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Home My WebLink About2011-00010 - new structure � CITY OF ORONO PERm�T No.: 2oii-000io , 2750 KELLEY PARKWAY . ORONO, MN 55356- �ATE �ssUE�: OU2U2011 952 249-4600 FAX: 952 249-4616 ___, � ADDRESS . 155 M��t1VNON DR �'�Cl� � �'`l i 1`1��1 `� b�e= C. !� � PIN : 32-118-23-43-0016 LEGAL DESC : KINTYRE TWO : LOT 2 BLOCK 1 PERMIT TYPE : NEW STRUCTURE PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : SINGLE FAMILY ACTIVITY : 101-SINGLE FAMILY HOUSES, DETACHED VALUATION : $ 600,000.00 NO"CF_: SFPERATL PGRMITS RGQUIRLD: PLUMI3ING. MECI IANICAL, SEP"CIC, I'IREPLACG, LnWN [RR[GA"fION. WELL(STnTG), GLEC"fRICAL(STA�I�F) PLAN RGVILW WAS PAID VIA CK#12�24 ON PERMI'I�#201 1-0001 1 IN THE AMOUN'C OP$2,�71.89 ESCROW F6E PAID V►A CK#5319(BY HOMEOWNER: ROLL)ON PE[ZMIT#2011-00012 IN TI-IE AMOUN"I�Ol�$2,500.00 CITY�I�G�,��OMMEN"CS IN I-19-201 I MGMO REGARDING RF,TA[NING WALL DGSIGN AND CONSTRUC"110N SHOULD BE � NOTED. ' .. (INITIAL) APPLICAI�IT PERMIT FEE SCHEDULE 3,956.75 KYLE HUNT& PARTNERS INC. STATE SURCHARGE(VA[,UATION) 300.00 18324 MINNETONKA BLVD DEEPHAVEN, MN 55391- TOTAL 4,256.75 ' (952)476-5999 Minnesota Stafe License#: BC- 1967 OWNER ROLL&JACQUELINE WILLIAMS-ROLL, MICHAEL 75 FERNDALE RD N WAYZATA, MN 55391- AGREEMENT AND SWORN STATEMENT The work lix��hich this permit is issued shall be performed according to the approved plans and specifications,applicable City approvals,and the State[3uilding Code. This permit is for only the�vork described and does not erant permission for additional or rclated work which requires separatc permits. AII provisions of laws and ordinances governin�this type ofwork � shall be compied�viUi whether or not spe cificd hercin.'('his permit��ill expire and hccome null and void if construction authonzed is not commcnced within 180 days of the date of issuance,or if construction is suspended ibr a period of 180 days at any timc atter work has commenced. ; The applicant is responsiblc for assuring all required inspections are requcsted in conformance with thc State[3uilding Code.This permit may be � revc �t am� une f due cause. ��'��e.Q� 1 ��Z i � ( � � � � Applicant Pcrmitee Signature � Date Issued By Si �ature Datc SEPARATE PERMITS REQUIRED FOR WORK OTHER AN DESCRIE3ED ABOV . . � � l� � ' City of Orono 1�� Building Permit Application � for New Structures or Additions ,,e-.t:,s Mailing Address: a� �� - � Permit number: ;�D� "DUG 1 p ��-,�,;i� � �,��\� PO Box 66 , �� Crystal Bay, MN 55323-0066 Date received: J Z ^'��C� � �� :_ �� ,, , � a (�r� __ a;� Street Address:' Received by: �'�� r:�>�� G k (L j✓c'� `A � Z, 4' ` F, � �i 7/-'�S \\LF�u��2��Gti� 2750 Kelley Parkway ni C,�� a� Plan reviewfee: Z �y] � 9k E 9 H�� Orono, MN 55356 t� -- 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: �� mc�c:-K � r��%4'� �e ° Job Site Address: � �- '�. $�pCk �..� 1�l Tv I`�, � C.a.'Q -3at��a3� bo� I� Will this be a Parade of Fiomes, emodelers howcas Home or other Display Home? ❑ Yes ❑ No (�-�^$� If yes, a special event permif is required with Police Department and City Council approva160 days prior to the event Shuttle bus service will be required unless applicant demonstrates su�cient on-site parking is available. Non-permitted events will not be allowed. CONTRACTOR/APPLICANT INF RMATI N: Name: u �' � � f`� ,(� State License# Expirat'yon Date: Phone: Q � - office V � 6 - yl�� cell Mailing Address: �' /�,t 0 Cit : t ��✓� ZIP: Contact Person: (p {,n/� qr ,�V� ,q/�, �pp icant is: Contractor / Homeowner (Circle One) Email and/or Fax: (y �,/�I1. 1` ,� � yq Q/� il1(, �. PROPERTY OWNER INFORMATION: n M �Q I Name: 3� U�.�(. � �A1`1�� S 'iCO�� d" V�ti1 C�f�,Gl,(.` Y��'1 Phone(day): � . (p- / � Address: 30a.3. � 0 �„q�, Cit : ZIP:�'J~J'�3S�p Email and/or Fax (` ARCHITECT/ ENGINEER I FORM TIO ` r Name: ��U�, 171�0(j Phone(day): (� � - 5 ,y� Address: (��,,, { , � S� Cit :1'11 nM��0�1� ZI P:5'rJ 3�� Email and/or Fax: D� tJ` irl'l!. �,'�S4f C 4 GC . CD PROJECT INFORMATION: 1. Type of Project 2. Proposed Use 3.Structure Type 4. Sewage Disposal& Water Supply � New Construction �„Single Family with f�„Residence ❑Addition attached garage ❑ Garage/Accessory Bldg. ❑ Public Sewer ❑Accessory Building ❑ Single Family with ❑ Deck C�� ❑ Relocation detached garage ❑ Office/Commercial � Private Sewer �`'r ❑ 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) ❑ Other:(speCify) 18202 Minnetonka Blvd Deephaven,MN 55391 Phone: 952-471-0590 Fax: 952-471-0682 www.m innehahacreek.or Estimated Construction Valuation (excluding land) $ � — STRUCTURE INFORMATION: 1.Structure Dimensions 1. Structure Dimensions(continued) 2.Type of Construction a. Length(ft.)= � Number of bedrooms= � �Wood/Frame ❑ Masonry b.Width(ft.)= �� Number of rage stalis: ❑ Metal Attached =� ❑ Pole Bldg. Areas in square feet Detached= -- ❑ ICF � ,,�-,r� ❑ On-site Prefab c. Basement= ��`'�� ❑ Off-site Prefab d. 1 S�Story = e�.� ❑ Other(please specify): e. 2"d Story= �_�� f. Yz Story = f g.Total Area= � REQUIRED SUBMITTALS: All of the information must be submitted in order for your application to be processed: Not Enclosed A licable � ❑ Permit A 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 -�C t � SS,pIIV� ❑ Access Permit 1 ❑ � Wetland Buffer Im rovement Plan ❑ En ineered Plans for Retainin Walls 4 feet or above 1,4(. ❑ Plan Review Fee ❑ � Other APPLICANT ACKNOWLEDGEMENT: • Agrees to provide all information required or requested by the Building Department; • Agrees to pay the City of Oro�o 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: ��+�'y� �� Plan Review Checklist for New Structures / Additions Address/PID/Legal: _ �� N d��l�f �'f� Description of work: /"�� 71��i� Septic review by: � Date Approved: �"�� r`� Zoning review by: Date Approved: f �f/� Building review by: Date Approved: / � Z �– 1 ) Grading review by: Date Approved: ��V`—`� r " Zoning File#: Resolution#: Resolution Date: Zonin District Fire De artment Post Office School District � Zoning: Lot Ar a: � � S AC Width: �� Depth: Survey Submitted: Yes 0 No Date of Survey: , ��__� (� Pro osed Setbacks: ro (Lake) Rear(Street) N S E W ) ( N S E W ) Other Buildings Wetland Side Si e i �� . Building Defined Height: .�� Building Peak Height: � #of Stories Ok?: YES FOR A BUILDING WITH A BASEMENT OR CRAWL SPACE: b 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 comice 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-rype or other arch- e roof roof SUBTRA� half the distance between the highest window and SUBTRACT half the distance between the highest window hi hest roof eak of a itched roof and hi hest roof eak of a itched roof SUBTRACT the distance between the basement floor/crawl ADD the distance between the slab and the highest � space floor and the highest existing grade within existin rade within the foundation the foundation or 10 feet,whichever is less. EQUALS Defined buildin hei ht EQUAL + efined buildin hei ht Lot Coverage: SF % Shoreland istrict CWD Permit Received Avera e Lakeshore Set ck Bluff Yes � No 0 N/A � Yes o 0 Yes o O Yes 0 No N/A P rmit Number: — Setback: Hardcover Zones Existin Pro osed Variance u' ed CUP Re ire 0-75' 0 Yes No 0 Yes No 75-250' Type(s): Type(s): 250-500' 500-1000' REMARKS (in-house): Updated: 09/11/2009 z:\forms�plan review checklist.docx Fees to be Char ed YES NO , Permit �,/ , Plan Review State Surcharge Investigation Fee SAC ,-Num6e�of SAC ilnits Sewer Connection Water.Connection Park Fee � Site Inspection Other(specify) Miscellaneo�s Fees Calculated By: S uare Foota e $ er S uare Foota e Basement X = $ 1� Floor X = $ 2nd FIOOt' X = $ Garage X = $ Estimated Construction Value: $ �Ol��(7(�0 i0� Orono Inspections Required Work Requiring Separate Permits Required State Permits � Site Plumbing 0 Grading/ Filling � Well 0 Hardcover Removal Mechanical � Fire �Electrical �ooting ,0'Septic 0 Water Connection �Poured Wall �ireplace � Sewer Connection Foundation Survey 0 Masonry �f Lawn Irrigation Radon Rock Bed � Mfg. �Framing 0 Other(specify) � Insulation s-Built Survey � inal � Other(specify) REMARKS (in-house): -�aV�Jltil.� � � � I'�i� � l��l.(�iN� Other Review: Reviewed by: Date Approved: Access:Existing: � YES 0 NO New: � YES 0 NO REMARKS (TO BE NOTED ON PERMIT AND INITIALLED BY PERSON PULLING PERMIT) Ct fVl GY�.aI�� ry'��'S I.n l"I�!-I I i'h�n0 ��e�ro<<�'wl h'�rn.i r� I MGZ!I S i�-Y, 9p Gav� S-�-rt�r.tum S 6H,1 a� la vla�}-e� • Updated: 09/11/2009 z:\forms\plan review checklist.docx � 1 �� WATER RESOURCE PERMIT APPLICATION—COMBINED JOINT NOTIFICATION FORM Use this form to notify/apply to the Minnehaha Creek Watershed District(MCWD),their engineering consultants,and the DNR of a proposed project or work which may fall within their jurisdiction.These agencies should advise you of their jurisdiction or permit requirements within 10 days.Fill out this form completely and mail with your site plan,maps,etc...to the MC�VD, 18202 Minnetonka Boulevard,Deephaven,MN 55391.Keep a copy for your records. YOU MUST OBTAIN ALL REQUIRED AUTHORIZATIONS BEFORE BEGINNING WORK. 1.Property Owner Name(Firs Las �!, Ip � IA� 1 t 1 u✓+'lS Mailing Address:3O,.a. C � City: f�t q, State:�� Zip:rj Email Address: ' Ma Phone: � —4 Fax: h 2. Location of ro osed ro� ttach ma with directions to site : ProjectAddress: �.p� ��J��Q� 1,�iV►'�L1�`L .� City: ) � ' � County:�C1�f1,t iV� Qtr Section(s): Sec � n(s): Township(s): Ra ge(s): Lot: �__ Block: Subdivision: PID: 3 3. Size of site: .'3� Q,�,�� Area of disturbance: 7��Q square feet, or --- acres Volume of excavation (or fill):�� cubic yards Length of shoreline affected: feet Area of existing impervious surface: Area of proposed impervious surface: (�1 4.Type of permit being applied for(Check all that apply): � EROSION CONTROL ❑ WETLAND ALTERATION ❑ STORMWATER MANAGEMENT ❑WATERBODY CROSSING ❑ FLOODPLAIN ALTERATION �SHORELINE/STREAMBANK IMPROVEMENTS ❑ DREDGING ❑ OTHER(DESCRIBE): 5.Project Purpose(Check all that apply): � SINGLE FAMILY HOME ❑MLTI.TI FAMILY RESmENTIAL HOUSING (apartments,etc. COMMERCIAL CONSTRUCTION �INSTITUTIONAL CONSTRUCTION(churches,schools,etc.) ❑ ROAD CONSTRUCTION �SUBDNISIONS(include number of lots) ❑ UTILITIES �LANDSCAPING(pools,berms, etc.) ❑ DREDGING ❑SHORELINE STABILIZATION(lakescaping,bioengineering) ❑ OTHER(DESCRIBE): 6.NPDES/SDS General Stormwater Permit number(if a licable): 7.Altematives (Describe any other sites or methods that could be used to avoid or minimize impacts to water bodies to achieve the project purposed.Attach additional sheet if needed.) 8.Project Timeline: Start Date: Completion Date: �j M !) 9.Applicants Re resenta ive ic se contractor,engineer,etc...) � Business Name:� i� 11�,�'$�'�� Representative Name: (9�L ,n �t �A�db�(1 Business Address:� 3� iM4 �1 6trd( c�cy:t�uchavw� State:��%' Zip: 5$3g � Email Address: Phone: Fax: 10.Names and addr sses of djoining property owners (Attach list if necessary): �I a —�at,o.��' �� Permits have been applied: City�County ❑ MN Pollution Control Agency (�" DI�R ❑ COE_� Permits have been received: Cit ❑ Count ❑ MN Pollution Control A enc ❑ DNR ❑ COE ❑ I hereby notify the recipients of this fonn of the project proposed herein and request 1 be advised of any pennits��r other determinations concerning this project that 1 must obtain. I understand that proceeding with work before all required authorizations are obtain maybe subject to Federal,State and/or local administrative,civil and/or criminal penalties. i✓ i'i_..-�--� .(o��v Si nature of Propert Owner Date �1cr►n.HQr��4vu�� Kyltl�+�w►��Par�-�,�,�51 to�vl �"1 �h INSTRUCTIONS—PLEASE READ CAREFULLY A copy ofthis form,with copies of all plans,drawings,etc... may need to be sent to an agency indicated below... Please check the appropriate spaces below to show everywhere you are sending this form.Remember to keep a copy for your records. ❑ MINNESOTA POLLUTION CONTROL AGENCY(MPCA)for NPDES phase II permit �The LOCAL GOVERNMENTAL IJNIT(LGU), city, county or water management organization �MfNNESOTA DEPARTMENT OF NATURAL RESOURCES (MDNR)Regional Office 0 US ARMY CORPS OF ENGINEERS(ACOE)at Dept. of the Army,Cotps of Engineers, St. Paul District ATTN: CO-R, 190 Fifth St. East,St. Paul, NIN 55101-1638 Note:The above Agencies may provide a copy of your completed form to the Minnesota Pollution Control Agency(MPCA). MPCA water qualiry requirements may apply to your proposed project. ATTENTION(from USD.A):Any activity including drainage,dredging, filling,leveling or other manipulations, including maintenance, may affect a land user's eligibility for USDA benefits under the 1985 Food Security Act as amended.Check with your local USDA office to request and complete Form AD-1026 prior to initiating activity. Application is hereby made for a permit to authorize the activities described herein. 1 certify that 1 am familiar with MCWD Rules and that the proposed activity will be conducted in compliance with these Rules. 1 am familiar with the information contained in this application and,to the best of my knowledge and belief,all information is true, complete and accurate. 1 further certify that f possess the authority to undertake the proposed activity or 1 am acting as the duly autharized agent of the applicant. . �� a,��.� �a)ao �o Signature of Applicant(Property Owner) Date �gnature of Agent Date NOTE: The application must be signed by the property owner where the proposed activity is to occur.The application may be signed by a duly authorized agent if a letter bearing the original signature of the property owner is submitted stating that the agent noted in the permit application is the authorized agent of the landowner for all matters relating to the permit. Please provide authorized agent information below: Agent's Name&Title: ��c'�� — ��` � �1' ► PiV Agent's Address: ��SJ� 1'LI�IA$� �� V U�`�V 1� � ��_1�( Agent's Telephone: �) ��lp"��,� 18 U.S.C. Section 1001 provides that:Whoever, in any manner within jurisdiction of any department or agency of the United States knowingly and willfully falsifies,conceals or covers up by any fick,scheme,or device a material fact or makes any false, fictitious or fraudulent statements or representations or makes or uses any false writing document kno�Ning same to contain any false, fictitious,or fraudulent statement or entry, shall be fined not more than$10,000 or imprisoned not more than five years,or both. Page 2 of 2 . �� ;: ��' �� . 3a i 1 �a3�o o� l� N1101.8 Ccrtificatc r�I ` a\ Builders Name/Cornpany Date: t°� l�o,3� t� Site Address: �B� �� 1J I�C� �1 ��«��'�, � Contractor Name: a' � �", 'n l�S �+� License Number: � Location Type of Insfa//ed Type Location Size Insu/�tion R-Va/ue Makeup Air 5�� . Roof/Ceiling _ � W5 _ --- ____ ---- - ---- Combustion Air >> Walls • �!� q Water Heating � ,,.,. ..—�.= � $- - 51ab-on-Grade � ' -- ,� ' �� ;� � , __._ _ _� a uf`�� urer�',' ` ��:: �Morie/ '.. ��,`�� Floor ► � p � � ► a D,ucts Outside�of Conditioned'S aces'` Rim]oist � - ,;i ,,� �:, �� . � q Interior Exterior or Integral `LOC t/On' ` ' R-l� /u6 Foundation Wall p,�pX � —--- ' . Interior Exterior or Integral � Avera e U-Factor SHGC so/arfieat ain coe�cient Passive Active Fenestration , Radon Control ❑ T In ut Ratin AFU Manufacturer Mode/ Ca/cu/ated H at Loss Heating�stem p � O _ . � T Out ut Ratin SEER Manufacturer Mode/ Coo/in Load/Heat Gain Coolin S stem � s X O T e Ln ion Continuou Venti/ation Tota/I�enti/ation Mechanica{Ventilation ,_ b L t�.� .. -— ------ - t ATTIC INSULATION K�n�r� �-✓ �. Address: _ 1 S S ��,,,�,,� �._��,� Date: S� � � �� d �) [f��n v Signature of Installer T�pe of Insulation and R-Value in ceiling: ��r- Q Sc� Were energy trusses used: ��. , Square footage of attic: _ a.��c� Number of bags o€insulation used: �$ This must be place: �ext to the building card when completed.A second card must also be placed in the attic,near the scuttle hole. � � � � NORDIC INSULATION, INC. 1550 - 93rd Lane Blaine, Minnesota 55449 (763) 784-7893 DATE TIME � CITY OF ORONO CALLED IN INSPECTION NOTICE SCHEDULED PERMIT NO. COMPLETED � ( ADDRESS��__ 'i.'".0 � ��fil yr� LA OWNER TELEPHONE NO. CONTRACTOR >; DESCRIPTION � � ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILL�NG Q ❑ 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 � ❑ 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: a Z—� �l.f o -�U n�fi�v� �.�e�l ��- '' �w�,t�-i.�1 C�.vt �Gr r� � a � W � Q � Z W � W � j d W� ORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE W ❑ CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY � ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY � BEFORE COVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN INSPECTOR WlLL RETURN ❑ CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS. Call forthe next inspection 24 hours in advance. �952� 249-46QQ OwnerlContractor on site: tnspector. r_1°��L�� White Copyllnspector's File Canary CopylSite Notice � `� ��/� TE TIME � CITY OF ORONO CALLED IN /� ��/ INSPECTION NOTICE SCHEDULED � �,' �� 7/G� PERMIT NO. �'//'�� COMP F��o� _� j �_ ADDRESS � S� OWNER TELEP E NO. � � "� �� CONTRACTOR '�-� � t � f'[ , ,, � DESCRIPTION u-� � � ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS y ❑ FRAMING ❑ MECHANICAL FINAL ❑ 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 i ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL � OWNER/CONTRACTOH TO MEET YOU:_YES_NO � COMMENTS: � W a � J O �-- J , � , _ 'i Z� I O ✓�. o _. � W � Q � z W � W � � d W� WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY 0 ❑CORRECT WORK,CAIL FOR REINSPECTION TEMPORARY V BEFORE COVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pHOTO TAKEN �NSPECTOR WILL RETURN ❑CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Cal1 for the next inspection 24 hours in advance. (952� 24J-46�� OwnerlContractor on site• Inspector. /,1/ \ �� White Copyllnspector's File Canary CopylSite Notice �—�3 c� .__— DATE IME v CITY OF ORONO CALLED IN � a`7 �� INSPECTION NOTICE SCHEDULED �6 ' l�a,�i1, PERMIT NO.av�/-d00/v cc��T . /� �;_� ADDRESS_��5��✓ i'l.G� � OWNER T LE�iON NO.��"�� CONTRACTOR � � >; DESCRIPTION � � ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING Q OURED WALL ❑ MECHANICALRI ❑ LAKESHORENVETLANDS ❑ FRAMING ❑ MECHANICAL FINAL ❑ 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 J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL � OWNERICONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W 4 � � O � � o �; � r L> �,��. W � Q � 2 w � W � � � � (,�WORK SATISFACTORY:PROCEED C� PROJECT COMPLETE W ❑CORRECT WORK 8 PROCEED � ISSUE CERTIFICATE OF OCCUPANCY O ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITiONWITHIN HOURS. � pHOTOTAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED ❑ INSPECTIONREQUIRED.CALLTOARRANGEACCESS. Cail forthe next inspection 24 hours in advance. �QSZ� Z49-4600 OwnerlContractor on site: � Inspector. �' L` ��"'� White Copyllnspector's File Canary CopylSite Notice f�� (�} � DATE TIME � CITY OF ORONO DGD�� i � INSPECTION NOTICE SCHEDULE Z(�/1 ,��``t� PERMIT NO.c�(�; �� COMPLETED ADDRESS � �� I�i Vl��,/f� C /� OWNER TELEPHONE NO. � �a -��-�U7 j CONTRACTOR � �-'I�C' � C�-f'� f- �: DESCRIPTION � � � �/� l � , � � ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRAD G/FILLI��i�,y� Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS L y ❑ FRAMING ❑ MECHANICAL FINAL O ❑ TREE REMOVAL Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROC�RESS � ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT � ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP � ❑ DEMO-FINAL ❑ SEPTIC INSTALL F _ 'j �� , ❑ HARD COVER REMOVAL J ❑ PLUMBING RI ❑ SEPTI FINAL ��fJ'``� � ❑ FOUNDATION/REMOVAL � OWNER/CONTRACTOR TO MEET YOU:�ES_NO 1 �L � , � � j� �!� S � �/4'f7�G�� COMMENTS: a ��s .S ►Zt� c�A � �� ✓�`�! V�: �iC ��,r�c,c�� O >. _- /� ,� � .v / .� ( �G S /.1 ��v � O � Q � � ��.P>L�Cj r/ � �S ��e.2, �,jC�C��P G'� � Z � �� . <n, 6, l%rl�' S�� lvc� f-=� W � � '� j �. n �/UU� d W ❑WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE � �CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY W O ❑Ct�RRECT WORK,CALI FOR REINSPECTION TEMPORARY V BEFORECQVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pH0T0 TAKEN INSPECTOR WlLL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED O INSPECTION REQUIRED.CAL�TO ARRANGE ACCESS. Ca11 for the next inspection 24 hours in advance. (952� 249-4600 OwnerlContractor on si e: Inspector. �lJ V� �� White Copyllnspector's File Canary CopylSite Notice /"�^ D TIME � CITY OF ORONO CALLED IN � INSPECTIO�O�CEDOO�b SCHEDULED �� PERMIT NO. COMPLETED ADDRESS � �) /� � OWNER TELEPHO NO.[Q�Z- �� 077 CONTRACTOR �" � � DESCRIPTION � �� ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING Q ❑ 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 � ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP ? ❑ DEMO-FINA� ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL � OWNERICONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W C j O � � O � W � Q � Z W � W � � d `�, W��IORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE �� W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY 0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR ❑CITATION ISSUED ❑ INSPECTIONREQUIRED.CALLTOARRANGEACCESS. Cail for the next inspection 24 hours in advance. (g52) 249-4600 OwnerlContractor on site: Inspector. White Copyllnspector's File Canary CopylSite Notice ,� � V �l1, � TIME CITY OF ORONO �'CALLED IN � D00/D INSPECTION NOTIC SCHEDULED �� / ' `-�fl PERMIT NO. ` � OMPLETED ADDRESS ��> I� l Y1" (. OWNER TELEPHONE/N0. 9�a �� '�7 CONTRACTOR l'�-'�- -C� l�C Lu'7�' � DESCRIPTION �-��"�'�" l a"�� / �'>'�'��fliZi� � ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICALRI ❑ LAKESHORENVETLANDS 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. ❑ FOILOW-UP _ ❑ DEMO-FINAL ❑ SEPTIC INSTALI ❑ HARD COVER REMOVAL J ❑ PLUMBING RI ❑ SEPTI FINAL ❑ FOUNDATION/REMOVAL � OWNER/CONTRACTOH TO MEET YOU:�YES_NO � COMMENTS: � W 0. � O �' T a � L � O � W ac _ Q ti Z W � W � j d W ❑WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE � ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY W 0 �'CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V �EFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. ❑ pHOTOTAKEN INSPECTOR WlLL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR � CITATION ISSUED ❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS. Ca11 for the next inspection 24 hours in advance. (J52� 249-46�� n OwnerlContractor on site � Inspector. �` � White Copyllnspector's File Canary CopylSite Notice � � �� DATE TIME �/ CITY OF ORONO CALLED IN INSPECTION NOTICE SCHEDULED �-� � PERMIT NO.�U��—�UO/D . COMPLETED ADDRESS /JS ��%y�f'� (� OWNER �� TELEPHONE NO. ��Z 7�� 7 7 CONTRACTOR 6 . >; DESCRIPTION V/ — �`�� ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS y ❑ FRAMING ❑ MECHANICAL FINAL ❑ 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 v ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ F�NDATI N/ E Q OWNER/CONTRACTOR TO A�T YOU:_YES_NO � COMMENTS: �"t��C� �S`S JC� � dC��`� a t'Y�i� �/ C� �,, �t� I��tLA�� o <�' ldo ��C C c! �v (' 1 C�'cr� �4� � �rl��-t 1 -- T�2� � �'� ��! � �e � ( �}-�-�rc SC�,� �-/-e Q - �-s � �l�l [ rl'e., �—�Cces'S`�� 1e �Dl� z �A- 1�� L ��A c�v N �C��- ��-�`'d�J2 � � c��.�T�� v�r� tZ�rr � �� " P �� r� �U�� O W ❑WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE � ❑CORRECT WORK 8 PROCEED �LC�SSUE CERTI E OF OCCUPANCY W � ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY � BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN INSPECTOR WILL RETURN ❑ CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR � INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. �95Z� Z49-4600 Owner/Contractor on site: Inspector. ��.' /S.� White Copyllnspector's File Canary CopylSite Notice DATE TIME CITY OF ORONO CALLED IN INSPECTION NOTICE SCHEDULED /O-� PERMIT NO��//�•Y�� COMPLETED ADDRESS SS Y�, Q- OWNER TEL P ONE NO. CONTRACTOR �: DESCRIPTION ��f O � � ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICALRI ❑ LAKESHORENVETLANDS 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 i ❑ DEMO-FINAL O SEPTIC INSTALL ❑ HARD COVER REMOVAL J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL Z OWNER/CONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � a � � rr� �T S � c ;� i-� •� � � -� . ,S �r,`,� 0 � � ��1C'� � �-ft �� /r�.c' �, � l��c-'-:� ( 0 � '�'... � �<'�' �t ��t�1 ,� � Q � z W � W � � d W� ❑WORK SATISFACTORY:PROCEED �ROJECT COMPLETE W ❑CORRECT WORK&PROCEED ISSUE CEATIFICATE OF OCCUPANCY � ❑CORRECT WORK,CALL FOR REINSPECTION TEMP�.IRARY � BEFORE COVERING �---"� �� PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pHOTO TAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED ❑ INSPECTIONREQUIRED.CALLTOARRANGEACCESS. Call for the next inspection 24 hours in advance. (g52) 249-4600 OwnerlContractor on site: � '' CInspector__�,t�=�� White Copyllnspector's File Canary Copy/Site Notice ' . : • • � . emo To: Finance Department From: Christine Mattson, Planning Assistant CC: Street File Date: 5/21/2012 G/L: 101-22205 Re: Building Permit Escrow Refund Building Permit#2011-00010 pertaining to 155 Kintyre Lane is complete. Staff is requesting on behalf of the applicant, Michael Roll & Jacqueline Williams-Roll, a refund of their $2,500 escrow. The following is attached: • Email from Bonestroo indicating no unbilled WIP on this project • Email from Campbell Knutson indicating no unbilled WIP on this project • Original signed escrow agreement • Copy of cash register receipt showing escrow amount received Mail to: Michael Roll & Jacqueline Williams-Roll 155 Kintyre Lane Long Lake, MN 55356 �'.�1� !\[i-1;:.�t �'':'1�%t�:�' ' ��GP�° �a 3��s y`'�c—�{f�3—'tbUt� i � �'C'C:�1�)t �G� �u.<.�,�1�� 7d'ri ti!p �U��i �� i�;chdPl Roll � R2ar��ing �nd Zari:ng l5a Mau.i.nn��! �r� �',St�:.ufi � 10!-::��L'S� I �k'=iEY'Y`8� �8Y"'ia8Y8:tqGE'Y 11eRL751 y 1 .._�___.____._,_ I �� TOtal t � "��`r(�i.00 . :ck �;t:�+cl� h�r�: 531! 2,5t�U..C}� w:\street filesUcintyre lane(flca mackinnon dnve)\155\escrow refund memo: `�a3'��'° �9ir�rael Rai� i r�a1 Appl�ed: �,5f�.(� i Changp 7er,��re�: _ _. _ .�C► � V BUILDING PERMIT ESCROW AGREEMENT ` Orono Buiiding Permit# �� " d o C5 i O AGREEMENT made this�•a�`day of �r�� , 20�, by and � een t TY OF ORONO, a Minnesota municipal corporation("City") and�oi.lrG1A�L �bG Wt�1�t�lS�o(� ��1l�t� �A��("Owners"). Recitals 1. A building permit application has been filed for u� loca ed at � �J5 �'-K`��r'��" �2 • the ("Subject Property"), legally described as 0 � 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 etiminate 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 #�Olf—�j0/D if compliance with the approved building permit is not accomplished. 3. MONTHLY BILLING. As the City receives consultant bills for incurred costs, the City will in turn send a bill to the 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 retumed 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 OF ORONO OWNER: . By: �� :�l��— ,��0 �ts:��,� ,Cc..� � ..� . , � n , �. �� . . � . � �. _ Christine Mattson From: Darren Amundsen Sent: Wednesday, May 16, 2012 9:17 AM To: Christine Mattson Subject: RE: Unbilled WIP None for us __� _.._ _ _ _._ _�_ From: Christine Mattson [mailto:CMattson@ci.orono.mn.usl Sent: Monday, May 14, 2012 4:26 PM To: Amundsen, Darren; 'Sherry Charboneau' Subject: Unbilled WIP Hello, Any unbilled WIP for the foliowing? Zonin A lication Address W�P 11-3533 3980 Dahl Road O Buildin Permit 2011-00236 1265 Bracketts Point Road O 2011-00339 220 Wakefield Road O 2011-00417 1255 Dickenson Street O 2011-00448 2940 Fox Street O 2011-00010 f/k/a/155 MacKinnon, now 155 Kintyre O Lane Christine Mattson Planning Assistant City of Orono 2750 Kelly Parkway � Orono f MN ! 55356(physical address) PO Box 66 i Crystal Bay ; MN ; 55323-0066 (mailing address) '�i' 952.249.4620 i 8 952.249.4616 � cmattson@ci.orono.mn.us i � www.ci.orono.mn.us Office Hours: Monday- Friday 8 am to 4:30 pm Summer Office Hours begin Monday,May 21,2012 Monday-Thursday: 7:30 am to 5 pm/ Friday 7:30 am to 11:30 am OUR OFFICE WILL BE CLOSED: Monday, May 28,2012(Memorial DayJ i Christine Mattson From: Sherry Charboneau [SCharboneau@ck-law.com] Sent: Tuesday, May 15, 2012 10:53 AM To: Christine Mattson Subject: RE: Unbilled WIP Christine: No unbilled WIP on any of these for Campbell Knutson. Have a good day. Sherry Sherry L. Charboneau Legal Assistant CAMPBELL KNUTSON P.A. 1380 Corporate Center Curve•Suite 317•Eagan,MN 55121 '�'(651)234-6230• Fax:(651)452-5550 �scharboneau@ck-law.com•www.ck-law.com From: Christine Mattson �mailto:CMattson@ci.orono.mn.usl Sent: Monday, May 14, 2012 4:26 PM To: Darren Amundsen (darren.AmundsenCa�bonestroo.com); Sherry Charboneau Subject: Unbilled WIP Hello, Any unbilled WIP for the following? Zonin A lication Address 11-3533 3980 Dahl Road Buildin Permit 2011-00236 1265 Bracketts Point Road 2011-00339 220 Wakefield Road 2011-00417 1255 Dickenson Street 2011-00448 2940 Fox Street 2011-00010 f/k/a/155 MacKinnon, now 155 Kint re Lane Christine Maitson 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 : g 952.249.4616 � cmattson@ci.orono.mn.us ; � www.ci.orono.mn.us Office Hours: Monday-Friday 8 am to 4:30 pm i Checklist for Refunding Building Permit Escrows Building Permit # �O< <—OO�I� Street Address: I� IMGLC,�lnl�101�1 Ir1b1N �� ln�l'�- Applicant Name: ��QUPJId.I'� VVt �� 41V1- I'�� — M�� Escrow request received Date: l 1 �a-J� Permit Type: Are all inspections completed? es No � �� If not, list what is outstanding: Was there a Temporary Certificate of Occupancy issued? Yes No Date: Was there a Final Certificate of Occupancy issued? Yes No Date: Q'��- � ' �' � _��- � � �O As-built survey required? Yes, approved on NO NA ❑ Email CK & Bonestroo to see if there is any unbilled WIP. Date email sent: ❑ Prepare memo for Finance Department z:\formslzoning standard forms\checklist for refunding building permit escrows.doc Last Updated: 10.31-2011 }►- R�itWorks � „� File Transaction f•�,�air7tain Reports � �ecbaSe Prcpefi; Record ( � � D � £3 6 � Permit �� D � � � �« `t � ��.. . � .� �� .�D � �� O*M � �♦ .. '� Pe[mR#: 2fF11-0�'MfF1Q ,. -,:: �,dtireq� PeEm it Addr�sa: 155 Kir�tyre La �' �'-�,i1 �!r� %,c{d re�� _ Ra o General� Fees Inspections(9} ��$ � Applicant Detail� CO Qetsii� � !Seq�InspectionType ��Inspectorl aate �Status �H�Fee'Rec � _. � - ' ; • Z Footing WGIB 125JZ011 P Y 0 ; � . 3 Fo�ndation S�rrvey V1dGIB 2131ZQ11 P Y 0 r . 4 Poured Wall WGIB 1f281"1011 P Y 0 _ I . 5 Framing 1h'GIB 41Z6JZ011 P Y 0 � - 8 Insu.lation '14'GIB 5131Z011 P Y 0 ; . ? {1s-B�ilt Su�rvey V4'GIB 9f1412011 P Y 0 1 . 8 Final 'A'GIB 8116lZ011 P Y 0 , _- � . 9 Fireplace VW'GIB 5J512011 P 0 --� __ _--- - f � � 0 ? ►� � X Add New Delete . ,. ,, �;.