HomeMy WebLinkAbout2011-00909 - attached garage - � CITY OF ORONO PERMIT NO.: 2011-00909
2750 KELLEY PARKWAY
ORONO, MN 55356- �ATE iss[1En: 10/04/2011
952 249-4600 FAX: 952 249-4616
REPRINTED ON 10/4/2011
ADDRESS : 2350 LONGVIEW CIR
PIN : 03-117-23-23-0005
LEGAL DESC : LONGVIEW
: LOT 006 BLOCK 001
PERMIT TYPE : ADDITION/REMODEL/REPAIR
PROPERTY TYPE : RES[DENTIAL
CONSTRUCTION TYPE : GARAGE-ATTACHED
ACTIVITY : 438-ADDNS OF RES GARAGES&CARPORTS
VALUATION : $ 60,000.00
NOTF: SEPARATE PERM[TS REQUIRED: ELBC"CRICAL(STATE)
* PRO"CGCT THE SEPTIC ARGA
* CULVERT TO BE REMOVGD BY CTTY FOLLOWING PROJECT COMPLETION AND PRIOR TO ESCROW RELEASE.
* PLUMBING IN CCEBSORY STRUCTURE COVENANT REQUIRED AND OVERSIZED ACCESSORY STRUCTURE
REQUIRED. �`� (INITAL)
ORtGINALLY PE IT WAS VALUGD AT$I 10,000 AND WE COLLECTED$725.89 FOR PLAN REVIEW. THE VALUE CHANGED SO WE
RECALCULATED THE PERMIT PEG TO REFLECT THE AMOUNT WE HAD ALREADY COLLECTED.
APPLICANT
PERMIT FEE SCHEDULE 522.75
BETZ BUILDERS INC.
300 CRESTVIEW AVE. STATE SURCHARGE(VALUATION) 30.00
LONG LAKE,MN 55356 TOTAL 552.75
(612)221-2963
OWNER
RYAN, MR. & MRS. THOMAS
2350 LONGVIEW CIR
LONG LAKE, MN 55356-
AGREEMENT AND SWORN STATEMENT
The work for which this permit is issued shall be performed according[o
the approved plans and specifications,applicable City approvals,and the
State Building Code. This permit is for only the work described and docs
not grant permission for additional or related work which requires separate
permits. All provisions of laws and ordinances governing this type of work
shall be compied with whether or not specified herein.This permit will
expire and become null and void if construction authorized is not
commenced within l80 days of the date of issuance,or if construction is
suspended for a period ot�180 days t any time after work has commenced.
The applicai�L�is-r ponsible�oc sauring all required inspections are
reque m co rmanc�''wf 'the State Building Code.This permit may be
re �ed at a time fo d�f use.
�r�=� �-..__z�_� ,ia y� o�/ iD� �/ i
Appl� ant Per tee gnature Date Issue y Signature Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
. ' �- ��7���
. . ��. �� 3
City of Orono •
Building Permit Appiication
for New Structures or Additions
Mailing Addr�sss: Permit number. ',�(,'1 � �q
O���O PO Box 66
Crystal Bay, MN 55323-0066 Date received:
St�et Atldress:' Reoeived by:
2750 Kelley ParkwaY Plan review fee: �
'rv���,�� Orono,MN 55356
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 appl�attons will be retumed. (Please print)
GENERAL INFORMATION:
Job Site Address: Z.3rj0 �.D1-IC�V I��J ��'�GL�
WII this be a Parade of Homes, Remodelers Showcase Home or other Display Home? Yes No
y y�ea,a s�ai e�renr pem►rr�s reqo�red wru►Par�e oepertmer�and crry ca,ndr e,�rove�so days�ror ro a►e e►�enr. snua+e aus seNke wia ne
requirod unbss applica►►t dettAa►sdates suA7cient ars�e pe►kir►g!s avepeble. Non-pe►milted e�w10 not be allowed.
CONTRACTOR/APPLICANT INFORMATION:
Name: ��f Z �U 1 I���KS
State License# �'��� � Expiration Date: 12
Phone: (o�2-22 - 29�3 (office) (cell)
Mailing Address: 00 C��S (�w A�� C' : N� L�P�I� ZIP:
Contact Person: 'P� TZ Applicant is: on ractor / Homeowner �c�a a»�
Email and/or Fax: � �D (? �,�a , Co n-�
PROPERTY OWNER INFORMATION:
Name: TD�1 �.`)A�ti(
Phone(day): �2,._ '1_�-��
Address: 2'�,5� VI W GI'�GL� C' : 1�1� ZIP:
Email and/or Fax �n ,r� D i - " " - "'
�
ARCHITECT/ENGINEER INFORMATION:
Name: CSD �STI.I U N — �G� `��S I C�i�
Phone(day): _ -3� ,t
Address: . '�. Ci : ���, ZIP: SS�-t-��--
Email and/or Fax: d "
PROJECT INFORMATION:
1.Type of Project 2.Proposed Use 3.Structure Type 4.Sewage Disposal&
Waber Supply
❑New Construction �Single Family with ❑Residence
❑Addition atteched garage �Garage/Acoessory Bldg. ❑Public Sewer
�Acxessory Building ❑ Single Family with ❑Dedc
❑Relocation detached garage ❑Offioe/Commercial �Private Sewer
❑Other.(speafy) ❑Multiple Family/Condo ❑Warehouse
❑Public ❑Storage ❑Public Water
*'Any ea�th movement may r+equire ❑Commercial ❑Other(specify)
MCWD rsview�permits. ❑Industrial „�Private Well
Minnehaha Creek Waterst�ed Distrid(MCWD) ❑Other:(sPepfY)
18202 NYnnetonka Blvd
Deephaven,MN 55391
Phone: 952�71-0590
Fax: 952�71-0682
. i
Estimated Constniction Valuation(excluding land) ; O�
Last Updated: 4/26l2011
- 19-
STRUCTURE INFORMATION:
1.Structur+e Dlmensions 1.Structure Dimensions(contlnued) 2.Type of Construction
, �i
a. Length(ft.)= ��� Number of bedrooms= � �'[Wood/Frame
❑ Masonry
b.Width(ft.)= 31 -� Number of gara e stalis: ❑Metal
Attached= � ❑ Pole Bldg.
Areas in sauar�e feet Detached=—T ❑ ICF
❑On-site Prefab
c. Basement= � ❑Off-site Prefab
d. 1 s'Story = ❑Other(please specify):
e.2"d StOry=
f. %Story =
g.Total Area= �3��'��,
REQUIRED SUBMITTALS:
All of the information must be submitted in order for your application to be processed:
Not
Enclosed A licable
�d' ❑ Permit A lication
❑ Pro osed Buildin Plans
❑ MN State Ener Code Calculations and Mechanical Code Re uirements Form
❑ Surve meetin all uirements
❑ � Stormwater Pollution Prevention Plan
� ❑ Hardcover Calculation s
❑ Se tic S stem Site Evaluation Re ort
❑ � Access Permit
❑ Wetland Buffer Im rovement Plan
❑ En ineered Plans for Retainin Walls 4 feet or above
'� ❑ Plan Review Fee
0 � Other
APPLICANT ACKNOWLEDGEMENT:
. Agrees to provide all information required or requested by the Building Department;
• Agrees to pay the City of Orono for engineering consultant review costs in excess of a500;
• Certifies that the infvrmation supplied is true and coReot 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 afternative
but to reject it until it is complete;
• Acknowledges the Escrow Agreement is completed and signed;
• Understands 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 apptication may not be issued.
• Agrees that in the event that weather or other conditions prevent the completion of an as-built survey at the time the
Certificate of Occupancy is requested, a temporary Certificate of Occupancy may be issued upon receipt of a 510,000
escrow to ensure completlon of the as-built survey and all site improvements.
a
ApplicanYs Signature: / _ Date: � p`v���
Last Updffied: 4/26/2011
-20-
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t iPerm�Fee Schedule ;756.75 ❑ �60�0 VAIUATION
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Description of work: ���.���� �� �� �-�tl��
_ �� ' `�.�� � j ` `�
��p�ic revie�v�t�y: Da�e�pp�o��ea:�,
��atir�� review!�ye � � �,,� ��te Ap�s�m�+�c�: �' ��
�t�EEe�sc�g reviev�b�: ��... Date e4pproNec�: � ` �� ` � �
�r�c�i�g� revee�r by: �� � � ��fie Ap��ao�ed:��f� � (�f
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Zoning File#: Resolution#: Resolution Date:
���Er� t3��tc@c$ �iee�e �r��er�t t�cs�4 C�fFice �cho�f �@��.r�ct
Zoning: Lot Area: SF/AC Width: Depth:
Survey Submitted: ���;�`�Fes � Ro Date of Survey:_ �i � ; �� c �
Pro osed Setbacks: �� �
Fronti(��ke) �€��ar j�treet� Q � � E � � (;, � S � !�'
� �p�� ,_ 1 OfF��r B�ilcf`s�gs ��tlae�t�
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Building Defined Height: ���r Building Peak Height: �� #of Stories Ok.: E:
FOR A BUILDIPEG 1N1TFi A B�SEtdlEM7 OR CRAWL SP�4CE: FOR R,BtJ(LDiNG Otd A SLAB FOUHDATIOf�: k
START WITH the distance between the basement floor/crawl START the distance between the slab and the highe
space floor and the highest roof peak,the top of WITH roof peak,the top of the cornice of a flat rooi
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-tyE
or other arch- e roof roof
SUBTRACT half the distance between the highest window and SUBTRACT half the distance between the highest windo�
hi hest roof eak of a itched roof and hi hest roof eak of a itched roof
SUBTRACT the distance between the basement flooN crawl ADD the ciistance between the slab and the highe
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
EQUALS Defined buildin hei ht
Lot Coverage: SF %
�ho����e�c� '�trEc' ���c�t3 E�er�zE�:f��ceivec� �,ver� e ��kesf�oce-�ef�ack �tu4'�
�, �, ' '`,��.�Yes � �o [� N/A u � � Yes E� Ro
� Yes �,� .� � Yes � No � t��/A
!,� 'Permit Number. `��� Sefback:
f�acc�c�Ne��o�e� Ex�s�.i� �ro osed �arEartce Re uired CU� �e �ire�
0-75 � Yes � iVo � Yes E� No
75-250' Type(s): Type(s):
250-500'
500-1000'
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RE(�ARKS in-house ;� �t�� � �. �;� ��.,� �rs'u/ �� i���,�,,,�{���`��
Updated: 09/11/2009
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�osc�l��r��ae����r�s �
Ca����E��r�e� ��:
� c��r� Fao��: � S er� �are F��4a: e
Basement x - �
1�Floor X - �
2nd Floo� � - $
Garage � ' �
Estimated Construction Value: $ �'a��E�l�':��
C��o�� I���ee�Eo�� Req�f��d� ��r€�.F��(�C&EP[E!g .t`rr���6'�$� ��P[YY@� �Gf�ileP�Cj ���'�� �'�E°{'1�t�
� Site � Plumbing f� Grading/Filling �2 Well
C� Hardcover Removal C� Nlechanical � Fire ���Electrical
,��Footing � Septic � Water Connection
�oured VVall � Fireplace � Sev�rer Connection
�� ����,�!�t6�¢� ���re�+ � Masonry � Lavvn Irrigation
� Radon Rock Bed � �f9•
,�'`�Framing l� Other(specify)
•' � Insulation
� �R,s-��i�� S�arv�y
�Final
E� Other(specify)
REMARKS (in-house):
��her t���rE��: G�e��ie��ed �Y:�.�� �. �ate ,�,p�ro�eec�: �
Access�Existing� � YES �� �!O i�Iew: E� YES �i f�0
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Updated� 09/11/2009
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C ty of Orono � 1
Building Permit Appiication
for New Structures or Additions
Mailing Address: Permit number. �l!�0 /�
Og.�,�.0 PO Box 66
Crystal Bay,MN 55323-0066 Date�eceived: //
� � StreetAddress:' Received by:
2750 lGelley Parkway Plan review fee: � 7',5, p `''l
'��o�.�G Orono,MN 55356 ���_ ���
Total Fee:
Main: 952-249-4600 Fax: 952-249-4616 www.ci.orono.mn.us
This appiication form must be completed in full and all required information must be submitted.
Incompiete applications wiil be returned. (Please print)
GENERAL INFORMATION:
Job Site Address: Z'�� �K��P �F VJ C(�L�
Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? Yes No
n y�s�e�e��pe�►►►�r Es►�ur►ed w�►��e►ane►a ar,d chy co�ndi e�►o�er so days p►►or to n,e e�r. sn�rws�w;�i ae
requlred unbss app/kant demonsbstea suA4cient a►-sA�a parkTip!s aveFkble. Non pem►ilMd events wiM n�be allow�xi.
CONTRACTOR/APPLICANT INFORMATION:
Name: L �IL�D rl�
State License# 3 Expiration Date:
Phone: _ 22\-2 office cell
Mailing Address: 360 G l C' : ZIP:
Corrtact Person: Applicarrt is: on actor / Homeowner �c�.u.ons�
Emai)and/or Fax: � � C�
PROPERTY OWNER I�ORMATION:
Name: �M �I�1�
Phone(day): �_ --1 2
Address: 3�� Y 1 W C I �.LE C' : b NV ziP: �5 3 5Co
Email and/or Fax t' n 2 'c.e
ARCHITECT/ENGINEER INFORMATION: t�`O^'�ass r y a�Q c�WG�td��� a�l e'�
Name: �TS,D OFSTl�U�l
Phone(day): '? 3- 2 - 7
Address: 3� S C' : ��N��ZIP: �S
Email ancUor Fax: co S �
PROJECT INFORMATION:
1.Type of Project 2.Proposed Use 3.3tructur+e Type 4.Sewags D(sposal8�
Water Supply
❑New Constru�tion ,�Single Family with ❑Residence
❑Addition attached garage �Ga►age/Accessory Bldg. ❑Public Sewer
�Accessory Building ❑ Single Family with ❑Dedc
❑Relocation detached garage ❑Office/Commeraal �Private Sewer
❑Other:(speafy) ❑MuRiple Family J Condo ❑Warehouse
❑Public ❑Storage ❑Public Water
'"Any eartl�movement may require ❑Commercial ❑Other(speafy)
MCWD review&permits. ❑Industria� '�,Private Well
Minnehaha Creek Waterahed D�trict(MCWD) ❑Other.(specify)
18202 Minnetonka Blvd
Deephaven,MN 55391
Phone: 952-471-0590
Fax: 952�471-0682
'n
Estimated Construction Valuation(excluding land) ;
�st u�a: a�zsrzot�
-19- �� �`
<�� '
� �J
. • .
� , ,
StRUCTURE INFORMATION:
1.Structure Dimensions 1.Structure Dimensions(continued) 2.Type of Construction
a. Length(ft.)= 7�' Number of bedrooms= � �1Nood/Frame
❑ Masonry
b.Width(ft.)= �� Number of garage stalls: ❑ Metal
Attached= ❑ Pole Bldg.
Areas in sauare feet Detached� ❑ ICF
❑On-site Prefab
c. Basement= — ❑Off-site Prefab
d. 1$'Story = ❑Other(please specify):
e.2nd Story= —'
f. %z Story = --
g.Total Area= Z 3��t"
REQUIRED SUBMITTALS:
All of the information must be submitted in order for our application to be processed:
Not
Enclosed A licable
❑ ❑ Permit A lication
❑ ❑ Pro osed Buildin Plans
0 MN State Ener Code Calculations and Mechanical Code R uirements Form
� ❑ Surve meetin all re uirements
❑ '� Stormwater Pollution Prevention Plan
❑ � ❑ Hardcover Calculation s
❑ ❑ Se tic S stem Site Evaluation Re ort
❑ � Access Permit
❑ Wetland Buffer Im rovement Plan
0 � En ineered Plans for Retainin Walls 4 feet or above
O ❑ Plan Review Fee
0 ❑ Other
APPLICANT ACKNOWLEDGEMENT:
. Agrees to provide all information required or requested by the Building Department;
• Agrees to pay the City of Orono for engineering consulfant review costs in excess of 5500;
• 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;
• Understands 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 you refuse to supply the information,the application may not be issued.
. Agrees that in the event that weather or other conditions prevent the completion of an as-built survey at the time the
Certificate of Occupancy is requested, a temporary Certificate of Occupancy may be issued upon receipt of a 510,000
escrow to ensure completion of the as-built survey and all site improvements.
ApplicanYs Signature: lX��� Date: � Z � �
f...
Last Updated: M26/2011
0
2335 Highway 36 W
St. Paul, MN 55113
Tel 651-636-4600
Fax 651-636-1311
www.bonestroo.com
September 21, 2011 �Bonestroo
Melanie Curtis
Planning and Zoning Coordinator
City of Orono
Post Office Box 66
Crystal Bay, MN 55323
Re: 2350 Longview Circle
File No. 000139-11000-1
File No. 2011-00909
Dear Melanie:
We have reviewed the plans for a proposed accessory structure at 2350 Longview Circle. The
plan is dated 9-12-11. We have the following comments with regards to engineering matters:
• It is our understanding that Minnehaha Creek Watershed District has reviewed this site
and confirmed that potential unclassified wetlands shown on the city maps do not exist.
• The site and grading plan for the accessory building is acceptable from an engineering
standpoint.
• This project will disturb more than 100 CY of material. Sediment and erosion control
information meeting the requirements of Orono's City Code 79-7(c)(2) must be
submitted. The minimum $2000 sediment and erosion control financial securiry should
be required of the owner for this permit.
If you have any questions, please call me at (651) 604-4894 or send an email to
darren.amundsenCa�bonestroo.com.
Sincerely,
BON ESTR00
i�_' � �'-�r�'�_—.�
Darren Amundsen
Cc: Chris Mattson
2335 Highway 36 W
St. Paul, MN 55113
Tel 651-636-4600
Fax 651-636-1311
www.bonestroo.com
September 21, 2011 �Bonestroo
Melanie Curtis
Planning and Zoning Coordinator
City of Orono
Post Office Box 66
Crystal Bay, MN 55323
Re: 2350 Longview Circle
File No. 000139-11000-1
File No. 2011-00909
Dear Melanie:
We have reviewed the plans for a proposed accessory structure at 2350 Longview Circle. The
plan is dated 9-12-11. We have the following comments with regards to engineering matters:
• It is our understanding that Minnehaha Creek Watershed District has reviewed this site
and confirmed that potential unclassified wetlands shown on the city maps do not exist.
• The site and grading plan for the accessory building is acceptable from an engineering
standpoint.
• This project will disturb more than 100 CY of material. Sediment and erosion control
information meeting the requirements of Orono's City Code 79-7(c)(2) must be
submitted. The minimum $2000 sediment and erosion control financial security should
be required of the owner for this permit.
If you have any questions, please call me at (651) 604-4894 or send an email to
darren.amundsenCa�bonestroo.com.
Sincerely,
BONESTR00
i� �
Darren Amundsen
Cc: Chris Mattson
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To: Finance Department
From: Christine Mattson, Planning Assistant
CC: Street File
Date: 10/16/2012
G/L: 101-22205
Re: Building Permit Escrow Refund
Building Perrnit#2011-00909 pertaining to 2350 Longview Circle is complete. The Applicant,
Thomas Ryan, has requested a refund of his$2,500 escrow.
Escrow refund request was a phone call in February of 2012. At that time the applicant was
informed an as-built survey was required.
Jesse Struve reviewed the as-built survey. An email was not sent to Bonestroo or Bolton &
Menk.
The following is attached:
• Original signed escrow agreement
• Copy of cash register receipt showing escrow amount received
Mail to: Thomas Ryan
2350 Longview Circle
Long Lake, MN 55356
w:l.street filesUongview cirde�2350�escrow refund memo 2011-00909.doc
BUILDING PERMIT ESCROW AGREEMENT
Orono Buiiding Permit#2011-00909
AGREEMENT made this o�^� day of -s �� , 20 ��, by and betWegn th CITY OF ORONO,
a Minnesota municipal corporation(°City°)and � • ,k.wv A�t srr,rww� �.��RrA� ("Owners").
Recitals
1. A building permit application has been filed for two detached garages located at 2350 Longview
Circle,the("Subject Property"),legally described as Lot 6, Block 1, Longview, Hennepin County Minnesota.
2. Owners request the C�y 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 a�escrow to ensure reimbursement to the City of its costs.
NOW THEREFORE,THE PARTIES AGREE AS FOLLOWS:
1. DEPOSIT OF ESCROW FUNDS. Contemporaneousiy with the execution of this Escrow
AgreemeM, the Owners shall deposit$2,500 with the City. All accrued interest, if 8ny, 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 guararrtee 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 consisterrt with expenses the _
OHmers would be responsible for under a building permit application. The escrow wilt 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 #2011-00909 if compliance with the
approved building permit is not accomplished.
3. MONTHLY BILLIN�3. As the City receives consultant bills for incurred costs, the City will in tum
send a bill to the Owners. Owners shall be responsible for payment to the City within 30 days of the Owners'
receipt of bilt.
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, shaU issue a Stop Work Order until the Owners pay all expenses
invoiced pursuant to #3. The City may dra�nr from tlie escrow account without further approval of the Clwners to
reimburse the City for eligible expenses the City has incumed.
5. CLOSING ESCROW. The Balanc:e on de�sit in the escruw, 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 IJNPAID CHARGES. If the project is abandoned by Owners, or if the eligible expenses
incurred the City exceed the amount in escrow,the City shall have the right to certify the unpaid balance to the
su ' pro y pursuant to Minn. Stat. §§415.01 and 366.012.
CI : C F OR OW ER:
By:
�ts: '
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� � CITY OF ORONO PERMIT NO.: 2011-00994
2750 KELLEY PARKWAY
ORONO,MN 55356- DATE ISSUED: 09/02/2011
952 249-4600 FAX: 952 249-4616
ADDRESS : 2350 LONGVIEW CIR
PIN : 03-117-23-23-0005
LEGAL DESC : LONGVIEW
: LOT 006 BLOCK 001
PERMIT TYPE : ESCROW FEE-TIED TO BUILDING PERMIT
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ESCROW FEE-TIED TO BUILDING PERMIT
NOTE: THIS$2500.00 ESCROW IS TIED TO BUILDING PERMIT-2011-00909
APPLICANT ESCROW FEE-BUILDING 2,500.00
RYAN,MR.&MRS.THOMAS TOTAL 2,500.00
2350 LONGVIEW CIR
LONG LAKE,MN 55356-
OWNER
RYAN,MR.&MKS.THOMAS
2350 LONGVIEW CIR
LONG LAKE,MN 55356-
AGREEMENT AND SWORN STATEMENT
T'he 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 perrr►it is for only the work described and does
not grant permission for additional or related work which requires separate
permits. Al!provisions of laws and ordinances governing this type of work
shall be compied with whether or not specified herein.This permit will
expire and become null and void if construction authorized is not
commenced within 180 days of the date of issuance,or if construction is
suspended for a period of 180 days at any time after work has commenced.
The applicant is responsible for assuring all required inspections aze
requested in conformance with the State Building Code.This permit may be
revoked at any time for due cause.
/ / / /
Applicant Permitee Signature Date Issued By Signature Date
SEPARATE PERMITS REQUIRED FOR WORK OTI�R THAN DESCRIBED ABOVE.
Checkf�st for Refunding Building Permit Escrows
Buifding Permit # �� 'lN'!��
Street Address:
�=�-�JIJ �
Appficant Name:
�Escrow request received Date: � ` �• !—�'�
Permit Type:
Are all inspections completed? Yes No
If not, fist what is outstanding:
Was there a Temporary Certificate of Occupancy issued? Yes No Date: �
Was there a Final Certificate of Occupancy issued? Yes No Qate: ��
As-built survey required? Yes, approved on l� 'l� '�� NO NA
�
❑ ee if there is any unbilfed WIP. ate email sent:
J- �uv� eo�.� �,�pu,1
❑ Prepare memo for Finance Department
z:\fortnslzoning standard forms�checklist for refunding building permit escrows.doc
Last Updated: 10.31-2011
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Jesse Struve
From: Jesse Struve
Sent: Monday, October 15, 2012 12:31 PM
To: Melanie Curtis
Cc: Christine Mattson
Subject: 20121015 2350 Longview Circle-2011-00909
Melanie,
I have reviewed and approved the as-built plan for 2350 Longview Circle.
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
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