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Home My WebLink About2010-00778 - attached garage t � CITY OF ORONO PERMIT NO.: 2010-00778 2750 KELLEY PARKWAY ORONO, MN 5535G- DATE ISSUED: 10/04/2010 952 249-4600 FAX: 952 249-4616 ADDRESS : 3300 GRAHAM HILL RD PIN : OS-117-23-11-0011 LEGAL DESC : GRAHAM H[LL PRESERVE 2 : LOT 000 BLOCK 000 PERMIT TYPE : ADDITION/REMODEL/REPAIR PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : GARAGE-ATTACHED ACTIVITY : 434-RESIDENTIAL VALUATION : $ 98,000.00 NOTE: SEPF,RATF.PERMI"I�S RFQUIRF_D: ELECIRICAL(STA1�E) ADDI"I'ION TO GARAGE PLAN RF,VIF,W Ft:G COLLF',CTGD 8/30/10 PERMIT 2010.00777 $677.14 AS BUILT SLIRVEY RF,QUIRED $2500 ESCROW AND GSCROW AGREEMEN"C RFQUIRED APPLICANT PERMIT FEE SCHEDULE 1,041.75 JMA BUILDERS LLC STATE SURCHARGE(VALUATION) 49.00 6065 EUREKA RD TOTAL 1,090.75 SHOREWOOD, MN 55331 (952)474-4193 Minnesota State License#: 091 10 OWNER MURPHY, ANN 3300 GRAHAM HILL RD LONG LAKE, MN 55356- AGREEMENT AND SWORN STATEMENT The work for which this permit is issued shall be performed accordina 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 pennission 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 speciTied herein.'1'his permit will expire and becomc null and void if construction authorized is not commenced within 180 days of the date of issuance,or if construction is suspended for a period of 180 days at any time after work has commenced. The applicant is responsible for assuring all required inspections arc re�uested in conformance with the State Building Code.This permit may be re okcd at any time for due cause. _ _ -~� - � �!/ /ZC� • �/ / C, Ap � t Permitee ' — Date Is d By Signature Date `� SEPARATE PERMITS REQU[RED FOR WORK OTHER THAN DESCRIBED ABOVE. \� \ t t ' City of Orono Building Permit Application ,� for New Structures or Additions � ° ��, 7�' Maifing Address: � aB�� -�Q 7 7 t� ��,�� PO Box 66 Permit number: �/� �: Q�\ Crystal Bay, MN 55323-0066 Date received: 8 ,30 /O � �'s��-� I I ��; ;r �� Received by: ,a �� -,s-�:;� s, Street Address:' �'�,n � �'(,r�,� �� 2750 Kelley Parkway Plan review fee: D/O'd D 77� '�9.kEs�� Orono, MN 55356 �77 � Total Fee: Main: 952-249-4600 Fax: 952-249-4616 www.ci.orono.mn.us 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: p � �}; o �, N /� �S J�jC� Will this be a Parade of Homes, Remodelers Showcase Ho e or other isplay Home? ❑ Yes No If yes, a special event permit rs required with Police Department and City Council approval 60 days prior to the event. Shuttle bus service wi be required unless applicant demonstrates sufficient on-site parking is available. Non-permitted events will not be allowed. CONTRACTOR/APPLI ANT INFORMATION: Name: SM� ��:��trS L��i State License# _pq,�b Expiration Date: �f��o�� Phone: office cell Mailing Address: �, Cit � ZIP: S 3 Contact Person: Applicant is: ontracto / Homeowner (Circle One� Email and/or Fax: M�vS�,r" �J i••►Sv+.C,oM PROPERTY OWNER INFORMATION: Name: Phone (day): Address: _ City: ZIP: Email and/or Fax ARCHITECT/ ENGINEER INFORMATION: Name: -}� Phone (day): gs -y - Address: <j S • p Cit : ' ZIP: S � Email and/or Fax: 9SZ- y70- � 0'7 PROJECT INFORMATION: 1.Type of Project 2. Proposed Use 3. Structure Type 4. Sewage Disposal & 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 require ❑ Commercial ❑ Other(specify) MCWD review&permits. ❑ Industrial ❑ Private Well Minnehaha Creek Watershed District(MCWD) � h r: (specify) 18202 Minnetonka Blvd (;� oV� '}0 4 Deephaven, MN 55391 Phone: 952-471-0590 Fax: 952-471-0682 www.minnehahacreek.or Estimated Construction Valuation (excluding land) $ p Last Updated: 9l29/2009 - 17 - �/, i ► ' s STRUCTURE INFORMATION: 1. Structure Dimensions 1. Structure Dimensions(continued) 2. Type of Construction r �� a. Length (ft.)= _�_ Number of bedrooms= — �Wood/Frame �-�y� " ❑ Masonry b.Width (ft.}= `�, b Number of garage stalls: ❑ Metal Attached =�_ ❑ Pole Bldg. Areas in square feet Detached = — ❑ ICF ❑ On-site Prefab c. Basement= ❑ Off-site Prefab d. 1 St Story = �� ❑ Other(please specify): e. 2"d Story= f. '/2 Story = g. Total Area= REQUIRED SUBMITTALS: All of the information must be submitted in order for your application to be processed: Not Enclosed Applicable ❑ Permit Ap lication ❑ Pro osed 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 � ❑ Se tic S stem Site Evaluation Re ort � ❑ Access Permit � ❑ Wetland Buffer Im rovement Plan � ❑ En ineered Plans for Retainin Walls 4 feet or above ❑ Plan Review Fee � ❑ 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 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; • 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. �� \ ApplicanYs Signature: \� Date: zd�V -v�S-�� , -� I , / Last Updated: 9/29/2009 - 18 - � • �� Plan Review Checklist for New Sfructures / Additions Address/ PID/ LegaL _ 5�� r� �.r�� .� � � Description of work: Septic review by: w(/-- Date Approved: – � - 1D Zoning review by: Date Approved: �iV Building review by: Date Approved: ct ' Z� —� Grading review by: Date Approved: � �--1 `D Zoning File #: Resolution#: Resolution Date: Zonin District I Fire Department Post Office School District Zoning: Lot Area: SF/AC Width: Depth: Survey Submitted: ❑ Yes ❑ No Date of Survey: �j D Pro o d Setbacks: Fron (Lake) R r ( S E W ) ( N S E W ) Other Buildings i Wetland Side Side � Building Defined Height: Building Peak Height: # of Stories Ok?: ❑ YES FOR A BUILDING WITH A BASEMENT OR CRAWL SPACE: FOR A BUILDING ON A SLAB FOUNDATION: START WITH the distance between the basement floor/crawl START the distance between the slab and the highest ' space floor and the highest roof peak,the top of � WITH roof peak,the top of the cornice of a flat roof, the cornice of a flat roof,the deck line of a the deck line of a mansard roof, or the mansard roof, or the uppermost point on a round uppermost point on a round or other arch-type � I or other arch-t e roof roof SUBTRACT half the distance between the highest window and SUBTRACT half the distance between the highest window I hi hest roof eak of a itched roof and hi hest roof eak of a itched roo` ' SUBTRACT the distance between the basement floor/crawl I ADD the distance between the slab and the highest space floor and the highest existing grade within existinq grade within the foundation i the foundation or 10 feet, whichever is less. � EQUALS I Defined buildin hei ht � EQUALS Defined buildin hei ht Lot Coverage: SF o�o Shoretan District j MCWD Permit Received Average Lakeshore Setb ck g�� ❑ Yes ❑ No ❑ N/A ❑ Yes �❑ ❑ Yes No , ❑ Yes ❑ No Permit Number: Setback: � Hardcover Zones I, Existin Proposed Variance Re uir I CUP Req red 0-75' � I ❑ Yes _ i ❑ Yes o 75-250' I TYPe(S)� � TYPe(S): � 250-500' 500-1000' � REMARKS (in-house): Updated: 09/11/2009 z:\formslplan review checklist.docx i � r Fees to be Charged YES NO Permit�_ .. . Plan Review State':Surcharge : Investigation Fee °SAC-.'Number:ofi:SAC Units _ Sewer Connection �:�1Yater-:Connection ;_, , , . Park Fee `Site�lnspecfion ' ' Other (specify) � ;Miscellaneous Fees _ , , <:: - ; • ; _ _. Calculated By: � Square Footage � I $ per S ua re Footage ; Basement X I � = I � 15t Floor X = i � 2"d FlOor � X = � Garage I� X = � Estimated Construction Value: � �� ,�(� � Orono Inspections Required Work Requiring Separate Permits Required State Permits ! � ❑ Site Plumbing ❑ Grading / Filfing ❑ Well ❑ Hardcover Removal Mechanical ❑ Fire Electrical �g�ting ❑ Septic ❑ Water Connection j�oured Wall � ❑ Fireplace ❑ Sewer Connection ❑ Foundation Survey I ❑ Masonry ❑ Lawn Irrigation ❑ Radon Rock Bed � ❑ Mfg. �raming ❑ Other(specify) I nsulation -Built Survey Final 0 Other(specify) REMARKS (rn-house): Other Review: Reviewed by: Date Approved: Access:Existing: ❑ YES ❑ NO New: ❑ YES ❑ NO REMARKS (TO BE NOTED ON PERM(T AND INITIALLED BY PERSON PULLING PERMIT) �45`(9r,r j�-�--S �d u-1� ��Lf-ow 25ov. � � .�u�u> u�� Updated: 09/11/2009 z:\forms\plan review checklist.docx S�� I T TIME � CITY OF ORONO CALLED IN `�� INSPECTION NOTICE 7 SCHEDULED 1� ►D �D� PERMIT NO. �D 1 D�O� / �� COMPLETED ADDRESS 33AD �r�'��'►+'` bd�. l� OWNER TELEPHONE NO. ��2 ��d �� 5� CONTRACTOR �I��_Lt �� DESCRIPTION �I��l��{�Ci ll� ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING � ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS � Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS � ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT v ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP _ ❑ DEMO-F�NAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL � OWNER/CONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W a � � J � !,( ,'�� '�� ,, �/.�li�r '�'- � ' O � W Q '�—�'�� 1%�( � .�v�. ,ti �' � � .., � z W � W � � GW �NORK SATISFACTORY:PROCEED [� PROJECT COMPLETE � ❑CORRECT WORK&PROCEED � ISSUE CERTIFICATE OF OCCUPANCY W O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN �NSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR � GTATION ISSUED ❑ INSPECTIONREQUIRED.CALLTOARRANGEACCESS. Call for the next inspection 2a hours in advance. (952� 249-4600 OwnerlContractor on sit�: Inspector_ t ,� ;: '''�1 , �� s White Copyllnspector's File Canary CopylSite Notice �DAT TIME ✓ CITY OF ORONO CALLED IN �� a INSPECTION N TICE �} 7 HEDULED � PERMIT NO. !G�D`��` �OMPLETED ADDRESS �� C� � l�� OWNER TELEPHONE N0.61Z S�� 3��77 CONTRACTOR `Il�f� �J�a/i�J >: DESCRIPTION OD��Y� � `,,� - � ��-rOOTING ❑ PLUMBING AL ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL � MECHANICAL RI ❑ LAKESHORE/WETLANDS y ❑ FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL � � INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Z Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS � ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT v ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FO�LOW-UP ? ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL � OWNER/CONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W a � � O >. � O � W � Q � Z W � W � � GW �WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE � ❑CORRECT WORK&PROCEED f i ISSUE CERTIFICATE OF OCCUPANCY W 0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITION WITHIN HOURS. ❑ pHOTOTAKEN INSPECTOR WlLL RETURN ❑CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑ INSPECTIOtV REQUIRED.CALLTO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. (952� 249-46�� OwnerlContractor on site: Inspector. l,>��,� White Copyllnspector's File Canary CopylSite Notice DA E TIME � CITY OF ORONO CALLED IN � �� INSPECTION NOTICE /QSCHEDULED a %� PERMIT NO. v?C�V '�D�`U COMPLETED , ADDRESS ��,�(`�D C�(��'lGL►'r1 � OWNER TELEPHONE NO��' 8�"3�57 CONTRACTOR `�J �: DESCRIPTION ��'��'� �� ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/G G/FILLING y �.POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS O ❑ FRAMING ❑ MECHANICAL FINAL ❑ 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: � W 0. � J O �. � O � W � Q � 2 W � W � � � d ��ORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE W ❑ ORRECT WORK 8 PROCEED � ISSUE CERTIFICATE OF OCCUPANCY 0 ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. C PHOTOTAKEN INSPECTOR WlLL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED ❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. (952� 249-46�� Owner/Contract on site- � r �, Inspector. _ �i' � �� White Copyllnspector's File Canary CopylSite Notice ni �y � (� T /T TIME CITY OF ORONO � CALLED IN / � ` � INSPECTION NO IC �J CHEDULED J L� PERMIT NO. �� / ��onn LETED ADDRESS OWNER TELEPHONE NO. � CONTRACTOR >; DESCRIPTION `, � � � ❑ 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 � ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP _ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL � ❑ PLUMBI SEP IC FINAL ❑ FOUNDATION/REMOVAL � OW /CONTRACTOR T OU: S_NO � COMMENTS: � W a � J O "� s, . ' �" ,(,1`.� 1 C - � v , � � O � - � W � Q � Z W � W � � O W ❑WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE � ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY W O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY 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. Cail for the next inspection 24 hours in advance. (g52) 249-460� OwnedContractor on site: inspector. White Copyllnspector's File Canary CopylSite Notice , � . : . . 1 • emo To: Finance Department From: Christine Mattson, Planning Assistant �^`� \ CC: Street File Date: 6/6/2012 G/L: 101-22205 Re: Building Permit Escrow Refund Building Permit #2010-00778 pertaining to 3300 Graham Hill Road is complete. The Applicant, Richard &Ann Murphy, has requested a refund of their$2,500 escrow. The following is attached: • All recent engineering review and inspections performed by Jesse Struve • Original signed escrow agreement • Copy of cash register receipt showing escrow amount received Mail to: Richard 8�Ann Murphy 3300 Graham Hill Road Long Lake, MN 55356 w:�,street files\graham hill road�3300\escrow refund memo 2010-00778.doc Christine Mattson From: Jesse Struve Sent: Wednesday, May 30, 2012 1:34 PM To: Christine Mattson Subject: 20120530 3300 Graham Hill Rd Christine, The applicant submitted approval plans from a registered engineer regarding the retaining wall. This is sufficient for closure of the permit. Jesse Struve, PE Director of Public Works/City Engineer City of Orono (952) 249-4661 - Direct (952) 249-4616- Fax www.ci.orono.mn.us 1 BUILDING PERMI g ESCROW AGREEMEN i�� j Orono Buildin Permit#2010-008�(� / v� AGREEMENT made this �� day of 1ev►1�� , 20� , b and between the CITY OF ORONO, a Minnesota municipal corporation ("City") and i[,h.9�.1 �f��/� ��7 ("Owners"). Recitals A �iJ mg permit application has been filed for an addition to the home located at �z,00 /I�he ("Subject Property"), legally described as Lot 7, Block 1, Abingdon Glen, Hennepin County Minnesota. 2. Owner requests the City to review this application. 3. The City will commence its review of the application and incur costs associated with said review only if the Owner establishes an escrow to ensure reimbursement to the City of its costs. NOW THEREFORE, THE PARTIES AGREE AS FOLLOWS: 1. DEPOSIT OF ESCROW FUNDS. Contemporaneously with the execution of this Escrow Agreement, the Owners shall deposit$2,500 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 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 2010-999�4 if compliance with the approved building permit is not accomplished. �-7'j� � � 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 the review has been completed and written notification is received from the Owners requesting the funds. 6. CERTIFY UNPAID CHARGES. If the project is abandoned by Owners, or if the eligible expenses incurred by the City exceed the amount in escrow, the City shall have the right to certify the unpaid balance to the subject property pursuant to Minn. Stat. §§415.01 and 366.012. CITY'.� CITY F , R: r " � �,i By: � �� i '� � ,� r i � Its: - - \ Internal Use Only: G Original to Finance Departrnent �Copy to Street File �" � - � �. File Tranca�tion _ R.eport�= _ _ _ . _ . _ _ �......_ �� ___.._.�. _. .. ___. ..._..�, ;, � x; � � � � F�� R�� "�r .,_.��i��rs .. �. ", � � # �� " ' ' r . ; t , . r .,� ,�.: w ....a. . � � y�, ' . . � , .... .. . t'.xp'R.?'a_ >. .a ... - , . .. � � . � � �.� E�e� , � �� ► ►�_ (� I �o�" P�r� � CI �� °;" � �-♦ — � ( Permit tt 2010-00778 _ _ _ _ _ PermitAddress: 3300 Graham Hill Rd � ` �"' Gener:�l I Fees ;.Ins�rections..�5}.:,Ilotes j Applicairt Detail � Ci]Detfiii ' ----�Fq �n�prction Typ? Inspector Date Status H Fee Rec ! — ► l-�� '��C» �2 Fr arning �,.��,��=18 1 n�<r'r101 i i F 'r` i i �3 FoureciV'Jall VVGIB 9l28�2010 P �J �� As-E�uift Survey tiJ��=1B 115�2011 P Y 0 �5 Final V'J�IB 12�Z1 t�C110 P 'r' 0 ►� 7'K Add I'1ew Oelete Checklist for Refunding Building Permit Escrows Building Permit # ��0 -�Z�� Street Address: �J?J� �I�O,,��CIVY} I� < < � Applicant Name: �i � 4— �1'WL � '-' �j� Escrow request received Date: ,Y�-- '�� . Permit Type: ' ��)� �-- Are all inspections completed? Ye No If not, list what is outstanding: Was there a Temporary Certificate of Occupancy issued . Yes No Date: 0 " b �0 �� Was there a Final Certificate of Occupancy issued? Yes No Date: ��4'— �� As-built survey required? Yes, approved on ,�� 2' °� NO NA �-�f z-' `��u�'C� ❑ Email CK & Bonestroo to see if there is any unbilled WIP. Date email sent: ❑ Prepare memo for Finance Department z:\forms�zoning standard forms\checklist for refunding building permit escrows.doc Last Updated: 10-31-2011