other(specify) �-
Square Footage $ per Square Footage
Basement X = $
1 S� Floor X = $
2nd FI00� X = $
Garage X = $
Estimated Construction Value: $ ,7� ��
Orono Inspections Required Work Requiring Separate Permits
Footing � Site � Plumbing ❑ Grading/Filling
❑ Poured Wall O Silt Fence/Erosion Control � Mechanical O Fire
❑ Foundation Survey e Hardcover Removal � Fireplace O Water Connection
� Framing Other(specify) 0 Masonry ❑ Sewer Connection
0 Waterproofing/Drain tile 0 Mfg. ❑ Lawn Irrigation
❑ Foundation Waterproofing ���" ����1 � Other(specify) � Landscaping
� Framing
❑ Insulation
�ps-Built Survey
Final
� Lathe Required State Permits
❑ Other(specify)
❑ Well � Electrical
REMARKS (in-house):
OFFICIAL REMARKS -TO BE NOTED ON PERMIT AND INITIALLED:
0 See Builder Acknowledgement Form
�Prior to release of escrow money an as-built survey must be submitted and approved.
Updated: May 2016
z:\forms\plan review checklist 5-2016.docx
Permit Application: Self-Checklist for Completeness
Please note, the applicant must initial in the boxes below to acknowledge the minimum required
information is included with the submittal. If not, the application will NOT be accepted. Call
952.249.4620 to schedule a meeting with staff if you have questions on application submittal
requirements.
�� Completed Application
�� Plan Review Fee Paid
�� Signed Escrow Agreement & Escrow Payment
�� Building Plans (to scale) x2
�� Certificate of Survey (to scale) showing the proposed project &
meeting all requirements x2
�� Hardcover Calculations (if applicable)
I am aware that Orono will not issue a building permit without a
copy of MCWD permits (or documentation from the MCWD stating
�� the proposed project does not trigger their permitting
requirements). I will contact the MCWD at 952-471-0590
regarding this project.
Signed by: �
Addres22 DICKENSON S T ORONO MN 55
Permit #: c� -���
Last Updated: January 2016
Christine Mattson
From: Adam Edwards
Sent: Friday, October 28, 2016 8:23 AM
To: Melanie Curtis; Christine Mattson
Subject: RE: 161059-1225 Dickenson Street, Orono-Revised Survey
Looks okay from my perspective.
From: Melanie Curtis
Sent:Thursday, October 27, 2016 6:46 PM
To:Adam Edwards<aedwards@ci.orono.mn.us>; Christine Mattson <CMattson@ci.orono.mn.us>
Subject: Fwd: 161059-1225 Dickenson Street, Orono-Revised Survey
Will the two of you confirm this meets our permitting needs and, if so, have him provide the hard copies.
Thanks.
Sent from my iPhone.
Begin forwarded message:
From: Todd Montreuil <todd(a)boulderima eg s.com>
Date: October 27, 2016 at 15:40:14 CDT
To: Melanie Curtis <MCurtis(a�ci.orono.mn.us>, Christine Mattson <CMattson(a�ci.orono.mn.us>
Cc: Homes Pmi <pmi(a�pmihomesinc.com>, sarah giel <sarah.�(a�gmail.com>
Subject: Fwd: 161059-1225 Dickenson Street, Orono-Revised Survey
Melanie, I just recieved this from Advance Surveying. Hopefully all looks good to get the Geils permit issued.
After you have a chance to confirm either I will print out 2 copies as requested or next day them to you.
Thanks,
Todd
Todd Montreuil
President
Boulder Images Incorporated
14555 South Robert Trail
Rosemount Mn 55068-1592
todd a�boulderima e�s.com
(651)322-7499 Office
(651)260-2337 Celular
(651)322-7754 Fax
www.boulderimages.co m
CONFIDENTIALITY NOTICE:
1
This email and any attachments are for the exclusive and confidential use for the intended recipient.
If you are not the intended recipient,please do not read,distribute or take action in reliance upon this message.
If you have received this in error,please notify us immediately by return email and promptly delete this message and its attachments from your computer
system.
There is no waiver of attorney-client or other privilege by the transmission of this message.
Begin forwarded message:
From: Josh Rinke <josh(a�advsur.com>
Subject: 161059-1225 Dickenson Street, Orono-Revised Survey
Date: October 27, 2016 at 2:57:53 PM CDT
To: "todd(a�boulderima es.�com" <todd(a�boulderima�es.com>
Cc: Mimi Wrob <mimi(c�r�,advsur.com>, Information<info(a�advsur.com>
Hi Todd,
Attached is the proposed survey showing revisions per cities comments and updated hardcover
worksheet. Please let me know if you had any questions.
Thanks,
Josh Rinke, Pl�.
z
Melanie Curtis
From: Melanie Curtis
Sent: Tuesday, October 04, 2016 8:41 AM
To: sarah.giel@gmail.com
Cc: Christine Mattson;Adam Edwards; 'Todd Montreuil'
Subject: RE: 1225 Dickenson Street/#2016-01183
Sarah
I wanted to send the code sections regarding grading and retaining walls for your information prior to Friday's
meeting. See below. Sections 78-966 and 967 are written kind of awkwardly. I highlighted the relevant parts. Section
78-1405 is lengthy so I only included the relevant parts. Please let me know if you have questions prior to Friday's
meeting.
Sec. 78-966. - Prohibition.
(a) It is unlawful for any person to perform or have performed the following land alteration activities without a conditional
use permit issued by the council:
(1) Remove, fill, use for fill, dredge, store or excavate rock, sand, gravel, dirt or similar earth material within the limits
of the city.
(2) Fill or reclaim any land by depositing such material or by grading of existing land to elevate or alter the existing
natural grade.
(3) Build, alter or repair any seawall or retaining wall, or otherwise change the grade or shore of lakeshore property.
(b) All land alterations involving filling and grading shall be performed only with clean fill as defined in section 78-1. Granting
of such permits is subject to other regulations and prohibitions of this Code and other applicable statutes or ordinances
of other governmental bodies.
Sec. 78-967. - Exception.
(a) The requirements of section 78-966 are not intended to govern the following land alteration activities:
(1) Normal and customary grading in the area of an existing or a newly constructed building, or the grading of the
driveway serving such building.
(2) Any earth movement less than 500 cubic yards which does not adversely impact the existing drainage.
(3) Grading, filling or excavating of 50 cubic yards or less within the shore setback zone of all lakes enumerated in
article IX of this chapter.
(b) Such grading and earth movement shall be subject to approval by the building inspector at the time of issuance of a
building permit, provided that a plan showing proper drainage and protection of adjoining property has been submitted.
Where such earth movement is not being performed in conjunction with a building permit, a separate land alteration
permit shall be required. Any unusual land alterations, including earth filling, removal or grading, proposed by a builder
shall be subject to a conditional use permit as provided for in this chapter. The following land alterations shall be
considered as unusual land alterations:
(1) All excavations for foundations in excess of 12 feet average depth if any amount of the excess material removed
below 12 feet depth is to be stockpiled on the site.
(2) Any additional fill brought on site in excess of 500 cubic yards, except for fill required to raise grade for adequate
frost footing protection, the intent being that structures shall not be artificially raised above the preexisting
surrounding topography.
(3) Grading or alterations that would propose any changes in elevations within five feet of adjacent residential lot
lines except for drainage swales and ditches.
(c) The building inspector shall have the authority to refer any requests for land alteration permits to the city council for
review and approval in instances where the land alteration appears to potentially create negative impacts or be not in
keeping with the goals and policies of the community management plan.
1
Sec. 78-1405. - Nonencroachments.
(a) The following shall not be considered to be encroachments on yard setback requirements:
(5.1) Retaining walls, subject to the following provisions:
a. Retaining walls may be located in all required yards when all of the following conditions are met:
1. The structure is located at least ten feet from the edge of the traveled roadway;
2. The structure is not located within a drainage, utility, or other easement, except upon approval in writing
for an encroachment agreement by the city; or similar approval from another regulatory and/or utility
agency;
3. The structure creates no impacts to drainage direction, rate or volume for adjacent properties.
b. Retaining walls which do not exceed two feet in height above existing grade, which are located within the
property and at least five feet from any property line, and for which the amount of imported fill associated
with the structure does not exceed 20 cubic yards, do not require a building or land alteration permit.
c. Retaining waiis exceeding two feet in height above existing grade or for which the amount of imported fiii
associated with the structure exceeds 20 cubic yards or which are located less than five feet from a property
line, shall require a land alteration permit and upon recommendation of the building inspector may require
city council review or a conditional use permit per the provisions of section 78-967.
d. Retaining walls exceeding the allowed height of a fence in a given required yard shall be located so as to
meet the required accessory structure setbacks established for that yard.
(6) In side yards only, no accessory structure shall be closer than ten feet from any side lot line.
(8) Fences erected in all zoning districts are considered as a nonencroachment when they conform to the standards
listed below. For the purposes of this section, the following definitions shall apply:
Permanent fence. A fence that is installed in a fixed or enduring manner that is not intended for a seasonal
or temporary purpose.
Temporary fence. A fence that is not permanently secured or anchored to the ground by posts or affixed
footings, and is installed and removed on a limited term or seasonal basis such as: snow fences, garden fences,
seasonal recreational fences such as hockey boards; fences installed for safety or access management purposes
for special events; and fences installed for the duration of a construction project such as silt fences, erosion control
bioretention logs, and septic drainfield site protection fences.
Fence height. The measurement from the top of any part of the fence, including posts or other structural
supports, lattice, ornate top design elements, and so forth measured to the existing grade below the fence, as
measured perpendicular to the slope (see Drawing). Exception: Post finials extending above the top of the fence
shall not be deemed as part of the fence for height determination purposes as long as they do not exceed ten
inches in width per finial and do not extend above the top of the fence by more than ten percent of the allowed
maximum fence height at that location.
a. Nonlakeshore/ots.
1. Fences and walls within a required front yard or side street yard shall not exceed a height of 42 inches
above original grade.
2. Fences and walls within a required rear or side yard shall not exceed a height of six feet above original
grade.
Melanie Curtis
5952.249.4627 �mcurtis@ci.orono.mn.us
From: Christine Mattson
Sent: Monday, October 03, 2016 3:50 PM
To: sarah.giel@gmail.com
Cc: 'Todd Montreuil' <todd@boulderimages.com>; Melanie Curtis<MCurtis@ci.orono.mn.us>
Subject: 1225 Dickenson Street/#2016-01183
2
Hi Sarah,
I just got off the phone with Todd Montreuil with Boulder Images. We have a meeting scheduled for Friday, October 7tn
at 1 pm with the Melanie Curtis (Planner) and Adam Edwards (City Engineer). Please confirm this day and time works for
you and/or your husband.
If you have any questions, please don't hesitate to contact me.
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
/? 952.249.4620 ! g 952.249.4616
� cmattson@ci.orono.mn.us ' �?' www.ci.orono.mn.us
Office Hours: Monday- Friday 8 am to 4:30 pm
OUR OFFICE WILL BE CLOSED: Friday, November 11, 2016
Thursday& Friday, November 24& 25, 2016
3
Christine Mattson
From: Melanie Curtis
Sent: Monday, October 03, 2016 2:26 PM
To: 'todd@boulderimages.com'
Cc: 'sarah.giel@gmail.com'; 'PMI Homes'; Christine Mattson; 'Jim Parker';Adam Edwards
Subject: FW: 1225 Dickenson Street/#2016-01183
Attachments: Survey Requirements - August 2015.pdf
Todd
Our engineer has reviewed the submitted survey and plans for the grading and retaining walls at 1225 Dickenson Street.
The following are his comments:
1. The permit is for a retaining wall however the grading plan also depicts a proposed addition to the house and a
proposed deck. From our GIS imagery it appears this addition is existing not proposed. Also Imagery shows a
much larger patio area than what is depicted on the plan (See image below).
2. While the grading plan does depict the proposed retaining wall it does not depict any change to grading behind
the retaining wall. The proposed grading plan should be depicted including the new drainage pattern to be
established. The new pattern must not increase the rate or volume of runoff on to neighboring properties.
3. The applicant should provide the amount of fill being imported to site to complete this project. 50-500 cubic
yards will require a minor land alteration permit. Greater than 500 cubic yards will require a major land alteration
permit/CUP approved by the City Council.
4. A haul route must be supplied and approved prior to construction.
5. The wall must not be within 5ft of the property line. Otherwise a variance is required. As depicted the wall is
exactly 5ft from the property line which leaves no margin for error or adjustment during construction. Care must
be taken during construction to ensure the wall is built a minimum of 5 ft from the line.
a
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The changes and/or information requested are required prior to issuance of the permit.
i
You and I discussed the project yet at that time you did not have a cubic yardage calculation for the fill or actual wall
plans. Upon reviewing the proposal it appears portions of the retaining wall system will be over 9 feet high when
measured from existing grade. This results in the wall appearing to be quite massive when viewed from adjacent
properties. If the filling calculation exceeds 500 cubic yards a CUP will be required, and one of the likely conditions will be
that the portions of the wall exceeding 6 feet in height may be required to meet a greater setback of 10 feet from the
side and rear property lines. If the fill calculation fails beneath 500 cubic yards, it is recommended that you move the
walls back to meet a 10-foot setback from the property lines as a courtesy to the impacted neighbors.
Please discuss with your surveyor the necessary grading plan requirements (i.e. proposed grades mentioned in #2 above)
to be shown on the survey prior to submittal. Your surveyor should be provided with the attached Survey and Site Plan
Requirements sheet if they do not have a copy. If you or the surveyor have any questions as to what is needed please do
not hesitate to call me or Adam Edwards, our Engineer (952.249.4661).
Thank you
Melanie
Melanie Curtis, Planner
Direct 952.249.4627
Planning &Zoning Office 952.249.4620
2750 Kelley Parkway, Orono, MN 55356
Email: mcurtisCo�ci.orono.mn.us
Website: www.ci.orono.mn.us
From: Christine Mattson
Sent:Thursday, September 29, 2016 10:11 AM
To:Adam Edwards<aedwards@ci.orono.mn.us>
Subject: 1225 Dickenson Street/#2016-01183
Ada m,
The applicant submitted a Zoning Permit for retaining walls when a building permit is needed for walls over 4
feet. Please review the one copy of the survey received and provide comments.
Thank you.
Christine Mattson
Planning Assistant
City of Orono
2750 Kelley Parkway € Orono f MN ; 55356 (physica/addressJ
PO Box 66 ; Crystal Bay ; MN ; 55323-0066 (mailing address)
i� 952.249.4620 i 8 952.249.4616
� cmattson@ci.orono.mn.us ; � www.ci.orono.mn.us
Office Hours: Monday- Friday 8 am to 4:30 pm
OUR OFFICE WILL BE CLOSED: Friday, November 11, 2016
Thursday& Friday, November 24& 25, 2016
z
Christine Mattson
From: Christine Mattson
Sent: Friday, September 30, 2016 1028 AM
To: 'Todd Montreuil'
Cc: sarah.giel@gmail.com; Melanie Curtis; PMI Homes
Subject: RE: 1225 Dickenson Street/#2016-01183
Todd,
We need you to pay the advance plan review fee at the time of submittal and prior to the permit being considered
"complete" for our review to begin. If you want to pay the advance plan review fee with a check please call 952-249-
4600 to obtain the amount and submit. We are open Monday through Friday 8 am to 4:30 pm.
Thank you for the electronic copy of the survey; however,your full-size survey should print 22" x 17". We are only able
to print up to 11" x 17" and are unable to print a scaled copy of the survey. Please bring in one additional full-size copy
of the survey or have one mailed to us.
Christine�
From:Todd Montreuil [mailto:todd@boulderimages.com]
Sent:Thursday, September 29, 2016 4:41 PM
To:Christine Mattson <CMattson@ci.orono.mn.us>
Cc: sarah.giel@gmail.com; Melanie Curtis<MCurtis@ci.orono.mn.us>; PMI Homes<pmi@pmihomesinc.com>
Subject: Re: 1225 Dickenson Street/#2016-01183
Christine, I have attached a completed Building permit application as requested. I have also attached a pdf of
both the survey and structural engineering plans if extra copies are required.In addition I have attached the
Minnehaha Creek Watershed District permit which I made note at the time of application was in the pipeline.
As far as the additional building permit fee in addition to the $2500.00 we submitted previously, I would
probably submit an additional check for record keeping purposes.
I see that you have Sarah Giel copied on this email as well. I will let her/Tom decide which works for them to
get the appropriate signatures.
I would like to bring it to attention that I was under the assumption when I submitted the zoning permit
application, updated survey, and structural engineering plans, nothing additional was required. I noticed you
mention a timeline of 4 weeks for issuance of the building permit. I was told 1-2 weeks for issuance of the
zoning permit which I informed our anxiously patient clients.
If there is anything additional that my clients or myself can do to be of help and move this forward in a timely
manner, please always feel free to contact me anytime.
Thank you,
Todd Montreuil
i
<GIEL BUILDiNG PERMIT APPLICATION.pdf�
<BII 2012 LOGO.pdfy
Todd Montreuil
President
Boulder Images Incorporated
14555 South Robert Trail
Rosemount Mn 55068-1592
todd(�boulderima e�com
(651)322-7499 Office
(651)260-2337 Celular
(651)322-7754 Fax
www.boulderima�es.com
CONFIDENTIALITY NOTICE:
This email and any attachments are for the exclusive and confidential use for the intended recipient.
If you are not the intended recipient,please do not read,distribute or take action in reliance upon this message.
If you have received this in error,please notify us immediately by return email and promptly delete this message and its attachments from your computer
system.
There is no waiver of attorney-client or other privilege by the transmission of this message.
On Sep 29, 2016, at 2:22 PM, Christine Mattson <CMattson(a�ci.orono.mn.us> wrote:
Todd,
We received a Zoning Permit application for retaining walls. A Zoning Permit is required for proposed
retaining walls under 4 feet in height. Some of your proposed walls exceed 4 feet in height. Retaining
walls over 4 feet in height require a Building Permit. I've attached a building permit application. Please
complete and return. Building permit applications require an advance plan review fee paid at the time
of submittal. The fee is based on the estimated construction value. For your convenience the fee can
be paid with a credit card, over the phone.
Only one copy of the survey was submitted with the application, two copies are required. However,
before you submit another copy of the survey our engineer should review the survey and provide
comments. We will notify you of any changes that need to be made to the survey or if we simply need
another copy of the survey submitted.
Attached is a copy of the escrow agreement. Please have the property owners sign and return. Please
note,we acknowledge receipt of$2,500 from Boulder Images for the escrow, but be aware per the
City's policy the money is refunded to the property owner.
We will be in contact with you regarding any comments and/or additional information needed to
complete the application. Please note, once we have a completed application (with all submittals)our
permit review and issuance timing is approximately 4 weeks. Please plan accordingly.
2
Christine Mattson
Planning Assistant
City of Orono
2750 Kelley Parkway � Orono � MN ; 55356 (physical addressJ
PO Box 66 j Crystal Bay -. MN ? 55323-0066 (mailing address)
S 952.249.4620 ' �3 952.249.4616
� cmattson@ci.orono.mn.us � www.ci.orono.mn.us
Office Hours: Monday- Friday 8 am to 4:30 pm
OUR OFFICE WILL BE CLOSED: Friday, November 11, 2016
Thursday& Friday, November 24& 25, 2016
<Building Permit Application for New Structures_Application ONLY 2016.pdf5<escrow.pdfy
3
Christine Mattson
From: Christine Mattson
Sent: Thursday, September 29, 2016 222 PM
To: 'todd@boulderimages.com'
Cc: 'sarah.giel@gmail.com'; Melanie Curtis
Subject: 1225 Dickenson Street/#2016-01183
Attachments: Building Permit Application for New Structures_Application ONLY 2016.pdf; escrow.pdf
Todd,
We received a Zoning Permit application for retaining walls. A Zoning Permit is required for proposed retaining walls
under 4 feet in height. Some of your proposed walls exceed 4 feet in height. Retaining walls over 4 feet in height
require a Building Permit. I've attached a building permit application. Please complete and return. Building permit
applications require an advance plan review fee paid at the time of submittal. The fee is based on the estimated
construction value. For your convenience the fee can be paid with a credit card,over the phone.
Only one copy of the survey was submitted with the application,two copies are required. However, before you submit
another copy of the survey our engineer should review the survey and provide comments. We will notify you of any
changes that need to be made to the survey or if we simply need another copy of the survey submitted.
Attached is a copy of the escrow agreement. Please have the property owners sign and return. Please note,we
acknowledge receipt of$2,500 from Boulder Images for the escrow, but be aware per the City's policy the money is
refunded to the property owner.
We will be in contact with you regarding any comments and/or additional information needed to complete the
application. Please note, once we have a completed application (with all submittals) our permit review and issuance
timing is approximately 4 weeks. Please plan accordingly.
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
yi' 952.249.4620 E 8 952.249.4616
� cmattson@ci.orono.mn.us ; � www.ci.orono.mn.us
Office Hours: Monday- Friday 8 am to 4:30 pm
OUR OFFICE WILL BE CLOSED: Friday, November 11, 2016
Thursday& Friday, November 24& 25, 2016
1
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� Of 2
MJP Associates,ltd.
4362 Oakmede Lane
White Beaz Lake,MN 55110
� � PH.651-426-7037
FAX 651-42G-6643
Structural Engineering Consultants ` � �O� www.mjp-associates.com
. pRON
Boulder Retaming Wall Design Submittal
MJP Associates, ltd. Project No.: 160902
Client:
Boulder Images,Inc.
3803 154`e Street West
Rosemount,MN 55068
Project Name:
1225 Dickenson Street
Boulder Retaining Walls
Orono,MN
I HEREBY CERTIFY THAT THIS PLAN, SPECIFICATION OR REPORT WAS PREPARED BY
ME OR UNDER MY DIRECT SUPERVISION AND THAT I AM A DULY REGISTERED
PROFESSIONAL ENGI EE� UN E T AWS OF THE STATE OF MINNESOTA
.
DATE: 09/21/2016 REG.NO. 20216
Digitally signed by Michael J Preston
M' DN:cn=Michael J Preston,o=MJP Associates,
�� a e J P re sto n Itd.,ou,email=mike@mjp-associates.com,c=US
Date:2016.09.21 12:15:38-05'00'
" f.
� ���� �: =��� t�:,
� ��� ��
CONTENTS
1 DESIGN CRITERIA
2 PLANS
3 DETAILS
4 CALCULATIONS (SUBMITTED ON REQUEST)
5 SUPPORTING DOCUMENTATION
1 Design Criteria
• The design for the boulder retaining wall making up this project is based on the following assumptions
and our understanding of this project from a recent telephone consultation with Boulder Images,Inc.and
proposed plans prepared by others& submitted by Boulder Images,Inc.
• Soil Unit Weight 120 PCF
• Field Stone Unit Weight 165 PCF
• "Ka"(Assumed Active Soil Pressure Coefficient) 0.307
• "Kp"(Assumed Active Soil Pressure Coefficient) 3.255
• "f'(Assumed Friction Coefficient) 0.50
• Minimum Wall Batter See Plans
• Top Wall Offset See Plans
• Soil Surcharge 0 PSF
• The retained slope is assumed to be stable.
2 Plans
2.1. Partial Plot Plan/Survey (prepared by others)
---�- . . , i
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z � SILT FENCE/
.q � 61�D ROLL
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`�' � PROPOSED �� �� I
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, /' ar.� TC}Vr1=9'5i2,5
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1 .48 .
�� . « ��CII T CCklf"C/ / � � . .. �
3.2
Client: Boulder Images .
Project/#: 1225 Dickenson St/160902 Schematic Site Plan
2.1
By: MJP Date: 09/21/16 NOT TO SCALE
MJP Associates, itd. - 651-426-7037
3 Details
3.1. Top 3C wall to 4.5' '
3.2. Bottom 3C wall to 4.5'
i
, �
�10°0
�
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� 6 1/2" —
957.5 � i . . .
18x -����� 6
� � 18
4�6 �i 18x .•.,. —
Max 18 � •� �:.•�•'•�:I��������
' – (�
953.0 Min � 24x24 ��: �.�. _ $
Varies _ II I_ II�
��������=������
TYP 5
7
Notes:
1 ) Refer to Plan for wall location & height
2) See "Design Criteria" for specifications.
3) Wall weight/ ft. @ maximum height � 141 1#/ft. as follows:
Stone designations refer to minimum depth x height in inches per lineal foot of wall.
4) Reduce Wall height by reducing top courses @ reducing wall heights.
5) Note minimum toe burial depth: 6"
6) Min 24" wide free draining granular backfill area as shown.
7) 4" 0 Drain tile wrapped with geotextile fabric and sloped to daylight.
8) 6oz commercial landscape fabric
Client: Boulder Images
Project/#: 1225 Dickenson St/160902 3. 1 Top 3C Wall to 4.5�
By: MJP Date: 09/21/16 SCALE: 1/4"= 1'-0"
MJP Associates, Itd. - 651-426-7037
SEE
3.1
�
, �
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�
i �
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� � '���'���'��`����—
i i '�.�'�_�����
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Varies ������������--
6 1/2" :o:.-:.-:.-. _
952.5 � . ..�-.•.IIIII -- IIII-IIII
� ' � 8x �.::�.:�.:.��:�;-11111- II--111
� � ' 8 ��:��IIII-
4'6" ''
Max � 18X •�.`•.����
.�.�� ��.����—
.�. :.�:.�._ ��
948.0 Min � 24x24 ��' �.� _ $
Varies _ IIII_ II�
��������=������
TYP 5
7
Notes:
1) Refer to Plan for wall location & height
2) See "Design Criteria" for specifications.
3) Wall weight/ ft. @ maximum height � 141 1#/ft. as follows:
Stone designations refer to minimum depth x height in inches per lineal foot of wall.
4) Reduce Wall height by reducing top courses @ reducing wall heights.
5) Note minimum toe burial depth: 6"
6) Min 24" wide free draining granular backfill area as shown.
7) 4" 0 Drain tile wrapped with geotextile fabric and sloped to daylight.
8) 6oz commercial landscape fabric
Client: Boulder Images
Project/#: 1225 Dickenson St/160902 Bottom 3C Wall to 4.5�
By: MJP Date: 09/21/16 �'� SCALE: 1/4"= 1'-0"
MJP Associates, Itd. - 651-426-7037
4 Calculations (Submitted on request)
4.1. 3C wall to 4.5'
5 Supporting Documentation
5.1. Soil Property Data
5.2. (n) Course Wall Geometry & Design Schematic
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Client: Boulder Images
Project/#: 1225 Dickenson St/160902 5.1 Soil Properties
By: MJP Date: 09/21/16 -NA-
MJP Associates, Itd. - 651-426-7037
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des H C2 WZ
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C1 I=
W1 =I�I�I
D = = _
Assumed Poi Itlll = III=— IIIII
Of Rotation =I I I(I=I I I I I Base
Notes:
1 ) Batter angle is "Theta"
2) Courses are assumed to have the equivalent weight of a cube as shown.
3) Moment Arm for Course(i) above the base course = [C2+C3+...C(i) x tan(theta)) +
1/2 C(i)]
4) Offset = (Hdes - C1) x Tan(theta)
5) Size depends on orientaion of upper stones. Compare area from X-section to
calculated value.
Client: Boulder Images
Project/#: 1225 Dickenson St/160902 �•2 3 (C) Wall
By: MJP Date: 09/21/16 SCALE: 3/16" = 1'-0"
MJP Associates, Itd. - 651-426-7037
. �.,r
MINNEHAHA CREEK WATERSHED DISTRICT
QUALITY OF WATER `'� QUALITY OF LIFE
Pursuant to Minnesota Statutes Chapter 103D, and on the basis of statements and information
contained in the permit application, correspondence, plans, maps, and all other supporting data
submitted by the applicant, and made a part hereof by reference, PERMISSION IS HEREBY
GRANTED to the applicant named below for use and development of land in the Minnehaha
Creek Watershed District.
��� � �� �0-_J
Issued to: Tom Giel Permit No: 16-508
Location� 1225 Dickenson Street, Orono
Purpose� Erosion Control-Landscapina
Date of Issuance: 9/28/2016 Date of Ex iration: 9/28/2017
By Ord of the Bo�rd f Managers
Rachel in
Permitti g Technician
This permit is not transferable without District approval, and is valid t t e date of 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 permit must be received by the District at least 30
days before expiration.
The applicant is responsible for compliance with all District Rules and for the action of their
representatives, contractors, and employees.
Conditions: Project to be completed as described in plans submitted to the
MCWD office on September 13th, 2016 according to the provisions of this permit.
• Properly install and maintain all required erosion control measures until the
disturbed areas are re-stabilized
• Notify MCWD in writing upon completing installation of perimeter and
sedimentation controls
• When the site is re-stabilized and the MCWD staff has performed a final
inspection, all perimeter control must be removed
(Statement concerning fees for inspections, violations, etc... on following page)
We collaborate with public and private partners to protect and improve land and water for current and future generations.
15320 Minnetonka Boulevard,Minnetonka,MN 55345 • (952)471-0590 • Fax:(952)471-0682 • www.minnehahacreek.org
i. "w✓ v
MINNEHAHA CREEIC WATERSHED DISTRICT
QUALITY OF WATER QUALITY OF LIFE
Inspection/Analvsis/Monitorinq Fees
A site inspection and monitoring by District staff will be performed where the activity involves:
• a commercial/industrial/multi-family residential development
• a single family residential development greater than 5 acres or of any size if within the
Minnehaha Creek subwatershed
• any alteration of a floodplain or wetland
• dredging within the beds, banks or shores of any protected water or wetland
• a violation
• any project which in the judgment of the District staff should be insp�cted due to project
location, scope, or construction techniques
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 by the work, analysis of the
work, and any subsequent monitoring of the work, which in the case of a violation shall be at
least $35.
Standard Fee Schedule
District professional staff $ 65.51*
District interns $ 40.35"
District clerical staff $ 46.69*
Consulting Senior Engineer $ contracted rate
Consulting Engineer/Technician $ contracted rate
District Counsel $ contracted rate
Application fee $ 10.00
Copy costs $ .25 + actual staff time
Color copy costs $ 1.00 + actual staff time
* Hourly
We collaborate with public and private partners to protect and improve land and water for current and future generations.
15320 Minnetonka Boulevard,Minnetonka,MN 55345 • (952)471-0590 • Fax:(952)471-0682 • www.minnehahacreek.org
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� ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT
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❑STOP ORDER POSTED.CALL INSPECTOR
❑INSPECTION RE(]UIRED.CALL TO ARRANGE ACCESS.
Ca8 for the next inspection 24 hours in advance. (952) 249-4600
pwnerlContractor on site:
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OWNER TELEPHONE NO.�'������"875�
CONTRACTOR �"�`��-(��—���a�S
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� ❑ DEMO-SITE ❑ SEPTIC I ALL
2 OWNERlCOKTRACTOR TO MEEf YWJ:_YE$�NO
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❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (952 j 249-4600
OwnerfContractor on site:
inspector: /�'
White CopyAnspector's Fil� Gnary CopYlSlts Notke
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❑CORRECTUNSAFECONDITION WRHIN HWRS. O PHOTOTAKEN
INSPECTOR WILL RE?URN
❑GTATION ISSUED
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�INSPECTION REWIRED.CALL TO ARRANGE ACCESS.
Call for the next inspectfon 24 hours in advance. (952) 249-4600
OwnerlContractor on site:
Inspector:�l r`^' �—
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emo
To: Finance Department
From: Christine Mattson, Planning Assistant �/Y ' '
CC: Street File
Date: January 4, 2017
CaIL: 101-22205
Re: Escrow Refund
Building Permit#2016-01183 pertaining to 1225 Dickenson Street is complete. Please refund
$2,500 to the property owner,Tom and Sarah Giel.
The following is attached:
• Original signed escrow agreement
• Copy of cash register receipt showing escrow amount received
_ _ _
Mail to: Tom &Sarah Giel
1225 Dickenson Street
Wayzata, MN 55391
w:�street fileskfidcenson st�1225�escrow refund 2016-01183.doac
i .
= LAND USE APPLICATION ESCROW AGREEMENT
Appltcatiort#�{O�to-O//83
AGREEMENT made this�day af , 201�, by and between the CtTY OF
ORONO,a Minnesota municipal corporat4on ("Cit�')and i
[a carporation—Qpt�onal� ("Owners').
Racitals
1. Owners have fiied Land Use A plication ��/��3formally requesting the City to review plans
for the proPertY addressed: 1 p (the °Subject Propetfy') legally
described as �b Q/o i �,
2. Owners request the Ci#y to review said plans which requires City approval and may require
consulting legal and/or engineering review.
3. The City is willing to vommence fts review of the application and incur casts assoclated with said
review only if the Owr�ecs establish an escrow to ensure reimbursement to the City of its c�st�.
NCW THEREFORE,THE PARTIES AGREE A8 FOLLOWS:
1. DEP08R O� ESCROW FUN�. Corrtemporaneously wfth the execution of this Escrow
Agreemen#� the Owners shall deposit S.�SbD. with the City. Ni accrued interest. IF any, shall be paid to the
City to reimburse the Clly for its cost In administering the escrow account.
2. PURPOSE OF ESCROW. The purpose of the escraw ts to guarentee reimbursement to the Cily
for a{I out-of-pocket oosts the City has incurred (including plann€ng,engineering, or legal consultant revtew)or will
incur in meeting with the dwn�rrs, reviewing the plans, and preparing agenda packet material for City Council
review af Land Use Appli�ation�U14-�V/83. Eligible expenses shal! be consister�t with expenses the Ownsrs
would be responsible#or under a land use appllca#ion:
3. MONTHLY BILLING. As the City reoeives consultant bills for EncuRed casts, the City will in turn
send a bill to the �wr�ers. Owners shaA be responsible for payment to the City within 30 days of the Owners'
receipt of bill. � '
4. DISBURSEMENT FRQM ESCROW ACCOUNT. In the everrt that the Uwners do not make
payment to the City within the timeframe outiined in #3 above, shali cease all reviews urrtil the Owners pay all
expenses invoiced pursuarit to#3. The City may draw from the escrow account without further approval of the
Owners to reimburse the City for eligible expenses th�City has incurt�ed.
5. CLOSING ESCROW. The Balance on deposit in the escrow, ff any, sfiall be retumed to the
Owners when all requireme�rts related to the project are comp{ete. City Staff shall revfew the terms of thls escrow
agc+eement two times per year to detennine whether the requirements ofi the proJect have been sua�sssfully
campleted and whether {t is appropriate ta retum the funds. Owner may also request the release o#the funds,
and such funds shal) be released upon Ci#y Staff receiving the approprfate verification that all requiremer�ts of the
proJed have been successfuily completed.
8. CERTIFY UNPAID CHARGES. If the pro)ect is abandoned by Owners, or if the eligibte expenses
incumed by the City exceed the amount in escrow, #he City shall have the rtght to certtfy the unpaid balance to the
subject property pursuant to Minn.Stat.§§415.01 and 366.012.
CITY: ITY OF ORQNO QWNE S: �
`- '(�C.
BY. � By;
Its: � its:
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Updated: May 2015
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� BOULDERIMAGESINC
10604
CITY OF ORONO 09/23/16
. Performance Bond TOM GIEL � `� 2,500.00
� 1225 DICKENSON ST. WAYZATA, MN
'
City of Orono
2750 Kelley Parkway ,
Orono MN 55356 952-249-4600 / �
Receipt No: 3.016510 Sep 23, 2016
i .
BREMER CHECKING Boulder Images
, 2,500.00
Previous Balance: .00
Permits •
2016-01184 1225 2,500.00
Dickenson St
101-32520
Zoning Permit
---------------
Total: 2,500.00
Check -----------=--=
Check No: 10604 2,500.00
Payor:
Boulder Images ,
Total Applied: 2,500.00
---------------
Change Tendered: .00
-----------
09/23/2016 02:02PM
� � ° CITY OF ORONO
2750 KELLEY PARKWAY * � 0 1 6 — 0 1 1 8 4 *
DATE ISSUED: 09/23/2016
ORONO,MN 55356-
(952)249-4600 FAX: (952)249-4616
ADDRESS : 1225 DICKENSON ST
PIN : 02-117-23-31-0048 .
LEGAL DESC : MINNETONKA BLUFFS
: LOT 000 BLOCK 016
PERMIT TYPE : ESCROW FEE-APPLICANT
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ESCROW FEE-APPLICANT
NOTE: THIS$2500 ESCROW IS TIED TO ZONII�iG PERMIT APPLICAITON 2016-01183
APPLICANT ESCROW FEE-APPLICANT 2,500.00
BOULDER IMAGES TOTAL 2,500.00
1225 DICKENSON Payment(s)
WAYZATA,MN 55391- CHECK 10604 2,500.00
(651)322-7499
OWNER
GIEL,TOM&SARAH
1225 DICKENSON STREET
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 City approvals,and the
State Building Code. This permit is for only the work described and does
not grant permission for addirional or related work which requires separate
permits. All provisions of laws and ordinances goveming 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 asswing 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