HomeMy WebLinkAbout2012-01090 - zoning permit CITY OF ORONO * 2 0 1 2 — 0 1 0 9 0 *.
� 2750 KELLEY PARKWAY DATE ISSUED: 1U06/2012
, ORONO,MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 3534 IVY PL
PIN : 20-117-23-42-0019
LEGAL DESC : TAYLORS SUBD OF SPRING PARK LO
: LOT 000 BLOCK 000
PERMIT TYPE : ZONING PERMIT
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : LAND ALTERATION(501+CU YDS)
NOTE: $AMOUNT TO BE DETERMINED BY CUP-SB COLLECTED IN ESCROW FEE
* PRIOR TO ESCROW RELEASE,FINAL INSPECTION TO BE PERFORMED AND APPROVED BY CITY ENGINEER (INITIAL)
ACTUAL ESCROW FEE AMOUNT COLLECTED $2,000
HOW DID THEY PAY? CHECK# 1241
ESCROW PERMIT#:(DON'T FORGET TO ENTER) 2012-01091
ESCROW FEE FOR: EROSION CONTROL&ENGINEERING REVIEW COSTS
APPLICANT MAJOR LAND ALTERATION 50.00
WILSON,RAY&TAMMY ENGINEERING REVIEW COSTS
3534 IVY PL
WAYZATA,MN 55391- TOTAL 50.00
PAID WITH CC# 7469
OWNER
WILSON,RAY&TAMMY
3534 IVY PL
WAYZATA,MN 55391-
AGREEMENT AND SWORI�i STATEMENT
The work for which this permit is issued shall be perfortned according to
the approved plans and specifications,applicable City approvals,and the
State Building Code. This permit is for only the work described and does
not grant permission for additional or related work which requires separ�te
permits. All provisions of laws and ordinances governing this type of work
shall be compied with whether or not specified herein.This permit will
expire and become null and void if construction authorized is not
commenced within 180 days of the date of issuance,or if construction is
suspended r a period of 180 days at any time after work has commenced.
The icant responsible for assuri all required inspections aze
r uested in co formance with the te Building Code.This permit may be
evoked at or e caus
c'� / / /1/ � / / '�
' e �gnature Date " I ed By Signature Date
�`" SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
� �
ti��� o�
City of Orono �� � � �
Zoning Permit A lication
Mailing Address: Permit number: ��� "d l� 9�
�Q� PO Box 66 Date received: /�'oZ-(o"�OZ.
O O Crystal Bay, MN 55323-0066 Escrow#and
Street Address: amount: d�� �� �Q ��
� � 2750 Kelley Parkway Permit Fee: a� O � ��
�� p� Orono, MN 55356
.�.�x0.�y,w Approved by:
Fax: 952-249-4616 Notes:
Main: 952-249-4600 `h^rvw•ci.orono.mn.us
This application form must be completed in full and all r quired information must be submitted_ (Please prinf.)
Job Site Address: Vv
CONTRACTOR/APPLICANT INFORMATION:
Name: A S S u.GE,c� �}S P.�.�-G T '
Phone: �'S'Z, �!' Q.�/Z Fax:
Address: 7�¢0 ���,p��,4 �`',�,4/G City:L"�(,R.r/�S.S�-,!/ZIP: SS3/��
Contact Person: ,j�,��c� /L.s�S E.� Contact's phone /2 �f' .st��, 2� ��
Email N/q- Applicant is: Contractor Homeowner (Clrcle One)
PROPERTY OWNER INFORMATION:
Name: �Ry W!<Sa.t/
Phone(day): �0 2 SSO �,�2 8
Mailing Address: ,s' �� GE ZIP:
Email and/or Fax fZ�Psvit�sCyt/ j)Eto�7T�r-, ca�
Overall Project Description: ,�i1iv,�tiv��
CBoxk TYPE OF PERMIT COST*
Dock, Residential—Permanent dock on any lake or initial seasonal dock not on $50+engineering review costs
Lake Minnetonka ermanent dock re uires CUP
Dock,Commercial $50+engineering review costs
Escrow for erosion control and en ineerin review costs $2,000
Driveway Permit(New or Replacement) No charge
Also re uired is a Minor or Ma'or Land Alteration Permit
Land Alteration, Major(grading,filling, or excavating) more 500 cubic yards or $50
more than 10 cubic yards in lakeshore setback (also requires CUP)
Escrow for erosion control and en ineerin review costs As determined b CUP
Land Alte�ation, Minor(grading,filling or excavating)—500 or less cubic yards $50+engineering review costs
outside of lakeshore setback or less than 10 yards in lakeshore setback
Escrow for erosion control and en ineerin review costs $2,000
Retaining Wall measuring under four feet require a zoning permit. $50+engineering review costs
Retaining walls measuring more than four feet(from bottom of footings to top of
wall)require a building permit. (Tiered retaining walls are considered one wall
unless the walls are separated by twice the height of the lower wall.)
Escrow for erosion control and en ineerin review costs $2,500
Stairway to Lake(New or Replacement) $50+engineering review costs
Escrow for erosion control and engineering review costs $2,000
Structure Permit for other structures not requiring a building permit but $50+engineering review costs
regulated by the zoning code(including, but not limited to accessory building of
less than 120 square feet,detached deck or platform and sport court)
Escrow for erosion control and en ineerin review costs $2,500
Tree Removal or other ve etation removal in 0 to 75 foot zone No char e.
(over)
*Permit fee will be collected at
the time the permit is issued.
Updated: April 23,2012
APPLICANT/OWNER ACKNOWLEDGEMENT: � �'
• ApplicanUOwner agrees to provide all information required or requested by the Planning Department;
• Owner agrees to pay the City of Orono for engineering consultant review costs where applicable;
• ApplicanUOwner 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;
• Applicant acknowledges the attached �scrow Agreement is completed and signed by Owner;
• ApplicanUOwner understands their project may require an initial and as-built survey per City Code Section 86-68.
• 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
overnmental a encies re uired b law. If ou refuse to su I the information,the a lication ma not be issued.
The undersigned certify that th ' tion plied is true orrect to the best of their knowledge.
.1� �
Applicant's Signature: Date: �4���/.�
Property Owner's Signature: Date: `����Z
SUBMISSION REQUIREMENTS: Except for tree removal permits, all permits
TYPE OF PERMIT: require a completed application form,escrow agreement(signed by the property
owner) and escrow check from owner, two copies of all plans, and three copies
of all grading plans or surveys/site plans �
Dock, Residential Seasonal Dock—survey showing proposed dock
Permanent Dock-plans as approved by CUP and copy of LMCD permit
Dock,Commercial 1. Structural plans for the dock
2. Survey showing the proposed location of the dock
3. Copy of LMCD permit
Driveway Permit 1. All Minor or Major Land Alteration Permit requirements
2. Hardcover calculations, existing and proposed
3. Driveway plans
Land Alteration, Major 1. Plans as approved by Conditional Use Permit
2. Erosion control plan or copy of MCWD Erosion Control Permit
Land Alteration,Minor 1. Grading plan including existing and proposed contours
(Less than 10 cu.yds.within 75'of 2. Amount of fill to be imported and/or exported and haul route
lake or less than 501 cu.yds 3. Amount of earth to be moved around on site
elsewhere.) 4. Erosion control plan or copy of MCWD Erosion Control Permit
Retaining Wall 1. Plans for wall(s)
2. Unless repair or exact replacement of existing wall, submit an updated survey with.
grading plan including existing and proposed contours �
3. Hardcover calculation worksheets if in shoreland district
4. Erosion control lan or co of MCWD Erosion Control Permit
Stairway to Lake 1. Construction plans for stairway, including footings
2. Topographical survey of property with proposed stairs shown
3. Erosion control plan or copy of MCWD Erosion Control Permit
Structure Permit 1. Plans for structure.
2. Survey of property with proposed structure shown and with setbacks to property
lines, other structures on property and the septic system indicated.The general
location of any sewer and water services should be shown if applicable.
3. Grading plan if grading is required
4. Hardcover calculation worksheets if in shoreland district
5. Erosion control lan or co of MCWD Erosion Control Permit
Tree Removal Call: 952-249-4600 to schedule a single tree removal inspection. A re-planting plan/
mana ement lan re uired for Gear cuttin ,buckthorn or other intensive ve etation removal.
Updated: April 23,2012
.
' � Plan Review Checklist for Zoning Permit Applications
Address ������ �� �
Description of work: � �����
Type of permit: ��l.l, ' ��v��-1 (�1� �� Q t,� q-- l���'� LQ�
.
Zoning review by: Date Approved: t � � z--� �Z---
Grading review by: � Date Approved: � � ` Z.J
Other Review, Reviewed by: Date Approved:
Zonin :
Zoning File#: Resolution#: Resolution Date:
Lot Area: SF/AC Width: Depth:
Survey Submitted? Yes � No Date of Survey: �� - C� _I �,
l
Existin Setbacks:
Front(Lake) Rear(Street) ( N S E W ) ( N S E W ) Other Buildings Wetland
Side Side
Pro osed Setbacks:
Front(Lake) Rear(Street) ( N S E W ) ( N S E W ) Other Buildings Wetland
Side Side
Shoreland District MCWD Permit Received Average Lakeshore Setback Met? Bluff
0 Yes � No 0 N/A � Yes o
�Yes � No � Yes ❑ No /A
Permit Number: Setback:
Hardcover Zones Existin Proposed Variance Requir CUP Required
0-75' ❑ Yes No 0 Yes No
75-25���' 21 �U '� Z C�� TYPe�s)� TYpe(s)_
. �
250-500' Zoning File#: Zoning File#:
500-1000' Resolution#: Resolution#:
Created: March 29,2011
z:\forms\plan review checklist for zoning permit applications.docx
.
Planning Review Checklist for Zoning Permit Applications +
Page 2 of2
Cubic Yards
In Out Total
Haul Route? ? � Yes � No
Explain haul route in detail:
Fees to be Charged Amount Orono Inspections Required
Permit Amount r''_.,("'�� p Site
�.1`}�
Escrow Amount -� ❑ Hardcover Removal
❑ Footing
Signed escrow received? 0 Poured Wall
� As-Built Survey
p�es � No � Planting Plan
� � Wetland
Escrow amount received? inal
� Other (specify)
Yes 0 No
Engineering'review needed?
�es � No
.
REMARKS (in-house):
Other Review: Reviewed by: Date Approved:
�-
M KS (TO BE NOTED ON PERMIT AND INITIALLED � Y PERSON PULLING ERMIT) �
� � .�� - � � �' �;� � ,'l�_
�-� �►� ID� � l�-��.
Created: March 29, 2011
z:\forms\plan review checklist for zoning permit applications.docx
DATE TIME �
CITY OF ORONO CALLED IN
INSPECTION NOTICE (� SCHEDULED
PERMIT NO. ��CI �-��IO`l� COMPLETED I " I 7'L�
ADDRESS J.��' I�� I�IC.�.0�
OWNER TELEPHONE NO.
CONTRACTOR
�: DESCRIPTION �. -�` L
�
� ❑ FOOTING ❑ PLUMBING FIN L ❑ EXCAV/GRAD /FILLING
Q O POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS
y ❑ FRAMING ❑ MECHANICAL FINAL
Q ❑ 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
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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W ❑WORK 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
INSPECTOR WILL RETl1RN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspec ' 24 hours in advance. �95Z� Z49-4600
OwnerlContracto�si e:
/
Inspector. ��+'
White Copyllnspector's File Canary CopylSite Notice
MPERVIOU COVERAGE SURVEY ~for� Ray Wilson - 3534 Ivy Piace, Orono, MN 55391
I S NORTH
HARD CO I/ER AREA (0 — 75 FT. ZONE,�
ST,4/RS/WALK TO LAKE = 120 SQ. FT � ��I i
TOTAL HARD COl/ER = 120 SQ. FT. ^ �, �, W �, c ���� �,���, � I
N AR Y AREA TO OHW = 7 767 S . FT. _'_ ' � \, � . .� W a �:� � -�-- �HW= � ,I
TO TAL BOU D ( � , Q , . " � '`�` _ _ I �`
PERCENT HARD COl/ER = 1.5� � '� 1 �` �` : ` ?y~^ `^
` .,
q6 IVY P�H�pUSE I � , I '
35ppJACF`R.955. ��o l ' : ��Q?': . . ' .:i � ' '. ' �
9�-y' 9cj`l:�1 GAR. 03' �: 1�'`���'`:.`. .`..`,:: 1
.................��......., ,� �
�. ,.,. �
9 :: � . . ... .. :.;: :
� �, , o . �. �• .
HARD COI/ER AREA �75-250 FT. ZONE� . ......��������� :
956.. ......., �. � �
. ��• I o I �
. • .
g5'/..',' � . '. i::::i'��'�' _ �
HOUSE & A TTA CHED GARA GE = 3, 145 SQ. FT. •�� �� � � � . '
�56 •33 9 LOT i 1 '7"7 : :: :� �
COl/ERED PORCH = 115 SQ. FT. �� 578 . 49 `w,.-'`:'" �Z � o � I ,
� : � �0: : `.'' ;: W,� :
4 S E A S O N P O R C H = 1 8 8 S Q. F T. � -' �• � �oN�. S T o o P=,s S Q..F T. I N I
� $LbC(t,N1AL4- � �, •:� ; :.; ::::; o . :
� ' EXISTING DRIVEWAY a` ��
C O I V C R E T E W A L K & S T O O P = 1 4 0 S Q. F T. 956.6 939 SQ. FT. oN �OT � 44.3 . �5 S � 1� � '� P ' �{I- E D G E O F W A T E R, A S
GRA l/EL ORl l/E = 939 SQ. FT. , ,..._ . '. � '25.4 ,9 ' �` ::: : � :�-- W I LAKE EL�E ATTEION�o 9217.9
;;�, : _ p � '', ,0 A'i�i:r''� r Z ` I
�9 „ HOUSE & ATTACHED GARAGE � s�; � �� . S ,qf � I
— 24:> � � N , 0 .
TOTAL HARD COl/ER 4 527 SQ. FT. , 'j�>';�:::<<� U, �9 g � �N
� e . . i�'sT�` 3,145 SQ. FT � o
,;���7'4�`r:�:.`-�:.':':�•-'?.° � .ST I
S09 » 0 E '�` :,�::.; J � �
75 TO 250 AREA = 14� �59 SQ. FT ���- , AR. FLR=958.8 ;o � -�- � , . �
� FFE= 949.9 i ; :
:_�t �: R �/'. ��Ib�'.
PERCEN T HARD CO l/ER = 32. 0� 24 4 J ' �? '6.Z � WA�S:& - ` `:�`. � �
�, _ � _ o �> I �
S STAIRS 12Q SQ FT.� � ]
q 9 'r 1 CONCRETE WALK- 5 6.1 w �
OSo �
��� '•,��,��".. I 124 SQ. FT. � FE= 960.4 / f m I I � �
TO TAL EXISTING HARD CO l/ER AREA EN TIRE L O T '���� PROPOSED ADDITIONAL DR� • ` J9.2 ?o , h� p o � > o � I �
� 187 sq. ft. / � . COVERED �ni , ' �' I
�Z : : : : . :
....- ;� / �� PORCH=115 SQ..FT. � � (, ' • �� ` I
.
HOUSE & A TTACHED GAR,4GE = 3, 145 SQ. FT. :- �( ;.5/ ,� `, � LOT: : : : :'1:'�;$��
� -''� ` �'. ........ ...... a : = I': :. :� 9 "�`l'. i i . �,/i�: I
CO l/ERED PORCH = 115 SQ. FT. -( `', o tiyo ::: ;� �
�, i _ ' � ' .1'�
4 SEA SON PORCH = 188 SQ. FT. � :;; co�� ' � 9�� ... ��� .. �... �"i 33:oi . I . N? �'`� `. I I
CONCRETE WALK & STOOP = 140 SQ. FT. . �"� w �' A.� ,. . �ti° �h� ��� �� I �
STAIRS/WALK TO LAKE = 120 SQ. FT. � �` `� ` �� � �� ` � ` � �
GRA l/EL DRl l/E = 939 SQ. FT. � �: A' . 5'� ' ��� `� ` � ` � �
zz ^ r
/ �� � :
a � ...��''�� _,- ; -;�� �� � �C'�� ��R�NO
TO TAL EXISTING HARD CO l/ER = 4,647 SQ. FT. ��m , •� ��� `�s� `. '� :% ' � • ' W— 9 9�4 ' 1 �
�` �SITE PL�
�,48 �3 .E �'�•�.. �_ �,' .�GRADING P AN ;
TO TAL BOUNDAR Y AREA = 21,926 SQ. FT. TO OHW .9b9"�'•• 1�'---, N8 9S SS) 956 .' o�i �
�7 APPROVED
PERCEN T EXIS TING HA RD CO l/ER = 2�.2� '.....�+� 95,'.. e ❑ APPROVED WITH RE NS �
❑ DlSAPPR
1�1 .�� FFE_9 3532�E PHOUSE BY
TO TAL PROPOSED HARD CO I/ER AREA EN TIRE L O T pD�P .���
-�
_ �m� DATE �� a ,a .
T O T A L E X I S T I N G H A R D C O l/E R — 4,6 4 7 S Q. F T. � � � - -:.�.�. ..:�,�.... ..,..�r..�.. �
f ADDI TIONAL PROPOSED ORl l/E BIT= �87 SQ FT ', ��2' \P NER �0� 18 0 "" � �"
�SW �oR �.958.2
TOTAL PROPOSED HARD CO l/ER = 4,834 SQ. FT. �AR
TO TA L BOUNDA R Y A REA = 21,926 SQ. FT To oH w L o t �77 an d L o t 178, TA YL OR'S SUBDI I/lSIOIV OF SPRIIV G PA RK L O TS,
PERCENT PROPOSEO HARD CO�ER = 22. 0� and situated in the County of Hennepin, State of Minnesoto.
NOTES Scale 1 "= 30 ' Drawn By: KDN Project Manager: JER �ob No.: 12523AB
— Field survey completed by E.G. Rud and Sons o� October �, 20,�. o Denotes Iron Set i, Denotes Iron Found Bearings shown are on an assumed datum.
- m�s survey Was prepared W�tno�t tne benefit of t�tie work. Additional easements, / he�eby certify that this pl�n, survey or report was prepared by me or under my
restrictions and/or encumbrances may exist other than those shown hereon. Survey subject direct SUPe/'VlSlO/� and thot l am a duly Reqistered Land Surveyor under the IdWS
to revision upon receipt of a current title commitment or an attorneys title opinion.
of the State of Minnesota. Dated this 17th day of October , 2012. �T1°" Professional Land Surveyors
— The purpose of this survey was to determine as—built impervious coverage. The %0/17/12: ADD PROPOSED DRII/EW,4Y 6776 LAKE DR. NE SUITE 110
boundary shown is based on a survey done by EGAN, FIELD & NOWAK INC. dated October www.egrud.com .
zoo5 and found monumentation. LlCEnSE NO. 4�S7B LINO LAKES, MN 55014
Tel:651-361-8200
- , . , ��L.. O1p0�� 177,178
;� � r�ii�l� (� Af�\ 17nr��i� 1`��,>�AR� 1'���'?�laR d�l(' T1'� �I��i�i 1(1 /17 /'�(11'� q� �,'�� 1h i��il U�I��,f,� P�)F i,�� ,
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. •
. • • � •
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emo
To: Finance Department
Frorr�: Christine Mattson, Planning Assistant
CC: Street File �
Date: 1/18/2013 �����
GIL: 101-22205
Re: Zoning Permit Escrow Refund
Zoning Permit #2012-01090 pertaining to 3534 Ivy Place is complete. The Applicant,
Ray Wilson, has requested a refund of his$2,000 escrow.
All engineering review was performed in house.
The following is attached:
• Escrow Refund Request
• Original signed escrow agreement
• Copy of cash register receipt showing escrow amount received
Mail to: Ray Wilson
3534 Ivy Place
Wayzata, MN 55391
w:�street files�ivy place�3534 ivy place(capra)�escrow refund memo 2012-01090.doc
Christine Mattson
From: Wilson, Ray(US- Minneapolis)[rawilson@deloitte.com]
Sent: Monday, December 31, 2012 11:01 AM
To: Christine Mattson
Cc: Melanie Curtis
Subject: RE: 3534 Ivy Place Escrow Agreement-Zoning Permit w Erosion Control 2012-01090
Chris
Can you please refund my escrow
Thanks
Ray
From: Christine Mattson (mailto:CMattsonCalci.orono.mn.us]
Sent: Monday, October 29, 2012 9:27 AM
To: Wilson, Ray(US - Minneapolis)
Cc: Mefanie Curtis
Subject: RE: 3534 Ivy Place Escrow Agreement-Zoning Permit w Erosion Control 2012-01090
Great...thank you.
From: Wilson, Ray(US - Minneapolis) [mailto:rawilsonCa�deloitte.coml
Sent: Monday, October 29, 2012 9:27 AM
To: Christine Mattson
Cc: Melanie Curtis
Subject: RE: 3534 Ivy Place Escrow Agreement-Zoning Permit w Erosion Control 2012-01090
I mailed it this morning
From: Christine Mattson [mailto:CMattson@ci.orono.mn.us]
Sent: Monday, October 29, 2012 8:45 AM
To: Wilson, Ray(US - Minneapolis)
Cc: Melanie Curtis
Subject: 3534 Ivy Place Escrow Agreement- Zoning Permit w Erosion Control 2012-01090
Ray,
We have received your zoning permit for minor land alteration/driveway changes. The escrow agreement
submitted had a watermark"sample" stamped on it. Please sign the attached escrow agreement and return to
me at your earliest convenience.
Thank you.
Christine Matfson
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 � 8 952.249.4616
1
�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: Monday, November 12,2012
*****Any tax advice included in this written or electronic communication was not intended or
written to be used, and it cannot be used by the taxpayer, for the purpose of avoiding any
penalties that may be imposed on the taxpayer by any governmental taxing authority or
agency*****
This message (including any attachments) contains confidential information intended for a
specific individual and purpose, and is protected by law. If you are not the intended recipient,
you should delete this message and any disclosure, copying, or distribution of this message, or
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v.T.i
2
'
ZONING PERMIT ESCROW AGREEMENT
Permit#2012-01090
AGREEMENT made this ��day of �r�g�i� , 20!y by and between the CITY OF ORONO,
a Minnesota municipal corporation ("City") and Ray Wilson ("Owners").
Recitals
1. A zoning permit application has been filed for a property located at 3534 Ivy Place the ("Subject
Property"), legally described as Lot 177 and Lot 178 Taylor's Subdivision of Spring Park Lots and situated in the
County of Hennepin, State of Minnesota.
2. Owner requests the City to review this application.
3. The City will commence its review of the application and incur costs associated with said review
only if the Owner establishes an escrow to ensure reimbursement to the City of its costs.
NOW THEREFORE,THE PARTIES AGREE AS FOLLOWS:
1. DEPOSIT OF ESCROW FUNDS. Contemporaneously with the execution of this Escrow
Agreement, the Owners shall deposit$2,000 with the City. All accrued interest, if any, shall be paid to the City to
reimburse the City for its cost in administering the escrow account.
2. PURPOSE OF ESCROW. The purpose of the escrow is to guarantee reimbursement to the City
for all out-of-pocket costs the City has incurred (including planning, engineering 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 zoning 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 permit#2012-01090 if compliance with the approved zoning permit is not accomplished.
3. MONTHLY BILLING. As the City receives consultant bills for incuRed 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.
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� ' " � ' CITY OF ORONO * z 0 1 z - 0 1 0 9 1 *
� ° 2750 KELLEY PARKWAY DATE ISSUED: 10/26/2012
ORONO,MN 55356-
(952) 249-4600 FAX: (952)249-4616
ADDRESS : 3534 IVY PL
PIN : 20-117-23-42-0019
LEGAL DESC : TAYLORS SUBD OF SPRING PARK LO
: LOT 000 BLOCK 000
PERMIT TYPE : ESCROW FEE-APPLICANT
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ESCROW FEE-APPLICANT
NOTE: THIS$2,000 ESCROW IS TIED TO BUILDING PERMIT 2012-01090 FOR A DRIVEWAY PERMIT/LAND ALTERATION.
APPLICANT ESCROW FEE-APPLICANT 2,000.00
WILSON,RAY&TAMMY ESCROW FEE-DEVELOPER 0.00
3534 IVY PL
WAYZATA,MN 55391- TOTAL 2,000.00
OWNER
WILSON,RAY&TAMMY
3534 IVY PL
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 additional o�related work which requires separate
permits. All provisions of laws and ordinances governing this type of work
shall be compied with whether or not specified herein.This permit will
expire and become null and void if construction authorized is not
commenced within 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.