HomeMy WebLinkAbout2015-00480 - zoning permit • CITY OF ORONO * 2 0 1 5 — 0 0 4 8 0 *
� 2750 KELLEY PARKWAY DATE ISSUED: OS/0]/2015
` ORONO, MN 55356-
952 249-4600 FAX: 952 249-4616
ADDRESS : 3640 JACOBS MILL RD
PIN : 32-118-23-24-0010
LEGAL DESC : JACOBS MILL
: LOT 004 BLOCK 001
PERMIT TYPE : ZONING PERMIT
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : STRUCTURE PERMIT
NOTE: (DRIVEWAY PILLARS)
APPLICANT STRUCTURE PERMIT 50.00
TOTAL 50.00
HOFFMAN,KEITH&MARY Payment(s)
3640 JACOBS MILL RD CHECK 8495 50.00
LONG LAKE,MN 55356-
OWNER
HOFFMAN,KEITH&MARY
3640 JACOBS MILL RD
LONG LAKE,MN 55356-
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 dces
not grant permission for additional 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 conswction 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.
'I'he 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. `�%'"
� � l I�-�'� '�-i � i
Applicant Permitee Sigr►ature Date Issued By Signature Date
� City of Orono
� � Zoning Permit Application
O Mailing Address: Permit number: �� �— ��b �
� �O PO Box 66
Crystal Bay, MN 55323-0066 Date received: ��
Escrow#and Q � � Z o �j.,L�� I
Street Address: amount: � '(
2750 Kelley Parkway Permit Fe�:�� ��
y ` Orono, MN 55356
� G
�, Approved by:
t�kESHO� Fax: 952-249-4616
Main: 952-249-4600 Notes: ��. `> •- 1 - I�_�
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wwtiv.ci.orono.mn.us
This application form must be completed in full and all required information must be submitted. (P/ease print.)
Job Site Address: �j(��L}� .J�(��� (�Z��Zc� ��' `�'
CONTRACTOR/APPLICANT INFORMATION:
Name: �.�-'���,,1
Phone: (o�Z- � ,`� - 3 0� Fax:
Address: ���U ��('Gt�S lYIiII 12iJc��' � City: c:.`��ne ZIP: SS�S �
Contact Person: --C�x�i� Contact's phone number �;,,L. zGt g-s��,rS-
Email Applicant is: Contractor Homeowner (Circle One)
PROPERTY OWNER INFORMATION:
�� 4'1�1C�, !1
Name: 1(..�.�i-V� � � ���C�
Phone (day): (�12- � ��� �o�3`f
Mailing Address: (��y(;� �,/�(��j�5 �'��� � I U f} _ ZIP: j� � S (..�3
Email and/or Fax
Overall Project Description: "[���,p�,�� �i 1� � �/ ���-�J-� —'�
/ J
�BoXk TYPE OF PERMIT COST*
Dock, Commercial $50+ engineering review costs
Escrow for erosion control and engineerin review costs $2,000
Dock, Residential - Permanent dock on any lake or initial seasonal dock not $50 + engineering review costs
on Lake Minnetonka permanent dock requires CUP
Hardcover Permit: Driveway, Patio, Sidewalk, etc. (New or Replacement) No charge
Also requires is a Minor or Major
Land Alteration Permit
Land Alteration, Major(grading, filling, or excavating) more 500 cubic yards $50
or more than 10 cubic yards in lakeshore setback (also requires CUP)
Escrow for erosion control and engineering review costs As determined b CUP
Land Alteration, Minor(grading, filling or excavating)-500 or less cubic $50+ engineering review costs
yards 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 engineerin review costs $2,500
Stairway or Lifts 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 engineerin review costs $2,500
Tree Removal or other vegetation removal in 0 to 75 foot zone No char e. Pre-inspection required.
Temporar Construction OfficelTrailer(associated with buildin permit) $30
(over)
*Permit fee will be collected when the permit is issued.
Updated: January 2015
APPLICANTIOWNER 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
altemative but to reject it until it is.complete;
. Applicant acknowledges the attached Escrow 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 govemmental agencies required by law. If
ou refuse to su I the information,the a lication ma not be issued.
The undersigned certify that the information supplied is true and correct to the best of their knowledge.
Applicant's Signature: Date:
Property Owner's Signature: Date:
SUBMISSION REQUIREMENTS: Except for tree removal permits, all permits require a completed
TYPE OF PERMIT: 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, Commercial 1. Structural plans for the dock
2. Survey showing the proposed location of the dock
3. Copy of LMCD permit
DoCk, Residential Seasonal Dock—survey showing proposed dock
Permanent Dock—plans as approved by CUP and copy of LMCD permit(if applicable)
Hardcover Permit 1. All Minor or Major Land Alteration Permit requirements apply as appropriate
2. Hardcover calculations,existing and proposed
3. Survey
Land Alteration, Major 1. Survey/grading plan including existing and proposed contours as approved by Conditional Use Permit
2. Erosion control plan.
3. A copy of Minnehaha Creek Watershed District(MCWD)permits or documentation from the MCWD stating the
proposed project does not trigger any of their permitting requirements. Please note,the City will not issue a
buildin ermit without information from the MCWD.
Land Alteration, Minor 1. Survey/grading plan including existing and proposed contours
(Less than 10 cu.yds. 2• Amount of fill to be imported and/or exported and haul route
within 75'of lake or less 3. Amount of earth to be moved around on site
than 501 cu.yds 4. Erosion control plan.
elsewhere.) 5. A copy of Minnehaha Creek Watershed District(MCWD)permits or documentation from the MCWD stating the
proposed project does not trigger any of their permitting requirements. Please note,the City will not issue a
buildin permit without information from the MCWD.
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 plan
5. A copy of Minnehaha Creek Watershed Distnct(MCWD)permits or documentation from the MCWD stating the
proposed project does not trigger any of their permitting requirements. Please note,the City will not issue a
buildin rmit without information from the MCWD.
Stairway or Lifts to 1. Construction plans for stairway or lift,including footings
Lake 2. Topographical survey of property with proposed stairs or lift shown
3. Erosion control plan
4. A copy of Minnehaha Creek Watershed District(MCWD)permits or documentation from the MCWD stating the
proposed project does not trigger any of their permitting requirements. Please note,the City will not issue a
buildin permit without information from the MCWD.
Structure Permit 1. Construction plans.
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 proposed.
4. Hardcover calculation worksheets
5. Erosion control plan.
6. A copy of Minnehaha Creek Watershed District(MCWD)permits or documentation from the MCWD stating the
proposed project does not trigger any of their permitting requirements. Please note,the City will not issue a
buildin permit without information from the MCWD.
Tree Removal Call: 952-249-4600 to schedule a single tree removal inspection. A re-planting p�an/erosion control/management plan
re uired for clear cuttin ,buckthom or other intensive ve etation removal.
Updated: January 2015
. PLAN REVIEW CHECKLIST FOR ZONING PERMIT APPLICATIONS
Address: �JIY� �(�LU �rl� �( 1�-� L-VIJ —W�0�
Description of work: ���V�... �(�u�.Q,�� `f� �-4' � "rJ
Type of permit:
Zoning review by: l ,�1�1� Date Approved: �'• 2.'I '#-�
Grading review by: N 1'� Date Approved:
Other Revi(w�, Reviewed by. � Date Approved: �- J� u� S
Zonin Information:
Zoning File#: Resolution#: Resolution Date:
Lot Area: SF/AC Width: Depth:
Survey Submitted? Yes 0 No Date of Survey: Revision date:
U f�l K.i'161N(�1
Existing Setbacks:
Front (L e) Rear(Street) ( N S E W ) ( N S E W ) Other Buildings Wetland
Side Side
I
Proposed Setbacks:
Front(�) 5, Rear(Street) ( N S E W ) ( N S E W ) Other Buildings Wetland
Side Side
� �
Shoreland District MCWD Permit Receive Average Lakeshore Setback Met? Bluff
� Yes � No N/A / 0 Yes No
0 Yes �No 0 Yes � No � N/A
Permit Number: Setback:
Stormwater Quality Existing Proposed Variance Required CUP Required
Overlay District Tier Hardcover Hardcover
� Yes No � Yes No
-- _.---____------- __..._.�___ TYPe�s)� TYPe�s)�
File# File#
Updated:January 2013
z:\forms\old stufflplan review checklist for zoning permit applications 2013.docx
Earth Movement-Cubic Yards
In Out Total
Haul Route? ? 0 Yes 0 No
Explain haul route in detail:
Fees to be Charged Amount Orono Inspections Required
Permit Fee Amount ���
� Site
Escrow Amount � Hardcover Removal
��� �d Footing
s
Escrow Agreement received? � oured Wall
0 As-Built Survey
�Yes � No � Planting Plan
0 Wetland Buffer
Escrow Money received? �Final
�Yes � No 0 Other(specify)
Engineering review needed?
0 Yes � No
REMARKS (in-house):
Other Review: Reviewed by: Date Approved:
�
\
� REMARKS (TO BE NOTED ON PERMIT AND INITIALLED BY PERSON PULLING PERMIT)
�
�
�
�
�-
Updated:January 2013
z:\forms\old stufflplan review checklist for zoning permit applications 2013.docx
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Christine Mattson
From: Tracy Gagnon [daisy_designs@comcast.net]
Sent: Friday, April 24, 2015 5:35 AM
To: Christine Mattson
Subject: Front view
Attachments: IMG_0745.JPG; ATT00001.txt
I have all info with me just waiting on association info. It is all staked out at house.
Thank you
i
Christine Mattson
From: Tracy Gagnon [daisy_designs@comcast.net]
Sent: Thursday, April 23, 2015 8:23 PM
To: Christine Mattson
Subject: Question
Christine
So I went out to my parents tonight and had to tell them the surprise and all was good except the length of wall
on pillar. They have 6 acres and 3 feet looks tiny. We really need 5 feet in proportion with the house. My Dad
says it's a private road and per the association this should not be a problem, he stated that he has documents
stating this? Please advise on this as I have all other items needed at your request. How do we get 5 feet
instead if 3?
Thank you
Tracy Gagnon
1
Christine Mattson
From: Lyle Oman
Sent: Tuesday, April 21, 2015 2:47 PM
To: Christine Mattson
Subject: FW: Pillars
Attachments: IMG_0846.JPG; ATT00001.txt
-----Original Message-----
From: Tracy Gagnon fmailto:daisv desiqns(c�comcast.netl
Sent: Tuesday, April 21, 2015 1:20 PM
To: Lyle Oman
Subject: Pillars
Lyle
I am doing some pillars for my parents and not understanding the permit instructions. The are 2 stationary
pillars 24x24 and 24x24 with a 5 foot swale. I have drawn them in on plan. These match all neighbors existing
pillars. Please let me know how to proceed and how much my family will owe for permit and what needs to be
inspected.
I appreciate all your help
Thank you
612-298-5445
1
lakes, 100 feet for recreational lakes, or 150 feet for natural environment lakes.
�` c. Special provisions. Split rail fences of no more than three rails within a required front,
street or side street yard may have a maximum top rail height of 48 inches above original
grade. Board rail fences within a front, street or side street yard for the specific purpose of
enclosing permitted domestic animals may have a top rail height of 60 inches and shall be no
more than 50 percent opaque.
d. lntersection sightline obstruction prohibited. No fence shall be installed so as to obstruct
a required clear view at street intersections as required by section 78-1371
e. Fence construction and maintenance.
1. The owner of a fence shall maintain it in a condition of reasonable repair and
appearance and shall not allow it to become or remain in disrepair or in a dangerous
condition.
2. Fences shall be installed with the finished side facing neighboring properties or the
street. The term "finished side" means that side having no structural supports.
(8) Entrance monuments, defined for the purpose of this section as a nearly permanent physical
structure or object, natural or artificial, used to depict an entrance to the property, erected in all
residential zoning districts are considered nonencroachments when they conform with the
following standards:
a. Each monument, with a maximum of two per approved driveway access, shall be limited
� to a single pillar with a footprint measuring no larger than 25 square feet and no length to
C exceed �ve feet;
b. The monument must be setback a minimum of five feet from all property boundaries
and never fewer than ten feet from the edge of the paved, traveled roadway;
c. Plans and/or elevation views of the proposed monuments are required to be submitted
for approval by the planning director;
d. All signage proposed for the monuments must comply with section 78-1467
e. The monuments are limited to eight feet in height including any appurtenances. Any
monument exceeding the maximum height must meet principal structure setback
requirements;
f. When more than one monument is proposed, and serving two or fewer residences, a
minimum horizontal width of 16 feet is required between them;
g. When more than one monument is proposed, and serving three or more residences, a
minimum horizontal width of 22 feet is required befinreen them;
h. Lighting is allowed, in conformance with section 78-1573 and at the discretion of the
planning director.
i. When a gate is proposed, the following requirements must be met:
1. The gate must open into the property not outward towards the right-of-way, and
� 2. Gates serving two or fewer residences shall have a minimum horizontal width of 14
'�- feet in the full open position, and
3. Gates serving three or more residences shall have a minimum horizontal width of
20 feet in the full open position, and
4. For all properties, gate height may not exceed the height of the monument,
measured from grade, unless principal structure setbacks are met (if monuments are
� not proposed then gate height shall be regulated in accordance with the fence height
regulations of section 78-1405(7), and
5. Gates must maintain an opacity level of no greater than 25 percent, and
6. For locked and/or secured gates a knox box, meeting the standards set forth by
the police and fire department, must be provided for emergency access, and
7. On major thoroughfares the monuments and gates must be located 40 feet from
the paved, traveled road to allow for vehicle stacking. A major thoroughfare for the
purposes of this section means any county road or state highway.
j. A building permit is required for installation. A survey must be submitted depicting
where the monuments will be placed, and the property corner pins must be located for
inspection purposes.
(Code 1984, § 10.03(15); Ord. No. 211 2nd series, §§ 1-5, 11-26-2001; Ord. No. 12 3rd series, § 1, 5-
24-2004; Ord. No. 30 3rd series, § 1, 11-28-2005; Ord. No. 43 3rd series, § 1
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DATE TIME �
CITY OF ORONO CALLED IN
INSPECTION NOTICE �y� SCHEDULED
PERMR NO. �D`5-O'D�O COMPLEfED '' "'
ADDRESS ��'� •��'t'`�'�=� ����� �'•
OWNER TELEPHONE NO.
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>`, DESCRIPTION � G r
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Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING
O ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL
Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION
Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ PROGRESS
� ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT
� ❑ FINAL ❑ WATEF HOOK-UP ❑ FOLLOW-UP
W ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ HARD COVER REMOVAL
J ❑ DEMO-SITE ❑ SEPTIC INSTALL ❑ FOUNDATION/REMOVAL
2 OWNERICONTRACTOR TO MEET YOU:_YES_NO
v�i COMMENTS:
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0 �CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECdA/ERING PERMANENT
O CORRECTUNSAFECONDITIONWffHIN HOURS. p pHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (952) 249-46�0
OwnerlContractor on site:
Inspector:
White Copyllnspector's FNe Canary CopylSite Notiee
��. y�;
' �1 I
DATE TIME
CITY OF ORONO CALLED IN
INSPECTION N T���, � �HEDULED �
PERMIT NO. c MPLET�
ADDRESS �
OWNER � TELEPHONE NO.
CONTRACTOR ��
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W OOTING ❑ D -FINAL SEPTIC FINAL
Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING
Q ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL
Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION
Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ PROGRESS
� ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT
Q ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP
W ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ HARD COVER REMOVAL
J ❑ DEMO-SITE ❑ SEPTIC INSTALL ❑ FOUNDATION/REMOVAL
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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V BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ pHOTO TAKEN
INSPECTOR WILL REfURN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Ca11 for the next inspection 24 hours in advance. (g52) 249-4600
OwnerlContractor on site:
Inspector.
White Copyllnspector's Ffle Cenary CopylSite Notice
� � � TE TI
CITY OF ORONO CALLED IN ' l
INSPECTION NOTI SCHEDULED - //— /
PERMIT N � PLETED �_
ADDRESS �"✓
OWNER �HONE NO o '� �5
CONTRACT R �
� DESCRIPTION .7�/�'I l�f' �l L Q�S
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Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING
Q ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL
Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION
i ❑ F ING ❑ MECHANICAL FINAL ❑ PROGRESS
� SULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT
� FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP
= BUILT-SURVEY ❑ SEWER HOOK-UP ❑ HARD COVER REMOVAL
J ❑ DEMO-SITE ❑ SEPTIC INSTALL ❑ FOUNDATION/REMOVAL
2 OWNERICONTRACTOR TO MEET Y�OU:_YE3_NO
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V BEFORECObERING PERMANENT
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INSPECTOR WILL REfURN
O STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
O INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspectron 24 hours in advar�ce. 249-46��
OwnedContraator on site:
Inspector:
White CopyAnapector's File Cenary CopylSite Notiee
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emo
To: Finance Department
From: Christine Mattson, Planning Assistant�,M
CC: Street File
tJ�' '
Date: June 17, 2015 �
G/L: 101-22205
Re: Escrow Refund
Zoning Permit#2015-00480 pertaining to 3640 Jacobs Mill Road is complete. Please refund
$2,500 to the applicant, Keith &Mary Hoffman.
The following is attached:
• Original signed escrow agreement
• Copy of cash register receipt showing escrow amount received
Mail to: Keith&Mary Hoffman
3640 Jacobs Mills Rd
Long Lake, MN 55356
w:lstreet filesyacobs mill yd�3640\escrow refund memo 2015-00480.docac
LAND USE APPLICATION ESCROW AGREEMENT
Application � -O
AGREEMENT made this�day of � , 20 (✓ , by and between the CITY OF
ORONO, a Minnesota municipal cor'oration ("City") d_I1Ad��
[a corporation—optionaQ ("Owners").
Recitals
1. Owners have filed Land Use Application# formally requesting the City to review plans
for the property addressed: (the "Subject Property") legally
described as LOh 4� �
2. Owners request the City to review said plans which requires City approval and may require
consulting legal and/or engineering review.
3. The City is willing to commence its review of the application and incur costs associated with said
review only if the Owners establish an escrow to ensure reimbursement to the City of its costs.
NOW THEREFORE,THE PARTIES AGREE AS FOLLOWS:
1. DEPOSIT OF ESCROW FUNDS. Contemporaneously with the execution of this Escrow
Agreement, the Owners shall deposit$�_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 meeting with the Owners, reviewing the plans, and preparing agenda packet material for City Council
review of Land Use Application # 11htS�00430 Eligible expenses shall be consistent with expenses the Owners
would be responsible for under a land use application.
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 cease all reviews until the Owners pay all
expenses invoiced pursuant to #3. The City may draw from the escrow account without further approval of the
Owners to reimburse the City for eligible expenses the City has incurred.
5. CLOSING ESCROW. The Balance on deposit in the escrow, if any, shall be returned to the
Owners when all requirements related to the project are complete. City Staff shall review the terms of this escrow
agreement two times per year to determine whether the requirements of the project have been successfully
completed and whether it is appropriate to return the funds. Owner may also request the release of the funds,
and such funds shall be released upon City Staff receiving the appropriate verification that all requirements of the
project have been successfully completed.
6. CERTIFY UNPAID CHARGES. If the project is abandoned by Owners, or if the eligible expenses
incurred by the City exceed the amount in escrow, the City shall have the right to certify the unpaid balance to the
subject property pursuant to Minn. Stat. §§415.01 and 366.012.
CITY: CITY OF ORONO OWNERS:
By: l�rlQ�lltil� By. �
.
Its: 6 �'�L�l �, Its
�. � �, , �. >.
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,:. � � : �� � ��������� � � ���
.. _. __ --.� _ �� �,.:�.���`��.�.�����+.�i. '������.��, r �
Updated: January 2015
� � CITY OF ORONO * 2 0 1 5 - PJ 0 5 PJ 1 *
' 2750 KELLEY PARKWAY DATE ISSUED: 04/29/2015
ORONO,NIN 55356-
952 Z49-4600 FAX: 952 249-4616
ADDRESS : 3640 JACOBS MII.,L RD
PIN : 32-118-23-24-0010
LEGAL DESC : JACOBS MILL
: LOT 004 BLOCK 001
PERMIT TYPE : ESCROW FEE-APPLICANT
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ESCROW FEE-APPLICANT
NOTE: TEIIS 52500 ESCROW IS T�D TO LAND USE APPLICATON 2015-00480
APPLICANT ESCROW FEE-APPLICANT 2,500.00
ESCROW FEE-DEVELOPER 0.00
HOFFMAN,KEITH&MARY
3640 JACOBS MII.,L RD TOTAL 2,500.00
LONG LAKE,MN 55356- Payment(s)
CHECK 8495 2,500.00
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� Cit"y of drono
� 2750 Ke11'ey Parkway
Orono MN 55356 952-249-4600
OWNER Receipt No: 3.013254 Apr 24. 2015
HOFFMAN,KEITH&MARY ,
3640 JACOBS MII,L RD ' 364u Jacobs Mi 11 Rd
LONG LAKE,MN 55356- ' Previous Balance: .00
, Permits
' Zoning Permit 50.00
; 101-32520
Zoning Permit
AGREEMENT AND SWORN STATEMENT Permits
Escrow 2,500.00
The work for which this permit is issued shall be performed according to 101-22205
the approved plans and specifications,appticable City approvals,and the Deferred Rev-Developer Deposi t
State Building Code. This permit is for only the work described and dces '-"---"""'-
not gant peratission for addidonal or related work which requires sepazau � TOt21: 2,550.00
---------------
pemuts. All provisions of laws and ordinances goveming this type of work ------"'---"-
shall be compied with whether or not specified herein.'This permit will Check ,
expire and become null and void if construction authoriud is not Pey�♦No: $495 2,550.00
commenced within 180 days of the date of issuance,or if wnstruction is 3640 Jacobs M i 11 Rd
suspended for a period of 180 days at any time after work has commenced. To ta 1 App 1 i ed: 2,550.00
The applicant is responsible for assuring all required inspecdons are ' ---------------
requested in confo�mance wi�h me Scace Building Code.This permic may be � Change Tendered: .00 �
rovoked at any time for due cause. --°'-'-'O°-°-
Duplicate Coey
� 04/29/2015 07:35AM
/ /
Applicant Permitee Signature Date Issued By Signature Date
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Add New Delets
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Christine Mattson
From: Tracy Gagnon [daisy_designs@comcast.net] �'�Q�JQ,(� � ( � I`-d"
Sent: Thursday, June 11, 2015 8:10 PM
To: Christine Mattson
Subject: Check
Christine �
We got final today. Do I need to bring to you to get my Dad a refund check.
Thank you
Tracy Gagnon
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