HomeMy WebLinkAbout2013-00233 - pool � t CITY OF ORONO
' � 2750 KELLEY PARKWAY * Z 0 1 3 - 0 0 Z 3 3 *
DATE ISSUED: 10/1ll2013
ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 75 LEAF ST
PIN : OS-117-23-11-0014
LEGAL DESC : GRAHAM HILL PRESERVE 3
: LOT 1 BLOCK 3
PERMIT TYPE : ACCESSORY STRUCTURE
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : POOL-IN GROUND
ACTIVITY : 329-STRUCTURES OTHER THAN BUILDINGS
VALUATION : $ 40,000.00
NOTE: SWIMMING POOL
NOTE: SEE CITY ENGINEERS COMMENTS AND INITIAI�(INITIAL)
NOTE: BUFFER AREA DISTURBED DURING CONSTRUCTIN TO BE RESTORED USING THE ATTACHED SEED MIX AND
ESTABISHED
PRIOR TO RELEASE OF ESCROW.��TNITIAL)
NOTE: AS-BUILT SURVEY TO BE SUBMITTED AND APPROVED PRIOR TO THE RELEASE OF ESCROW. _�7�NITIAL)
APPLICANT pERMIT FEE SCHEDULE 574.51
DOLPHIN POOL&SPA,INC. STATE SURCHARGE(VALUATION) 20.00
3405 N HWY 169
PLYMOUTH,MN 55441- TOTAL 594.51
(612)542-9000
Minnesota State License#:20266452
OWNER
KAPSNER,JASON&JULIE
75 LEAF ST
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 Ciry 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 separate
permits. All provisions of laws and ordinances goveming this type of work
shall be compied with whether or not specified herein.This permit will
expire and become null and void if construction authorized is not
commenced within 180 days of the date of issuance,or if construction is
suspended for a period of 180 days at any time after work has commenced.
The applicant is responsible for assuring all required inspections aze
requested in conformance with the State Building Code.This permit may be
revoked at any ti e c se.
` ��l/� l � /l�l // l /3
Applicant Pe ' e Signatu Date Issu By Signature Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
t �
� City of Orono - I� �
Buildin Permit A lication �I `��
�
J p p ..�
� for a Swimming Pool
O Mailing Address: Permit number: �J�� � �
�- �O PO Box 66
Crystal Bay, MN 55323-0066 Date received: '�-!D-/�
Street Address: Received by: �T
� � 2750 Kelley Parkway Plan review fee:
���� � g8/�
t,� ��,�' Orono, MN 55356 d���_p��3� �`L
KESH�
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. (P/ease print) � � ���
GENERAL INFORMATION: /���
Job Site Address: �jc` �y�� �.'
CONTRACTOR/APPLICANT INFORMATION:
Name: i�,. , i �,r�c -� �,a11 �:e.�c
State License# ��-���ySa Expiration Date: 3 �-3i-- �,$'
Phone: •763-��-9CY`..ty Fax: �� �,-T��-`'�c�i�
Address: �i Cit : i�k �rt�.,�if ZIP: ' �
Contact Person: �uit� av<„� Contact's phone number '�E,,3-;3t.v-��c�3
EmaiL �a��i��;�r p � �.; �,��1�Ct^�� CCSV�L�\ - Applicant is: Contractor Homeowner �c���ie o�e�
�
PROPERTY OWNER INF9RMATION:
Name: ��,ds,�,�,�
Phone (day): l�/�_ ;�:x./- �r6���
Mailing Address: r7 �c�. ZIP: -` - y-�
Email and/or Fax: Y� t�" •Y R•C. Y'v �
ENGINEER INFORMATION: .JU(I C.I�i1��YtQ��' P�'ti�- C.Q��'�1
Name:
Phone:
Address: City: ZIP:
Email: Fax:
PROJECT INFORMATION:
1. Pool Dimensions: 4.Accessory to: 5. Pool Type: 7. Retaining Walls?
�O X �v feet �Single Family ❑ Above ground ❑ yes �,no Height `
2. Heated? ❑ Multiple Family/Condo �In-ground 'A building permit is required
�yes ❑ no � Public for any wall over 4 feet in
❑ Other(specify) height measured from the
3. Excavated materials will be: ❑ Commercial bottom of the footing to the top
❑ Industrial of the wall, even if it replaces
❑ removed from site 6. Sewage Disposal & an existing wall.
�sed on site ❑ Other: (specify) Water Supply Tiered walls are considered
❑ Other: (specify) ❑ Public Sewer one wall unless they are
separated by twice the height
❑ Private Sewer of the higher wall.
Total Cubic Yards
❑ Public Water
❑ Private Well
Estimated Construction Value $
Last Updated: 3/1/2013
-7 -
, r �
REQUIRED SUBMITTALS: � �
All of the information must be submitted in order for your application to be processed:
Not
Enclos A `licab'!e �
❑ Permit A lication
❑ Plan Review Fee
❑ Pool Plans
0 Surve includes radin lan
❑ Hardcover Calculation Worksheets
❑ ❑ Erosion Control Plan or co of MCWD Permit
O ❑ Se tic S stem Certification
� ❑ O Wetland Buffer Im rovement Plan
O Escrow& Escrow A reement
❑ ❑ Other
❑ ❑ Other
❑ ❑ Other
❑ �
APPLICANT ACKNOWLEDGEMENT:
• Agrees to provide all information required or requested by the Planning& Building Departments;
• Understands, if applicable, an as-built survey and as-built hardcover cover calculations, are required to be submitted after the
project is complete(including final grading and landscaping)prior to refunding the escrow;
• 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;
• 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 permit may not be issued.
ApplicanYs Signature: ,,._ Date: � �� `��
i
Owner's Signature Date: '
� �����.�� ���,�����u� �������..��� ��� f����� ���������� � I?�4.�'�����'�'��
Address/P�rrr�it�umb�e: � ���� � �" i Y � �
Descrip�iior� ���or6�: ��`� �
Se�ti� redEe�r by: Date Appro��c�: L � r' � �
,` r, , / f r- , .
Zoning re�ie�v by: ° � D�fie Approvec�: •f��7
Builair�g re�iewr by: Date f�pprove�: ���� — ��3
GradEn� revievv by�: �t�r D�te Apprcvet�: 9 /
ZoniRg Di�tr6ct:��� Zoning Fiie�B: Reso#: Reso Qate:
Zoning: Lot Area: S /AC l�6icfth: l.oE C�verage: SF %
�urvey�ubmittec£: es � No Date�f Survey: 'B "� Revised date � :
Fro o�ecE Setb�cks: 4 c't �`�
Fr�nt( �) F�e�r��t? ( � S E 1�11 ) (� S E 1�iP ) Ofiher uiicfings lidet[aRd
tcEe Stc�e }�y,yv
�� � � � ��
a
Qe�ned He��ht: � � P ` k f�eight: ��� FFE: FFE mirtus 6 feet= (Ex t6n C r� e�f
Perime�er(iEr�ear feet) _ �0°�_ #of Sfarie� Qk? �YES
FOR A BUILDING WITH fn BASEfifiENT OR CRAVirt SPACE:
The dis#ance between the lowest FOR A BUILDIPIG ON A SLAB FOUPIDATIOPI:
START WITH proposed floor(of the basement or crawl
space)and the highest point of the roof. START WffH The distance between the top of siab and
If you have a...
Uie highest poir�t of the rooi.
If you have a...
• GABLE OR HIPPED ROOF(no . GABLE OR HIPPED ROOF(no
windows): Subtract half the windows): Subtract half ihe distanc
distance between the highest point between the Aighest point of the roc
of the roof to the low point of the
P��f to the low pant of the coRespondin�
SUBTRACTION cortesponding gable or hi SWBTRACTION " gable or hipped roof
(BASED ON ROOF . (`,ABLE OR HIPPED ROOF(with (BASED ON . GABLE OR HIPPED ROOF(with
TYPE) windows): Subtract half the ROOF TYPE) windows): Subtract half the distanc
distance betwee�the top of the between the top of the highest
highest window and the highest window and the highest poirrt of the
point of the roof roof
ALL OTHER ROOF TYPES(flat, • ALL OTHER ROOF TYPES(flet;
• mansard,etc):No subtraction. mansard etc:No subtraction.
ADDITION Add the distance between the top of slab
SUBTRACTION Subtract the distance between the (BASED ON and the hi hest existin
(BASED ON EXISTING �semenUcrawl spaoe floor and the EXISTIN6 the foundation. g g�de adjaceM tc
GRADES) highest e�usting grade adjacent to the GRADES
foundabon OR 10 feet(whichever is less). EQUALS Deflned building heigM
EQUALS Deflned building heigM
Shoretanci Distric� C1A/E3 Permit Received l�vera e Lakeshoce Setback�tiet? Biuff
Yes Q No � N/A 0 Yes No
Yes Q No �3 �� � Yes � No �A
Permit Number: .. Setback:
Stormwrater Quality Etti��ir�g P�rcpos�d W�r6ance t�equireef CUP Requireci
Oveel� �{�tftCt YE�P F�aK9cover Harcicover
� Yes No Q Xes No
4 � � � �' `�'� TYPe(S)� Type(s).
Updated: January 2013 .�
v:\forms�plan review checklist 2013.docx
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R�A�AF�KS (in-house):
Fe�s tc�b� Char ec� �E� ��
F�t'�'t� � �`
t�Ean Rev�e�► �
��e�ta�c��t�ge �-�''.
lnvestigatiarc Fe� �
�1�e�-h�umber mf��,C tis�� # '-
Other(specify) �`"�
S uare Foota e $ er S uare Foota e
Basement X - $
1�Fioor X = $
2"�Floor x $
Garage X - $
Estimated Constructfon Vmlueo S ��'i����
Orono Ir��pections Reqeeirec! V�ork Requiring Sep�rate Perrr�it� ReQ�ired State Per�ifs
� Site O Piumbing i� Grading/Filling 0 ell
� Hardcover Removal ,,�3"Mechanical � Fire Electrical
�Footing C� Septic � Water Connection
Q Poured Wall � Fireplace � Sewer Connection
C.� Feuc�d�tion Sunrey � Masonry C� Lawn Irrigation
C� Radon Rock Sed t� Mfg.
C] Framing CL Other(specify)
Q Insuiation
A�-Buitt S�rdey
�Final
C� Wetland Buffer
Q� Other(specify)
i �
REf�ARKS (in-house):
Other Review: t�e�ie�ed by: Dat�Approveti:
Acces�: Existing: E� YES � NO New: Q YES � NO
OFFIClAL REti�l�RKS -TO BE NO'�ED C�E� PERt�E{�'14ND [N[T4�E.LEQ
4 � � ��d � � � � �
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Jesse Struve �
From: Jesse Struve
Sent: Wednesday, September 25, 2013 10:50 AM
To: Melanie Curtis
Cc: Christine Mattson
Subject: 20130925 75 Leaf St#13-00233
Melanie,
I have reviewed the proposed pool location and am fine with what is being proposed, but the applicant should be aware
of:
1. The survey shows proposed walls extending right up to the existing buffer area. They will impact the buffer
during construction and will need to restore all impacts with approved seed mixture.
2. By installing the walls up to the buffer line,this will not allow for a mow able area next to the retaining wall
which may be problematic for the owners to maintain.
3. All retaining walls shown on the survey appear to meet the height requirements(below 4'). If any of the walls
are installed over 4'or any tiered walls which exceed 4' not separated by 2x the height,the applicant will be
required to have an engineer review and sign off on the walls.
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
C'hristine Mattson
From: Christine Mattson
Sent: Friday, September 27, 2013 11:53 AM
To: 'kgardner@mnpools.com'
Cc: Julie Kapsner; Melanie Curtis
Subject: 75 Leaf Street/ Pool Permit#2013-00233
Kevin,
We have the pool permit ready, but before we can issue it we need the property owner to submit a check for$2,500 for
the building permit escrow. lulie has already signed the escrow agreement we just need a check. Once we receive the
escrow money,we can issue the permit.
Please don't hesitate to contact me if you have any questions.
Christine Mattson
Planning Assistant
City of Orono
2750 Kelley Parkway Orono MN 55356 (physical addressJ
PO Box 66 Crystal Bay MN 55323-0066 (mailing addressJ
�° 952.249.4620 g 952.249.4616
�� cmattson@ci.orono.mn.us � www.ci.orono.mn.us
Office Hours: Monday- Friday 8 am to 4:30 pm
1
, ,
Christine Mattson
From: Christine Mattson
Sent: Friday, September 13, 2013 4:18 PM
To: 'Julie Kapsner'; 'Brian McCullough'; markg@gronbergassoc.com
Cc: Melanie Curtis
Subject: 75 Leaf Street/#2013-000233
City Engineer,Jesse Struve, has reviewed the survey dated 8-06-2013 which was received on August 28, 2013 and has
the following comments:
• All proposed retaining walls must have top of wall (TW) and bottom of wall (BW) labeled. The proposed
retaining walls are not labeled. Retaining walls over 4' must be engineered.
• The current layout shows retaining walls constructed right up to the wetland buffer edge. The way it is shown,
the contractor cannot construct the retaining walls without impacting the wetland buffer area. If they want to
do the work as shown,they will need to include a planting plan, and provide the proposed see mixture.
Please don't hesitate to contact us if you have any questions.
Christine Mattson
Planning Assistant
City of Orono
2750 Kelley Parkway Orono MN 55356 (physica/address)
PO Box 66 Crystal Bay MN 55323-0066 (mailing addressJ
� 952.249.4620 8 952.249.4616
�3 cmattson@ci.orono.mn.us � www.ci.orono.mn.us
Office Hours: Monday- Friday 8 am to 4:30 pm � �~ "�
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Jesse Struve
From: Jesse Struve
Sent: Tuesday, September 03, 2013 1:45 PM
To: Melanie Curtis
Cc: Christine Mattson
Subject: 20130903 75 Leaf S#13-00233
Melanie,
I reviewed the permit for the proposed pool at 75 Leaf St and have the following concerns:
1. It appears the location has drastically changed since the previous survey submittal. The new location is only
about 16.5' from the delineated wetland boundary. The required setback from wetlands is 35'.
2. All proposed retaining walls need to have the top of wall (TW)and bottom of wall (BW) labeled. The proposed
retaining walls are not labeled.
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
Christine Mattson
From: Christine Mattson
Sent: Monday, September 16, 2013 2:45 PM
To: 'Mark Gronberg'
Cc: Julie Kapsner; Brian McCullough; Melanie Curtis
Subject: RE: 75 Leaf Street/#2013-000233
Mark,
When you say later version, do you mean a survey dated after 8-6-13? If so,we do not have a copy of a survey dated
after 8-6-13, please provide two for us to review.
Thanks!
Christine�
From: Mark Gronberg [mailto:markg@gronbergassoc.com]
Sent: Friday, September 13, 2013 4:34 PM
To: Christine Mattson
Cc: Julie Kapsner; Brian McCullough; Melanie Curtis
Subject: Re: 75 Leaf Street/ #2013-000233
I am sure there is a later version of the survey that addressed these items.
Sent from my iPhone
On Sep 13, 2013, at 4:18 PM, Christine Mattson <CMattson@ci.orono.mn.us>wrote:
City Engineer,Jesse Struve, has reviewed the survey dated 8-06-2013 which was received on August 28,
2013 and has the following comments:
• All proposed retaining walls must have top of wall (TW) and bottom of wall (BW) labeled. The
proposed retaining walls are not labeled. Retaining walls over 4' must be engineered.
• The current layout shows retaining walls constructed right up to the wetland buffer edge. The
way it is shown,the contractor cannot construct the retaining walls without impacting the
wetland buffer area. If they want to do the work as shown, they will need to include a planting
plan, and provide the proposed see mixture.
Please don't hesitate to contact us if you have any questions.
Christine Matfson
Planning Assistant
City of Orono
2750 Kelley Parkway Orono MN 55356 (physical addressJ
PO Box 66 Crystal Bay MN 55323-0066 (mailing addressJ
�' 952.249.4620 � 952.249.4616
� cmattson@ci.orono.mn.us � www.ci.orono.mn.us
1
.
Christine Mattson
From: Christine Mattson
Sent: Thursday, June 27, 2013 2:24 PM
To: 'Julie Kapsner'
Cc: 'Mark Gronberg'; 'Brian McCullough'; Melanie Curtis
Subject: 75 Leaf Street/#2013-00233
Attachments: 13157 6-25-13.pdf
Julie,
Our engineer has reviewed the revised survey dated 6/25/13 and has the following comments. Please have your
surveyor address the comments and submit a revised survey for our review.
Please contact us with any questions, but note, Melanie and I are both out of the office tomorrow, returning on
Monday,July 1St.
Christine�
We have reviewed the revised plans that have been submitted for the proposed pool at 75 Leaf Street. According to the
plans,the circular portion of the pool deck will be approximately 1' above the ground elevation. Due to its proximity to
the 75' setback line, we recommend that additional information be provided as to how the grade transition will be
accomplished (i.e.grading, retaining wall,etc.)
�
� �
Christine Mattson
From: Melanie Curtis
Sent: Friday, June 21, 2013 9:35 AM
To: 'Julie Kapsner'
Cc: 'Mark Gronberg'; 'Brian McCullough'; Christine Mattson
Subject: RE: 75 leaf st, orono
Attachments: 75 Leaf Street, 2013-00233
Hi Julie
Our engineer reviewed your survey yesterday afternoon and provided the following comments:
1. It appears that a retaining wall will be required around the circular portion of the pool deck based on the proximity of the
972 contour.
2. It appears that a retaining wall will be required between the house and the pool deck near the northwest corner of the
house.
3. Proposed grades for the proposed walk need to be shown.
4. Existing elevations for the existing patio, concrete pad and building corners should be shown on the survey.
Please have your surveyor address the comments and once received (and verified) we should be able to issue the
permit. Willie Gibbs &the planning department (me) have already signed off on the permit. We will need the escrow
($2500) at the time of the permit issuance. You can drop that off at any time.
Thanks! Melanie
Melanie Curtis � 952.249.4627 � mcurtisC�ci.orono.mn.us
From: Julie Kapsner [mailto:juliekapsnerCa>me.com]
Sent: Thursday, June 20, 2013 5:11 PM
To: Melanie Curtis; Christine Mattson
Subject: Fwd: 75 leaf st, orono
Hi Christine and Melanie,
With the below in place from watershed district, do you anticipate the permit going through and , if so, do you need
the $2500 soon to pass it?
I believe Mark Gronberg already got his survey in to you .
Thanks !
Julie Kapsner
Sent from my iPhone
Begin forwarded message:
From: Kevin Gardner<k�ardner@dolphinpool-spa.com>
Date:lune 20, 2013, 3:20:49 PM CDT
To: 'Brett Eidem' <BEidem@minnehahacreek.or�>, juliekapsner@me.com
Cc: 'Brandon Wisner'<bwisner@minnehahacreek.org>
Subject: RE:75 leaf st,orono
Thank You Brett,you're a great help.
KG
1
. �...
. From: Brett Eidem [mailto:BEidem@minnehahacreek.org]
Sent: Thursday, June 20, 2013 3:10 PM
To: k4ardner@dolphinpool-spa.com; Juliekapsner@me.com
Cc: Brandon Wisner
Subject: 75 leaf st, orono
Kevin,
We will be re-issuing the permit with today's date and the new date for when the plan was received. We
will be emailing the city, letting them know that we still approve the new location. If you could, please
send in a digital copy of the new plan.The one brought in yesterday is just too big for us to save a digital
copy of. Besides that, nothing more will be required on your end. We will email and mail the new permit
to you and the homeowner.
Please let me know if you have any questions.
Thanks,
Please note: Due to the District's office move, we will not be processing applications and
associated correspondence from Wednesday, June 26th thru EOD Friday, June 2gtn
Brett Eidem
District Representative
Minnehaha Creek Watershed District
18202 Minnetonka Boulevard
Deephaven, MN 55391
Direct: (952) 641-4517
Main Office: (952)471-0590
Fax: 952-471-0682
www.minnehahacreek.or�
MINFiEHAHA CitEElC
wwT�RS�Ei! R�STRICS
New office address July 1: 15320 Minnetonka Blvd., Minnetonka, MN 55345
z
Melanie Curtis
From: David Martini [davidma@bolton-menk.com]
Sent: Thursday, June 20, 2013 2:30 PM
To: Melanie Curtis
Subject: 75 Leaf Street, 2013-00233
Melanie,
As requested, I have reviewed the Building Permit Application for 75 Leaf Street, Permit Number 2013-00233. Based on
my review, I offer the following comments for you consideration:
1. It appears that a retaining wall will be required around the circular portion of the pool deck based on the proximity of the
972 contour.
2. It appears that a retaining wall will be required between the house and the pool deck near the northwest corner of the
house.
3. Proposed grades for the proposed walk need to be shown.
4. Existing elevations for the existing patio, concrete pad and building corners should be shown on the survey.
Please let me know if you have questions or need additional information.
David P. Martini, P.E.
Principal Engineer
Bolton & Menk, Inc.
(952)448-8838 ext. 2458
This email has been scanned by the Symantec Email Security.cloud service.
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1
Christine Mattson
From: Christine Mattson
Sent: Friday, May 17, 2013 10:18 AM
To: 'kgardner@mnpools.com'; 'juliekapsner@me.com'
Cc: Melanie Curtis
Subject: 75 Leaf St-2013-00233
Attachments: admin@ci.orono.mn.us_20130517_100753.pdf; Escrow Agreement 2013-00233.pdf
Hello,
City Engineer,Jesse Struve, has reviewed the survey submitted for the proposed pool at 75 Leaf Street and has the
following comments below. Also per the April 22 letter that was sent,we are still waiting for a couple of items. We
need documentation from the Minnehaha Creek Watershed District(MCWD)to know if your project triggers any of their
requirements. Also, please sign the attached escrow agreement and return it to the City along with a check for$2,500.
A copy of the April 22"d letter is attached for your reference.
If you have any questions, please don't hesitate to contact us.
Christine Mattson
Planning Assistant
City of Orono
2750 Kelly Parkway � Orono � MN � 55356 (physical addressJ
PO Box 66 � Crystal Bay � MN � 55323-0066 (mailing addressJ
`d 952.249.4620 � �, 952.249.4616
� cmattson@ci.orono.mn.us � � www.ci.orono.mn.us
Office Hours: Monday- Friday 8 am to 4:30 pm
Summer Office Hours begin Monday, May 20, 2013
Monday-Thursday: 7:30 am to 5 pm/ Friday 7:30 am to 11:30 am
OUR OFFICE WILL BE CLOSED: Monday, May 27, 2013 (Memorial DayJ
From: Jesse Struve
Sent: Thursday, May 16, 2013 1:08 PM
To: Melanie Curtis
Cc: Christine Mattson
Subject: 20130516 75 Leaf St - 2013-00233
I reviewed the application for a new pool at 75 Leaf Street and have the following concerns:
• How they show the contours, the contractor cannot grade this without impacting the wetland buffer area. If
they want to do the work as shown, they will need to include a planting plan, and provide the proposed seed
mixture.
• This woufd normally require an additional escrow (separate of the erosion control escrow), but since this will
minimally impact the buffer area,the City can tie both the erosion control and wetland buffer escrow into the
one$2500 amount. The applicant should be aware this means the escrow will not be returned until the buffer
area has established itself and has been inspected by the City's wetland specialist.
i
Jesse Struve
From: Jesse Struve
Sent: Thursday, May 16, 2013 1:08 PM
To: Melanie Curtis
Cc: Christine Mattson
Subject: 20130516 75 Leaf St-2013-00233
I reviewed the application for a new pool at 75 Leaf Street and have the following concerns:
• How they show the contours, the contractor cannot grade this without impacting the wetland buffer area. If
they want to do the work as shown,they will need to include a planting plan, and provide the proposed seed
mixture.
• This would normally require an additional escrow(separate of the erosion control escrow), but since this will
minimally impact the buffer area,the City can tie both the erosion control and wetland buffer escrow into the
one$2500 amount. The applicant should be aware this means the escrow will not be returned until the buffer
area has established itself and has been inspected by the City's wetland specialist.
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
, ��CEIVEC� City of orono
�oN Hardcover Caiculation Workshee�-� � ��p�
2013
i\Y�, `! Property Address: �S LE�! � �' ��F�7 ��"��'.�'.�u�"�t)
� F �� �P�epared by: Date:
_ _ C'�a,c�-r���� ,c .0�'.�`�C r.r*Ff ,�.v�. 8-6 J..�
Stormwater Quality Overlay District Tier: (Circle one) Tier 1 Tier 2 Tier 3 Tier 4 Tier 5
Step 2: PROPOSED HARDCOVER
In the following table, identify all items of proposed hardcover on the property, keyed by letter to
Certificate of Survey(survey must accompany this form). Include all existing hardcover items that are
intended to remain, as well as all proposed hardcover items that will be added. Use as many lines as
necessary to accurately depict proposed hardcover status of the property. For Tier 1 properties, identify
any features by letter which are split at the 75' setback line and calculate hardcover square footage
se aratel for each ortion.
Key to Hardcover Item (Describe) Length x Width Total
Surve S uare Feet
Exam le Gara e 24'x 30' 720 S.F.
A ,� S.F.
B � S.F.
C S.F.
� i t/ 6 7 S.F.
E T� � riE�S S f 'YS �9'�/C7 S.F.
F 3 yG S.F.
G �e�,.�` e K S.F.
H ,�,e,rv�'F�, .€e.�. 7 S.F.
I .�a .�.� �E / S.F.
J �,� ,�� �� S.F.
K �a�� .�,� .,� S.F.
L ���e"cR 6T6 I�.r D `� S.F.
M ✓+ �� ,�' S.F.
N .��+ �*� F ' f � S.F.
0 �'? �'° � ,�,: 5.�' S.F.
P �� �� y"� S.F.
(� �� �g .�a � S.F.
R •� i� �o y S.F.
S /.t�r��i - n.�o �r� D � ,� 2/ S.F.
T c, 5o S.F.
U s/ �� S.F.
V �� s� ! S.F.
W •i s/ S.F.
X « �� S.F.
Y S.F.
Z S.F.
1 Total Pro osed Hardcover !o S.F.
Excludable Hardcover See Cit Code Sec 78-1684 :
-K TTOi!/F C.[JAGL_S � S.F.
fJ" BOLIGUFK 4G1 /lS� S.F.
♦� �r S.F.
S.F.
S.F.
2 Total Excludable Hardcover �6'� S.F.
3 Net Pro osed Hardcover Subtract line 2 from line 1 Q$ S.F.
4 Total Lot Area �,.��Op,�, S.F.
Proposed Hardcover Percentage [(3)_(4)] 7. 2 fi %
January 8,2013
��� ���
�- TWIN CITY SEED coMPaNY
310NWT Native Wet Trail
Mixture: 310
Common Name PLS Rate %of Mix Component
kg/ha Lbs/ac
Bluestem,bi 2.8 2.5 25.0
Indian rass 2.8 2.5 25.0
Wild- e,Vir inia 2.2 2.0 20.0
Switch rass 0.6 0.5 5.0
Blue-'oint rass 0.3 0.25 2.5
Green bulrush 0.3 0.25 2.5
Wool rass 03 0.25 2.5
Giant bur reed 03 0.25 2.5
Cord rass, rairie 1.7 1.5 15.0
Grass Totals: 11.3 10.0 100.0
Common Name Bulk Rate %of Mix Component
kg/ha Lbs/aC
Winter Wheat* 62.7 56.0 80.0
Rye-grass,annual 12.5 11.2 16.0
Wheatgrass,slender 3.1 2.8 4.0
Cover Cro Totals: 78.3 70 100.0
Wet Forbs Mixture(Table 3876-6) 2.2 2.0 100.0
GRAND TOTALS: 91.8 82.0 100.0
*Oats to be subsrituted for s rin lantin s
Purpose:Native mix for wetter areas.Infiltration ponds,dry ponds,wet ditches. Tall height.
7265 WASHINGTON AVE. S. EDINA, MINNESOTA 55439
PHONE: 952-944-7105 FAX: 952-944-7239 800-545-TURF EMAIL: twincityseed@twincityseed.com
/'�pril 1, 2013 VINYL POOL
75 �,�,�� �.5�-�
Dear Kapsner Family,
The following is our proposal for a Vinyl Lined Swimming Pool for your home located Orono,
Minnesota. The pool is to be rectangle in shape, 20' wide by 40' long and depths from 3' to 8' deep.
STAI RS:
The pool steps will be corner type (2) at the shallow end of the pool. The stairs are constructed of
galvanized steel with the vinyl liner over the steel giving the stairs a clean look.
AUTOMATIC COVER:
This pool will have what is referred to as under-track Automatic Safety Cover. The automatic cover is
manufactured by Cover-Star. A polymer box is used to house the cover. An aluminum "flush" lid is
used to cover the box. 4" piers are installed on the outside of the auto cover box and around the pool
perimeter to support the deck. The color of the cover is to be chosen by others.
PLANS AND SPECIFICATIONS:
Dolphin Pool will furnish all plans and specifications covered by this quotation to meet all State and
Local building codes.
TAXES AND BUILDING PERMIT:
Dolphin Pool will pay all local, state and federal taxes on labor and materials for their work on this
pool. Dolphin Pool will apply for the permit but cost of the permit to be reimbursed to Dolphin by you.
POOL CONSTRUCTION:
The entire pool will be constructed of a 14-gauge 2 3/4 oz. galvanized steel panel 42" in height. The
panels are supported with a 12 gauge A Frame brace and a deck brace located every 4'. A concrete
bond beam a minimum of 6" is then poured around the perimeter of the panel's base and braces.
WARRANTY:
The Legacy T"" Pool is structurally warranted for Life and transferable one time. Select Legacy T""
liners are warranted for 20 years of prorated coverage with first five years of full coverage. Pool and
Equipment are unconditionally guaranteed for one year.
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3405 Highway 169 North,Plymouth,MN 55441 (763)-542-9000 Fax(763)-542-9001 MN License#BG20266452
Page 2.
POOL BASE:
A minimum of 2" of Vermiculite and Portland base is troweled on the bottom of the pool.
VINYL LINER:
A Vinyl liner is then installed into the pool and attached into a extrusion at the base of the auto-cover
track. The liner pattern is to be chosen by you.
COPING:
Dolphin to setup forms in order for OTHERS to pour coping.
CONCRETE DECKING:
BY OTHERS.
PLUMBING:
Dolphin Pool will do all the plumbing from the pool to the pool equipment. All the pipe and fittings are
to be sized to exceed minimum flow and turnover rates.
DRAIN:
Adequate drain around the pool deck BY OTHERS
WATER SERVICE:
A garden hose is to be used for filling for the pool, water must be adequate quality.
ELECTRICAL SERVICE:
Adequate electrical service and grounding facilities to pool equipment and wiring of filter pump,
heater, light, and grounding of pool and deck equipment BY OTHERS.
GAS SERVICE:
Furnish and install the gas supply to pool heater, final connection, permit and test line as per city
code BY OTHERS.
EXCAVATION:
Dolphin Pool is responsible to excavate for this pool. All excess material to stay on site. If any
underground obstacles, high water table or unsuitable soil conditions are encountered soil correction
will be charged back as an extra.
NOTES:
. , �
Page 3. VINYL POOL
POOL SPECIFICATIONS:
20' Wide x 40' Long
3' to 8' Depth
62 GPM at 8 Hr. Turnover
SWIMMING POOL EQUIPMENT
FILTRATION
1 Cl2a11 811d CI@al' Fllt@P http://www.aentairpool.com/pool-aro/aroducts/filters-cartridqe-clean-clear-alus-filters-27.htm
1 Pentair Whisper Flow Self-Priming Pump, http://WWW.pe11t811pOOI.00171/p001-p�0/pfOdUCtS/pfOdUCt.php
1 336,000 BTU PI'Opall@ http://www.ravaak.com/product.aspx?id=E841D1F9-5916-486D-6753-78A6471032E8
2 Surface Skimmers
3 Adjustable Inlets
1 Automatic Cleaner fitting
2 Main Drain, Anti.-entrapment
DECK EQUIPMENT
1 6ft DIVICIg BOaPd EDGE SYSTEM b�/htt�://www.interfab.com/aool-divinq-boardslEdae-Divin4-Svstem.asax
1 In-Wall Ladder w/Grab rails
1 Stainless Steel Handrail (for the stairs)
4 Concrete Deck Anchors w/Escutcheons
MAINTENANCE & SAFETY EQUIPMENT
� AUtOfYIatIC POO� C�@aCl@I'htt�://oolaris280aoolcleaner.bloasaot.corn/
1 Gold Line P-4 Electrical Panel Chlorine Generator and Includes Biogard Minerals
� �.O�O��.E� �Ig�'lt http://www.aentairpool.com/aool-pro/products/liqhtinq-color-chanqinq-intellibrite-5p-color-led-74.htm
1 20' Safety Rope w/4 Floats
1 Deluxe Vacuum Head, Telescopic Pole 16'
1 Leaf Net, Wall Brush and Vacuum Hose
1 Water Test Kit
1 Chemical Start Up Kit
Kevin Gardner Date
General Manager
763.300.9003
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�� � � � � Construc�iion Orawin Difterent -3' N011AINAL � '
9�
�� . methods end precau�ons may be
� � dictated by various ground 4" MIN. CON�RETE DECK
c�nditions. This is to be �(2000 psi MINIMUM)
deterrnined by and is the . .. ..,. , .
,
re nsib�ity of the con+� �y.��i •�j• � �•'�='�:� .-:., j;;::.:::.:�.�.r.: .• ..;...,• Y: ....; �:.
� YQ�V� �1� ► •��,.�l�y:,r�•,:�.lw�.:,•ti,.� ��y�d�: �:'"� � •1��:��i��',�I,•
is not an agerrt of the manufacturer o • :•`� �:.' :�'.;::...�'`, .�• ` •::~>..•�� ;.' �-.':
of the vomportent parts. °
Mstailation is to be done in ° ALL BACKFfLL TO BE
� acc�r+dancc�with all federal, state NON-EXPANSIVE SOIL UNDISTURBED
and locai building c�odes, as weN as , EARTH
. A.N.S.i./N.S.P.I. suggested .
standard$.
� ` � ADJUS�ABLE
. A-FRAME
VINYL LINER
,.
� 8" MIN. CONCRETE
� COLLAR AROUND FIJLL
' � . .: PERIMETER OF POOL
.;. �
2" MIN. FILL ° :� -' :��_ �!...•; t••��, a '. �p - = � • ' '' {250Q psi MINIMUM�
PQOL BOTTOM ' Y � -'� ' -•
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. 4y �' � !I' � 'r
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' 2'-6" OVEREXCAVATION
�
Jesse Struve
From: Jesse Struve
Sent: Wednesday, September 25, 2013 10:50 AM
To: Melanie Curtis
Cc: Christine Mattson
Subject: 20130925 75 Leaf St#13-00233
Melanie,
I have reviewed the proposed pool location and am fine with what is being proposed, but the applicant should be aware
of:
1. The survey shows proposed walls extending right up to the existing buffer area. They will impact the buffer
during construction and will need to restore all impacts with approved seed mixture.
2. By installing the walls up to the buffer line,this will not allow for a mow able area next to the retaining wall
which may be problematic for the owners to maintain.
3. All retaining walls shown on the survey appear to meet the height requirements(below 4'). If any of the walls
are installed over 4' or any tiered walls which exceed 4' not separated by 2x the height,the applicant will be
required to have an engineer review and sign off on the walls.
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
�
Christine Mattson
From: Adam Edwards
Sent: Friday, June 05, 2015 12:14 PM
To: Christine Mattson
Subject: RE: 75 Leaf Street/#2013-00233
Chris,
I reviewed the subject plan. No issues with Pool as built.
However- I do note the driveway is lager on the as-built than on the plan. No issues with it from a grading view but did
not know if it impacts hardcover. O�� '��
N�
C�
Adam
From: Christine Mattson
Sent:Thursday, ]une 04, 2015 3:28 PM
To: Adam Edwards
Subject: 75 Leaf Street/ #2013-00233
Adam,
An as-built survey was submitted for an in-ground pool. Please review and provide comments.
Thanks!
Christine Mattson
Planning Assistant
City of Orono
2750 Kelley Parkway 0 Orono � MN � 55356(physica/addressJ
PO Box 66 j Crystal Bay � MN { 55323-0066(mailing addressJ
'� 952.249.4620 ( 8 952.249.4616
� cmattson@ci.orono.mn.us � � www.ci.orono.mn.us
Summer Office Hours: (Monday, May 18 through Friday,August 28,2015)
Monday-Thursday: 7:30 am to 5 pm
Friday: 7:30 am to 11:30 am
OUR OFFICE WILL BE CLOSED: Friday,July 3,2015
1
5� DATE TIME �
CITY OF ORONO CALLED IN �(� -ZS
INSPECTION NOTICE 2 SCHEDULED /o'2 " .3 .'00
PERMIT NO.�d�3 ��O2'3+-� COMPLETED
ADDRESS �s ��Sf
OWNER TELEPHONE NO. 7�v3 5�4�2 �j�2�
CONTRACTOR [����C P4lJ�-S
�: DESCRIPTION �����9 �Bd�
�
� ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING
Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS
� ❑ FRAMING ❑ MECHANICAL FINAL
� ❑ TREE REMOVAL
Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION
Q ❑ RADON SLAB ❑ WATER HOOK-UP O PROGRESS
� ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT
v ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP
_ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL
v ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Cail for the next inspection 24 hours in advance. �95Z� Z49-46�0
OwnerlContractor on site: �
Inspector. .
White Copy/lnspector's File Canary Copy/Site Notice
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CITY OF ORONO CALLED IN �
INSPECTIO T SCHEDU�ED — ��' �
PERMIT NO. ��3 COMPLETED
ADDRESS � �
OWNER TELEPHONE NO. ��-3� '��7
CONTRACTOR
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� DESCRIPTION �'~ `�`�� �
�
W ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCA GRADING/FILLING
� ❑ POURED WALL ❑ MECHANICA�RI ❑ LAKESH RFJWEfLANDS
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❑ FRAMING ❑ MECHANICAL FINAL ❑ TREE RE OVAL
Z ❑ INSULATION ❑ WOOD BURNERlFIREPLACE ❑ SITE INSP�CTION
Q ❑ RADON SLAB 0 WATER HOOK-UP ❑ PROGRES$
� ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT
� ❑ DEMO-SITE O SEPTIC MAINT. ❑ FOLLOW-�1P
_ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL
� ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNbATION/REMOVAL
2 OWNERICONTRACTOR TO MEET YOU:_YES_NO
c�., COMMENTS:
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� CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
O ❑ RRECT WORK,CALL FOR REtNSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN
INSPECTOR WILL REfURN
❑CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours'n advance. 95 9-46��
OwnedContractor on site:
Inspector. �
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White Copyllnspector's File Canary CopyfSite Notice
�-�� 3-�
DATE TIME
' CITY QF ORONO CALLED IN 4 "� "�
�" INSPECTION NOTICE SCHEDULED l� '10�15
PERMIT NO. Zo�3-b0L�.3 COMPLETED
ADDRESS 1 S �� S��
OWNER TELEPHONE NO.
CONTRACTOR
� DESCRIPTION � � �� �� ��V���
W ❑ FOOTING ❑ DEMO-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 ❑ COMP�AINT
Q ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP
_ ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ HARD COVER REMOVAL
� ❑ DEMO-SITE ❑ SEPTIC INSTALL ❑ FOUNDATION/REMOVAL
2 OWHERICONTRACTOR TO MEET YOU:_YES_NO
��., COMMENTS��� Y�,VCVM/� ��� Vl�t� ClbYY1Y1l.Ql'��'
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0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑pHOTO TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
O INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (952� 249-460�
,
OwnerfContractor on site:
Inspector.
White Copyllnspector's File Canary CopylSite Notice
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� • • • • •
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emo
To: Finance Department
From: Jeremy Bamhart, Community Development Director�
CC: Zoning File
Date: June 19, 2015
G/L: 101-22205
Re: Escrow Refund
Work related to building permit 2013-00233 has been completed, and it is now appropriate to
retum the escrow. Please refund$2,500 to the applicant, Jason and Julie Kapsner.
The following is attached:
• Copy of cash register receipt showing escrow amount received
Please retum the check to 75 Leaf Street, Long Lake, MN 55356
��n �-�u I i� ��SI�
�5 � � ���
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u:\escrow refund memo.doac
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* � .
BUILDING PERMIT ESCROW AGREEMENT
Orono Building Pertnit#2013-00233 .
�
AGREEMENT made this�_day of e- , 20�by and befinreen the CITY OF ORONO,
a Minnesota municipal corporation("Cit�')and Jason 8 Julie Kapsner("Owners").
Recitals
1. A building permit application has been filed for a swimming pool located at 75 Leaf Street, the
("Subject Property"), legally described as Lot 1 Block 3 Graham Hill Preserve, Hennepin County Minnesota.
2. Owners request 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
consuftant 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 #2013-00233 if compliance with the
approved building permit is not accomplished.
3. MONTHLY BILLING. As the Cfty receives consu�ant bills for incurred costs, the City will in turn
send a bill to the Owners. Owners shall be responsible for payment to the C�y 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• C TY O ORONO OWNER:
By� S�c,l 1�v S��
�ts:�� �
�
� � .~ . .. , ��
CITY OF ORONO * 2 0 1 3 — 1d 1 0 2 9 *
2750 KELLEY PARKWAY DATE ISSUED: 10/0]/2013
ORONO,MN 55356-
(952 249-4600 FAX: 952 249-4616
ADDRESS : 75 LEAF ST
PIN � : OS-117-23-11-0014
LEGAL DESC : GRAHAM HII.,L PRESERVE 3
: LOT 1 BLOCK 3 �
PERNIIT TYPE : ESCROW FEE-T'IED TO�UII.DING PERNIIT
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ESCROW FEE-T'IED TO BUII,DING PERMIT
APPLICANT ESCROW FEE-BUII.,DING 2,500.00
KAPSNER,JASON&JULIE
760 DICKEY LAKE ROAD � TOTAL 2,500.00
LONG LAKE,MN 55356-
C��it�y of Orono
�750 Kelley Parkway
Orano MN 55356 952-249-4600
OWNER Receipt No: 3.009798 Oct 1, 2413
KAPSNER,JASON&JULIE Julie Ka r�er
760 DICKEY LAKE ROAD PS
LONG LAKE,MN 5535Cr Planning�a�r�d Zonin
2013-(f1�9 75 Lea� St 2,500.04
101,�2205 �
Deferred Rev-Daveloper De�si# �
AGREEMENT AND SWORN STATEMENT
The wark for which this peanit is issued shall be performed according to Jotal: �SQQ,Q(j ;
the approved plans and specifications,applicable City approvals,and the �k --- '
State Building Code. This permit is for only the work described and dces {��k N0� 1847 I
not gant pernrission for additional or related work which requires separate p� 2��•� I
permits. All provisions of Iaws and ordinances goveming this type of work JU11B'I{�i�5T1Er �
shall be campied wiffi whether or not specified herein.This permit will Total Appl ied: �QQ�Q()
expire and become null and void if construction authorized is not � '
commenced within 180 days of the date of issuance,or if conswction is (�Ide92 TEhdEP'2d C ,(�} �
suspended for a period of 180 days at any time after work has commenced. f
The plicant is responsible for assuring all required inspections are 14/01/�013 12:40P�1 �
' conforman with the State Building Cod�This permit may be
oked time for u cause. f _ I — ��
�
/ / / /
A plican ermitee S�gn Date Issue y ature Date
SEPARATE PERMITS REQUIRED FOR WORK O'THE N DESCRIBED ABO