HomeMy WebLinkAbout2015-0119 - new structure CITY OF ORONO * z 0 1 5 - 0 1 1 9 s *
' 2750 KELLEY PARKWAY DATE ISSUED: 11/06/2015
ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 10 MYRTLEWOOD RD
PIN : 36-118-23-33-0009
LEGAL DESC : MYRTLEWOOD
: LOT 001 BLOCK 001
PERMIT TYPE : NEW STRUCTURE
PROPERTY TYPE : RESIDENTIAL
COIVSTRUCTIOIY TYPE : SINGLE FAMILY
ACTIVITY : 101-SINGLE FAMILY HOUSES, DETACHED
VALUATION : $ 1,400,000.00
NOTE: SEPARATE PERMITS REQUIRED: PLUMBING,MECHANICAL,FIREPLACE,WATER CONNECT[ON,SEWER CONNECT[ON,
ELECTR[CAL(STATE)
NOTE:PLEASE SEE AND INITIAL NEW BUILDER ACKNOWLEDGEMENT FORM
APPLICANT PERMIT FEE SCHEDULE 7,934.59
STATE SURCHARGE(VALUAT[ON) 660.00
CHAMBERLAIN FINE CUSTOM HOMES S.A.C. 2,485.00
1 1578 CHAMBERLA[N CT
EDEN PRAIR[E, MN 55344- TOTAL 11,079.59
(952)649-7653 Payment(s)
Minnesota State License#: BUIL-BC661410 CHECK 5309 I 1,079.59
OW1vER
Chamberlain Capital LLC
11578 CHAMBERLAIN CT
EDEN PRA[RIE, MN 55344-
AGREEMENT AND SWORN STATEMENT
The work for which this permit is issued shall be performed according[o
the approved plans and specitications,applicable City approvals,and the
State Building Code. This permit is for only the work described and does
not grant permission for additional or related work which requires 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 are
requested in conformance with the State Building Code.This permit may be �}•��
revoked at any time for due cause. �-
�� ,�) ----
/ . .--
f/./���C_[".t \_ �� \�—�—'�4� � I� 1�� �,�
Applicant Permitee Signature Date Issued By Signatu Date
�.ly v i ul UI�W
2750 Kelley Parkway
Oruno MN 55356 952-249-4600
Receipt No: 3.U14619 Nov 6, 2015
Pail Investments LLC
Previous Balance: •��
Permits
2015-01198 10 Myrtlewood 7,934.59
Rd
101-32510
Building F'ermits
Permits
2015-01198 10 Myrtlewood 660.00
Rd
101-20802
Due to govts-State
Permits
2015-01198 10 Myrtlewood 2,485.00
Rd
101-208G9
SAC Charges due to MWCC
Total: 11,079.59
--------------
---------------
Cher,k
Check No: 5309 11.079.59
Payor:
Fail Investments LLC
Total Applied: 11.079.55
�hange Tendered: •���
11/06/�015 02:05PM
' Builder Acknowledgement Form
10 Myrtlewood Road /#2015-01198
Builder
Permit Conditions Initials
Prior to the start of framing, a foundation as-built survey must be submitted
and approved by the City or a stop work order will be issued. �S�
Schedule a minimum of one hour for the framing inspection. ���
Erosion control shall be installed and inspected by the City prior to any land
disturbing activities. The contractor must provide a minimum of a 24 hour �,�C'_—
notice prior to inspection.
Erosion control shall be maintained throughout the entire project and must �
remain until vegetation has been established.
Prior to the issuance of a Certificate of Occupancy an as-built survey and ��,�
hardcover calculations, if applicable must be submitted and approved.
In the event of winter or other unfavorable weather conditions (which
prevent the completion of the exterior improvements and/or as-built �./
survey) a Temporary Certificate of Occupancy (TCO) may be necessary. A � `�`�
TCO requires a $10,000 escrow.
Advisory Comments
Any changes to the exterior/landscaping improvements, i.e. patios,grading,
sidewalks, retaining walls, etc. not currently shown on the approved survey ���
and landscaping plan will require a separate Zoning Permit application to be
submitted and approved prior to the work commencing.
Any retaining walls that over 4-feet in height or tiered walls not separated
by twice of the height of the lower wall require engineered plans and a �,��_
building permit to be submitted and approved prior to construction.
w:\street files\myrtlewood rd\10\builder acknowledgement 2015-01198.docx
�
,
� , ,�' ,�'�
� �- '� �q.�9
City of Orono 1�� �
Building Permit Application
for New Structures or Additions
Mailin Address:
���' . PO Box 66 Permit number � �� `L�(
(�'`, Crystal Bay, MN 55323-0066 Date received: � _
(� 1 Street Address:' —� �G.� � Received by: � �r�d�a�-
� — 2750 Kelley Parkway � `��"�\ Plan review fee:�� �� �� � r �
�,
�`� �^ � � � � Orono, MN 55356 �� r��� � �� �'� �
... i u 4-..________--
�,,��.�sN`��ti,' Total Fee: _`_'�-----
Main: 952-249-4600
-�—T Fax: 952-249-4616 www.ci.oronomn.us �U'� '�1,� � i��-r �'�-�
This application form must be completed in full and all required information must be submitted.
Incomplete applications will be returned. (Please print)
GENERAL INFORMATION:
Job Site Address: 10 Myrtlewood Rd
Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes ❑ No
If yes,a special event permit is required with Police DepaRment and City Council approva160 days prior to the event. Shuttle bus seniice will be
required unless applicant demonstrates sufficient on-site parking is available. Non-permitted events will not be allowed.
CONTRACTOR/APPLICANT INFORMATION:
Name: Chamberlain Fine Custom Homes
State License# Expiration Date:
Phone: (cell) - - (office)
Mailing Address: I 1578 Chamberlain Ct Cit : Eden Prairie ZIP: 55344
Contact Person: Paul Cameron Applicant is: ontractor / Homeowner (Circle One)
Email and/or Fax: Paul a,Chamberlaincap.com
PROPERTY OWNER INFORMATION:
Name: Chamberlain Capital LLC
Phone (day): 952-649-7653
Address: am er atn t City: Eden Prairie ZIP: 55344
Email andlor Fax Paul(c�Chamberlaincap.com
ARCHITECT! ENGINEER INFORMATION:
Name: Design Group C / Christine Charles
Phone (day): - -
Address: City: ZIP:
Email and/or Fax: ccharles(adesign�;roupc.com
1
PROJECT INFORMATION: Descri tion of pro�ect:
1.Type�f Project 2. Proposed Use 3.Structure Type 4.Sewage Disposal&
Water Supply
�lew Construction �Single Family with ❑Accessory Bldg./Garage
❑Addition attached garage ❑ Deck �Public Sewer
❑Accessory Building ❑ Single Family with ❑Office/Commercial
❑ Relocation detached garage [�Residence ❑ Private Sewer
❑Other: (specify) ❑ Multiple Family/Condo ❑ Retaining Wall(s)
❑ Public 4-feet or greater �Public Water
**Any earth movement may require ❑Commercial ❑ Storage
MCWD review 8�permits. ❑ Industrial ❑Warehouse ❑ Private Well
Minnehaha Creek Watershed District(MCWD) ❑ Other: (speCify) ❑ Other(speCify)
15320 Minnetonka Blvd
Minnetonka.MN 55345
Phone: 952-471-0590
Fax: 952-471-0682
vvww.minnehahacreek.or
Estimated Construction Valuation (excluding land) $ 1.4 million
Packet Last Updated. August 2015
Page 21
.
ST�tUCTURE INFORMATION:
1.Structure Dimensions 1.Structure Dimensions(continued) 2.Type of Construction
a. Length(ft.)= 55 Number of bedrooms= 5 [�Wood/Frame
b.Width(ft.)= g� Number of garage stalls: ❑Masonry
Areas in square feet Attached= 3 ❑Metal
❑Pole Bldg.
c. Basement= 2,414 Detached= ❑ ICF
d. 151 Story = 2,438
❑On-site Prefab
e.2nd Story= 1,634 ❑Off-site Prefab
f. '/z Story =
❑Other(piease specify):
g.Total Area= 6,486
REQUIRED SUBMITTALS:
All of the information must be submitted in order for your application to be processed:
Not
Enclosed A licable
� ❑ Buildin Permit Escrow A reement and Fees
� ❑ Plan Review Fee
� � Com leted A lication Form
� ❑ Pro osed Buildin Plans—2 full size sets,to scale and 1 reduced 11 x 17 or 8 YZ x 11 set
� ❑ Minnesota State Ener Code Calculations and Mechanical Code Re uirements
� ❑ Surve —2 full size,to scale meetin ALL surve re uirements
� � Hardcover Calculations
❑ � Se tic S stem Certification
� ❑ Minnehaha Creek Watershed District(MCWD)Permit or
Documentation from MCWD statin no ermit is re uired
❑ � Landsca e Walls and/or Retainin Wall Plans
❑ � Stormwater Pollution Prevention Plan SWPPP
❑ � Access Permit
� ❑ Data Privac Adviso Form
APPLICANT/OWNER 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$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;
• Understands some or all of the information that you are asked to provide on this application is classifled 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.
. Agrees that in the event that weather or other conditions prevent the completion of an as-built survey at'the time the
Certificate of Occupaney is requested,a temporary Certificate of Occupancy may be issued upon receipt of a s10,000
escrow to ensure completion of the as-built survey and aIF site improvements.
ApplicanYs Signature: °����---~.�- Date: 9/16/15
rau Camcr�n �r C am cr a�n Fine Custom Homes
Owner's Signature: ��'����--� Date: 9/16/15
Paul Cameron for Chamberlain Capital LLC
Packet Last Updated. August 2015
Page 22
City of Orono
' Geobase Data by PIN
�i. ,��J^���~=lf�'; �: �c-�
PIN#: 36-118-23-33-0009
� ' � These properties must have Grinder Pump,tell contractor or give them a hand out from the drawer up front-See Engineer with
y ,- Questions!
I
RESO#6514 needs signatures
SPECIAL PROJECT:
Before Issuing New Home SAC Must Be Paid&
Before Issuing Sewer Connection Permit: 1. Pull& Pay For Orono Connection Permit 2. Pay City of Wayzata Sewer
Connection Charge(Charge x No. of SAC Units, See Project Info&Current Year Fee Schedule for Wayzata)(These are Pass
Through Fees That We Will Forward to the City of Wayzata Once Collected) 3. SAC Charges to be Paid. 4. Remind Them
Inspections Will Also Need to be Done!
[LOG ANY ADDITIONAL FEES YOU COLLECT IN FOLDER BY CASH REGISTER&IN PARCEL SCREEN OR SEE
RACHEL]
Before Issuing Water Connection Permit: 1. Pull& Pay For Orono Water Connection Permit 2. Pay City of Wayzata Water
Connection Charge(Charge x No. Of SAC Units, See Project Info&Current Year Fee Schedule for Wayzata) 3. Water Meter&
Horn Permit to be Applied For& Issued. 4. Remind Them [nspection Will Also Need to be Done!
[LOG ANY ADDITIONAL FEES YOU COLLECT [N FOLDER BY CASH REGISTER&IN PARCEL SCREEN OR SEE
RACHEL]
5. If Connecting to Water,Must Pick-up and Pay for Water Meter&Horn,see Current Year Fees.
Information on Water Availability Permits: These are for permits for future hook-up to water 1. Issue Orono permit 2. Schedule
Inspection with Building Inspector [If this permit is issued,the line is installed to house but homeowner hasn't connected to the
water system, see notes on water availability permit]
Variance
09/17/2015 Page 2 of 2
;
� PLAN REYIEW �HECKLIST �OR NE�N �TR�1CT�1RE� /A�dITlO�� '
� Address: L� �YtTr�illY�0�. � Permit No ��� ������__�
� D�s�r�ption Qf.work, '�l(. `�J� �I Y�I�.. �afe Rec'd �. <���...
.
. . �. � :
� , °.
. ..
�
o,
, . �
. � �
��. , _. � � ;
,
. , . _ ; �.
.
,
. _. . . ,;. .
. , .
. . , .
. ��.
' $epxic r,eview by�l�� `�" ���v► . ���te.A►pproVeq �"'� �1 � ,�`a f`
� . .' �,�� � ,�t�,t �, '� � f `� � ,
"_` Zon'in,g re�rie�►by ,' � ' ;K ��te App�o�►e� ' �' ,
� . . ��.rirb �w.�+a 4� r .+.�� � .
,� m: � ,�. « .. ,t.�� � �u t�, ' r
� � �uiiclingre�ri�v�y� a � .,�?ate,Apj�r�i�v��� �a�.����;�.��„�� .�
P � �
E .' �� � i �[ `� } '� , �} r s: S�h�e s 'r 1i�T��� ,�et_ `Y
t . . ' "F � - , j ; � , � . � � ^Y . � „ �. . � � ;
� J ti m �
� '�` x����� 1'SY�@VI/��/•��,� z�+—r�+w—� ' s-�-�"r,���e� :.rr�'.��,r.r x� ��ats.�qPpr����' � i; .,ab�s ,�r'�z,�, � � ? �fi z �
� � `� 'z � r t "� a �i F € + ''
� f,.� : �` ��i �t {ys'� ��.Y�' ..f� � �,�.� � +����r,�'� �,'°a�,12 k�,.��+ '�fi i?`s't �r �w
f .. . `. .. . .. ..
y a tl
. � � �. �i �. ..� .. �� r�a �d�. ���"`�a�" k: s' ;��'�y.i ����'-�,i s i+ �t . �,: .
a
E ��n�g t�`�a���at� �,� N ;� 7i�n��g�i18�. �� �'��� ,��es��`#' ��d�i�'����;��
� � ��.
� � .� , :. k l .�'� � l L t a,;s F 4 ,.. V.� s r: �- a�'3 �:° � �,a.� '4� m i iRdky'��-`��'��a. ,� x
� �' �Qni�9�9Lot Atea�� �� w ���� � �� �Wid#i�_=;,_„_� � ;���t��y��'���� �!�� �����z�� ; ��D�o
_ ,
� . �� ,:l{ . �� ., ' j : n^: �.3 4 ` + f ;,k�YS `� a» �4' 11r^ :,. , -�� � ,� r a
i,l� �y�i `j�ti:�° d 't�� �/Y �. : .}p rr K'� f" uz IA��€'1� h�" �i' �t '�j {i�ixcYs` �
S�N���W.��llll�rCj�i �"'A���I��� ��� ��41i'OF���r�x4§� � Xi�����i.i��f:..��y����S���CI�i���/���� S M1 q�` ���
; � � a 5 �. ° .S�d ;� � ' - # ° , .�`' '°} w y s� �+._� �'�`�'��*�Rd r :'"s�` ��'a. 'Ye _ �x '
� Lat��sc�pe p��ra s�i��n�t��d? ,:� �!'�e's, ' t� No ��iridsc��er�: t x ? � � ,, ,`. � ,
:r $ '�t �y�� M s � ,;t`�' yi� .. Iry ri �� � _ +M F tp � .� v ��^-, • � d
*J�r�����i�V����aM �� � � �'�-�'{twr�l1��`�; �� ���'�, ..'>" � �a �"%� v� �,.t t .� §�S k�=:
� � + �� ' ��� �� � :�. . .
l, S .t, „ y S�^ '� �i �. T � c i
� ���'"� �.. ` �;' i•� �:' �T �� �'. { ��, '.�r '�F'�� � ��s a �»..�-z :� .� z.�:k �,:�y�i«���,�'�� �..��.3 � � ��*_...
�� ?'� A! ri/Al�.t� -.� ��7����{V��' �.�,�z . ����.n 7a�.� FS�-.4��jar ��' .�y,�� �"Mi����,����,F}�w�k """a�,��,t�����v4�°t'.
Y '4 � $. [ % .:; w ;.: Q '� � T id ;'�. J Y t � �,., y 9„ ..v.�
y . 4 ^� 3
� . '� ,: � �t L �.� � r. ?���� �.'s tr � �'r �(1��F i 4'k+ �'! ��a �t ..I k�r� '�"�;� �r �� n;. a���
� { x � ��r �-'t �-�p *k -��,} � � t g �� y � a `a°�
�@ � . `: � ; �' +¢ � �. w��t ;'� � ..v�4 �'� ;�:� "r,
! ,p 9 � ,� jf.�# S s �, T 'M1 t R ,y ., �.lC .3; � �" S z 9 F �� k G �i- �FI.� �� �p:V,"°�' � ����t �"i� '�x��,
_ Yx e i.. .. � i f/': ��,.- k'i."c .(..� i+ y '', r��. k f.
��sY 5.; �? a x,�,°� � ,� +'�`�.,x.�. s 'y ' r a a .� s��+ "� �ar�`,�`�'yi � .�:°. �t.'�'� `� z. �:�,
� t .?+ �y�' s. g�� �� e
,. �� ���`,,�g��x� . ,� r J� s '�����a��s 'r '��'�� � ���fl����l�.�'���;� �^ , �¥ ��` ���
� a^,� : s� 5. �_ s' x".� r � t{' �i e p�h a. �' :n �..-£ �. �:, °",w
:e 7� ��� s i�a,-r 1 ,+y,`* z�; �.: r`: d g�f � '�",�s x tih-�! .'�,� �`� y ,.�,,
y.� 'y�� � t�yy, �y� � ��� �3 � c #y�pj - ,t... w �,� �'� � rr t�x II'�`� s'"�.��4:. ��`�. . A
� �,1�7��{T���1�1�,1�1�`���J�� fiFi����(��9"'�� ��''� �a�V�Jbt� 4 � ��� "�Xe��iS �.�v'1� 4��.. � y���. ���.�M ' ���t�'"ts':'�.
k: ^u� �+-3.. + ,� ! �. �+i. '�--�r . . � � �y .cv x.l :? •�
� ' y ,�- ����� '� 7,� '"A s ..- M � e .Y:� r '�n t l- � �,� - � 'x� � n rM,.h .�,f`',,,at`,.y� �p-y .
r , aa � �, J �` .g { f�. ' � x ��� a .:� a �.M #- � -� s s�
�.« Y
:��
# S #�!Y v- �k : '"If'a.'. t 'v 7 d,,
4� ��,,�. �� � ���,.`� �j� '" y �.t � � �, �6 ` � ,'� �r�t�� �.�. x :�� � ;^�+_ .ra fln �'" +�t
" � rs #�i'� rj -��' '1' � •+j�,� w�.�`�..?;{ ,�.s�4 .� �, a€.,
g x�- i�;��' "r�; yt .�rE `J�4,st�� '" �� � � r .�� � ���c- �`� ,+x c ''S�E` �.a"'�}'E�$�.�S'}t'an �i-��+v,.�'i�*i:`'���' .4f�`�'e.�' R a.'��
t �� ,���--��� - �,�sa ..�� a, �,:;:�. �p��'t�,�`r ,� �rt �,�.�,.`_ �"" "��'` `"�x ;�: `e��• ���'a..��� � ��m,"s"_."���,�" ,�*5�,�.��� ��:«"��'na,y°�"", ..ya��� `'„- ra sy; ,,;�, ����
S rf � sn � �,r✓,�i���r �; a` +� �.� a�� ,� p 4��� !� `a, �° � :-�`s� t`��e•�s^ �q`�,�*� �D v�;
Yf n
4 3a _`�=i *+��,�;d't� 'u` t% a t� �+4,�*r4Sa 9�v w`''y�" r "� ., +'°''`"'h,�.; E t �S zr'�t*,�t;;r��n,"� <:: .r r�"Ki" `�^ dt+'`' n� � vk-w».-rt�s ist«:;;C''"`f^ic - r�
"�' �'r �.�#.� A7�> �:� s�ra. �3 '�s"� `.w�.t � � �:� �iv � �z�i d +�,d�'+�+ 3� y�, �.-t' �� 4 �y �a �`� r �
�- r� ,- 7-VR��+� ������ ����F �.!�� ��~.��� &' `�'.,�� x �..,G,� �.y� t k�r`::� �.;`�`,�s . ��'vc-�- �''�*,r a���%' ��A�
�� `x � ��s�n` ` +*a. �.s� > a,c.�. ,� s`�. ,,,, '� ,� t v �,u��� 'e "'�� s � �t ,+ �+;�,,;.
��t�'"*��'fi ��,< ��,�' �`'2�-�'"�`''`"`� �'a^ '` £.,e�n z 9 b 4��S�11���° �RthByd�!^��'r��€ �` h�u. � ,�„ .� :-��„ sti<, ` a^ �..��� �� �:
� -� ,� �;� .�. '��._ .��°�`�" �'�OOt 0��#18� .;� �ew . 4��� �� �`� � �, �g ��'g� r�.r e�c � :-�
,� .i ��. �E$�e �'!'1�' � +�, � c s ��torCiCAY!!J�S�f���t ° � �� ���t.a,�',��"� '',,"�`:�'��`�s����'' rm• �-,:`�� �r
� i � >'� {�, a r �'���,�t'��.� :�1�.'��1��������1G0� � � -��x�i � �,,: a.���.�� '' ������ ��.�, i �"
�� � �
�,�-#ti� � �",�r ° ''7 �.€**Sa��"r?°�`^''� � .� t` `� ,� _. r#�e���.�� s .c ��-�`"n :� �` 4 �r'� � ��Ir'�v^a �ie�.>a� »�#��'��f,�..�a.,. � ��+�. '� �*�,"<
� i�s � �w � i � �� .y �, p y"' .0 . i -V �' $ �...
x� ; �rcy;� ts,�e� � k��sxL sN ��' y`� � 1� p ���d �'� �t�� '"'�n y. �'�� ��}. u e4 u,_'��+3��.c�� ,r� F,""�,,: T�q,e r `"' ��x-� '"t�^;, 5�.n� �`_.`�'.,�+ a 4'rk.n. �:�
�f }�� Gr>a ;�'' �r'{1�'�-�." }, 5§. � 1'" ��` ,�`I��F��-� . '�,� '�,,,�,"`:�', a��7 �r.�.a ^"l5 c � ». ,a �; �d �.; �`,�,r�'"''.��...��
�p{ y '�, � � y^F+' s�� '�)� �+ v,; � `�y�,� � ryr.y7�,)� w � < i ,�,�:� �a,�� q�6�3 ` 3y.� � ° �
E�eS'dt �'.�h {� �.' 1"Yk [ ��V��1�� .y`� C��'�L�4 ��� SJ,«,��� ��+��� � '•»d^S� i{ -.�* �+�A�� � .R � :.� _
P 1 x `�` � 'S ja� i"a... k fi* t a..' 1, �"�' ''k' } `'` -:. ''�` . � � r ,i" � .`
rc '�� t4"f'`�E'�sQ �"�tP-�S. YYItfi��WS�ks#tY '�d��81��1�d�Sf�flS�"'� 't� a ��� 6 �a: �.'�4'"�'�,''�"'�' � g,�,�. �� �.�
� v': � `�` �C�F�.����`��,&` `�,s�� ��s�,��,,.�,�`1{�1i„���qihYoftF�g�, �` i '� a �, � cT�,3 t.�'�� �" ';� _a s 'ka �. �` �.
2 3, �t�r�5 '`r t''€ +� ����fC�� Y.�i,^.n�'�1 f�R6g�pp�ql � :��.` 3�'rF*� 'C 'Nt5 ,� r� �° ...�.t`n � 'i�` � �1 �.y ka�� �.�= m' .x.
! .,�.. . 7� .�r �_ � �.� ��x x,+ �n.. �;�'"r�?`� k .e�'� a *CS �,� ��'i. ,g� x� � :-:t - t" -r .a,:
�' �.' .�'"-r � #� °�'a �' � •' -+ .t �`�8�3��� YDO� - a � � a t A���:.�4 X t s..?l `.7����� r s,✓�`�» �`�r �" � s
� } . � �'c% �,'� s� � ,i,^y R s h-d,� �?� k ` a d � ��'o:a'_. �. ��'v,. '�' ';:`�`� F ���'r�. � `�w�`ry �6� �P��� "'�s� .�#, a� �. �- � �� ��,::
�, :��� � ,�" • s,�'GdBI� FII � l2C�C��" � ,n ,� „�.� �_ ,s��,. �i.
n Dp /'�y�{� .
e:f Y' -t �? "7 � � � 4."" � - l7n" � ' '� '�^�"���r �. Y '�'`"� .�
S` - � � �.� z . t .v Yza �,it i '" � '
�� ' � �.� y r a ��Idb ' Sil�tra��t�l�fi th�d ta�lce � 1�p� �'.�b- s�r� �' „���F� ?�k �Z�*;�
�4�. ':�x r w �i'� � „�ti .� �:�x .:w � ra Yy_�1''�� m'.'t,.}�, �q �� yt � 4�M a �r i�'
�'i''�..y'� ��t .a�� ��r `4�r.T:,b,`W �b.t. E��rh r 1���1��@��;'�Of��11M"•>„ "x��"'- 3,t, �'�; �`�S�- �3 �:d�� �N'7 h�,p � ��1:tfi'�� �, _q�Q �1
y�._v .,F�.Y� .�,A ri _-"F e�,�1iy„ �y ��.3 r�'�.�!Y,11�1C� ,f�_¢1O_��@�� � �g � B g a 41�k ���"�`',� ��° +��r.., 1�.�5 i"y�a,� . 4�'�`+t��,r 4tiI ���ro a�
� 'r� � � z�e'�`3 a � a �`��"s �..�`� �`4� ��� g „-��,� �� �:t `Y a a� , '��:. 7 - as,� . H;
� �a� << `" �,,,� ;� a , � i ` �'..
,, s�s "�r �� �7� �"r . �, �;d ���s*� "�.� ���'�.' �� �Is.a� �60. (7�.. V�''�r �k 3,y
.; x . ��. � �+i3� �r'� w _�.'�^ .�. «,w� -. :� �. ���..��, ti �,,� ��t�ar�'�,�.. ; � T � ,; �,� �`;:..0 y�' :���3��,1'-, �„ar y�.:;
r , � , � �� ♦ �qL�t3�#iE��tp�F`�YA����flaf�' � � r ��5� A � s a n �h�, �F' � � 3 � ;
[ � +�-w G�L�` iP��� �' '
3 t�: � ; � �..� � .� ^h78�'(15�x8tC,�9"'�CS,¢U�tC�Ct(bl1 a`' € �3 ? "'� � '� ' ��� "b b��, � 1f'��.{��' s::.
'p k%v ' .. . , i F`,� #r' t� �l � � � �y.-`f`
i'� ��? ' �l���C,n ����.r����.S���C�i,N�� � �l`�ybB�WE@�1�18 � �y.�r-k � y��d a �-rt .k. a+ : �? z,: ���: ..:.,� tYVCC�1t;�`'� Y�,.
� ,�r.; r �.E} „��t1S�Q�Of��.�' ',base,�i,i'er�`fl sPA<'.eflo��ndth� s � �Yss��<=�-'�a sr ,�;�r^^ ',�x�x, s ��^'",,�11@;�, 19�es`��' '�`�
' '' ',..EX($TII�G� '�� �Fii��ie5t bici gr�de adjac�nt td the� ,�' `�F +~� �4��, ' � ° ,� x '� � � w•and �ii�he�Sf � �
� a� ��+, ����5�; t.��QLCl�8�0���9 feet�whicMever�s less) � ���a# �� a'".a, S. �*� � � � ,�:ok���r��uC� �'? �r ��x:it p�,.
b ,r' �.} ,y � �, �` x�, • a,:1�1�.5�rr+ly+�,� �'�.��g� ��.
� # ;fQUf1 ' �G ne I F�{ �. , _ 4 � t� (�ai m�nsart��et�)�Ncr� '
�� � �� �1 ,, ��'� � � sL1�f`°c�- . � �
� � �f� . .;�, � ".� �'� � 3 � > �,4. t� .� � x9 s*. -'
�,,"^�t��, si j � �,. '[?e�i�l`b"�.1� �h�9fit '�
� , :
° �Q4�1�1$° �>:
, . ,. ,.0 � � x .: � -
}
.
. . � � . �_ . . : K
. �
. ,,�
. � w: , : . .
_, w„
. . �r
, 4 � . � � ,. � � .
`�.,�
� Upclated: October 2015 � � �
z:\forms�plan`review checklist 1D-2015.docx ' �
� � <� ,�.
, : �� R
� < < ,` ' �r � �z
` � � ' A .Av�rag�Lak�sh ��a�k � .
�`� �►h9�'ei�,'t�d D�stelc� �VICWD�'ermit z �_�� � ���'�
�
. , .
�., .. � �,• � �`�,�< �. �.
�� � ;., , '�� �; ` �x �
s _ � �,r � � � #� - .� p _ '. ..� , .: j a . �' � ,� r;. ^X ��,�� ��+ # .;# ,
' `� � � #.� ��TJ�11t�t�lh'It321'; � 'f��^' ���� ,` � /Y�$" �. �0 % 1��� �+ .�}� #
� x. � �'S�l�Y :'�,� y�,7'�'� �. 5 �, c ; F, x �, �. '� V �'.� � �
�'��. s � '��.t a�+ '`��'�- �s � _s
, ,x, ' ,�w_ , .� ��a¢��l i e���''��aCf1�C�. # < � }
� G .�;x ry l � :
� �.�x.� s,s` x 4 ' �c� �, a � n v� �` �,� �fi+t3f �'r �� 1 ,
� �� a� .r 7:�� '�,.x't�.:`�� • -1 `�3+f.�YYE"�Z.r�'c�.s "'�..;'c 4r . ° �, � n, h � s �c wy � P� '� s
� S� ��� nb�. ��t��i�lL��y �,'� ���w7�A�. '� ���,��i?g!'1i s �' * Jfr .`h�'�s. � c�sy '4'.�"R�+j"i'+� '�z��L " •M
� ' �,�a r:t��y,�ist���''����`�� �� � Hardcov�'= x .�I�r,���t�x �� �t�1/�t`1,��t����ir��, ��j'��� ��y�, ���
�S'fl�. 3 �' �� r r ' ��y r t t � ' ,tk ht�` .t - i � � .,Zj`p ��`.t,`'S
K F e a, � �-b� e d �Ll��w� ��.� � '�. ���'t« ., ` ',
�,��� - �� �ir���ane �� �� � o � � /� � �,�t � �> ,�A = � � �
�� `�
, ,� �,
�� ;F a t} �^fi �� � �-> f t� �v � .. L ,�,t,. .� .. � rv ��'�.�'� �;� f 3�'4 ��t ; T j��Y" ,��'*"- � ,.
f}? � . �a R A M4 �,. ;��i � ' A i Y �� T` 1"Y - S` } h'.�. �2 'k
��-r,�y �'� `���-.a°'�t3�.�� ��'i'�.�t� g '�t r.;',k„ <,._� i� . � X <�� n ww,3,n 3 9 ,pi }'�.�F'f� x-�'�•aC � � '�, Y� ���`��"v��� s�+a�` I�4a�.:
� i.:�y p°F ,::. '�''§ �i;.�,."'�` ,�""'tro �*'. .n�s1` � .k �.A,- ;: a r ��,,. +o"� ;.a 4 �,r:����'ky��.,�� :» �3 S 'a�e °�* :� � '�'�z�� '*�1�., "'tr:
�.��s:��s �ti,�i a-� r#' ,�, t ;��'$... T �;` �;'.� r ; 7 _� y 7. �.,�� a: ; �- � �H - » �� r ,.��.h.:
�Jr...{F,�"x 4 ° � d �� .�. f� .:;; r� �.w�#r �..�`'C'yYi,a.�'67,�t �,�,.`t�c '` Yv* ;r �iS � cs� �*,�5'"��.��� Fa��'4 z.,e#� 2$x�,4;.uk�,°T "`es�v.::L3,'��4 ��s �y��4 �'
#-'-`� y_. �. ��"� �3.. � '� w F� 6 �}•r � . �. .�.sR.Js, .m�,.'"s�s„ . rs .& �'z. t�»v.'�
�xr7'�� � a.. 'r�w�..�'.�a�L� z9�� �t'' R §"�'.�"v"tr+.�� J �+;�'s idM1 t� r` § ��i"r�. � �'' . .�" t���a�� ��� '�'�3k�E:
���� � .y?"'{���.�L-��,",.� , sa � *r r ��e � y�sr�" ^& s�. ;'�, VP�9.,���}�` � � yX��`R� s �"� ���'
�°w'��T`�Ka�u ��-, �.> M � �.�`�":2��M�r� �x �'F�,.-;, ���
��«�i���� ���4���!�����x" .. ;������:"t � i��a, '� '✓S;a`1us��t,
'��" xa� . �- ;`����`..
9",:� ;��. "�`'�`.'"�'. 'A� ?'fi"�y 4 a" t�,'�'+.1'� �"��"'`�R : .r r,���d` �'^�`a��k* } �4�-�*,§�-.�t�"�`,`k" " �, K'� _# v ,�•a+Y..
E•x �� .��; M,r �; �,�, t G� 7��'"
� � Y �
1 .�k5 z '� r. . :r.a.r 3'. ril. � `-.'F r �.a . ; ��C f c�!a „�r+e t�
�,'y � ���`Ya�'"���'°��,�^,?>"� `-� 4 +' � � P����*
�'a�; ;� ��, ,� �.*��,�`�'k"�' `���� ' ,� �r
�{
g 'v r . � a,� � n � * �'a+ � s, �- i1 3. vg fi� "�} .. . t � � a�^
� '�.�� �"�,� ,.n�S :�,� + '�-. 4 r�__ 1 �r���'w�- �s a� �'.� a v`�: Vt'` s-..:�..r �sA. .:,�� r a& ,� i p w�,
��r. � w+4 t i,� ., 'z° � yn' � V�Y. 1 '' a �^x-,�2-�_
;�3� a '�'�, � .'w'<r;. .i;t �,�r. .r,.r�. . ,�,�4,, a )� ��:� . `�•"�- 'Gr�2� q� �.c,�^`
L � ` �T1 � f: � Yv a�,k ' s�,.V�^'tr��, �"�.�*.��t�7�� S�a �
t�} ��1 y � � �u`'r:- � ,�'�u� .. .. 1 i �(&'��+s ��.�,^�Ay `� „}�;��.
-� * � ��.�a'� �,,. r� #s '` "� ,w,��'p i � - 4 -y,t h".v Sa^ }-5,� o f�ti� � �� � �y�yr +t k��
�,aZ��'� .�n �c� aa��yfi .�:a � ,•{� a.�a4.n f 'Y� w�-:,�a -3�3 '�" T .€i t' i�',,.," � ���.� �' �_n,`�-5r.� � r�S x� .- �a�% ��-� � ����e.
K�'+� ��'�''� .:;�a'„ ?a� �. S�� " M �,�;:Y ,� � r�b r C� �"-� ,�. �,z '�1. i� � �t34 w,� :i f� �,::3 f�r7� +k��",���3�°",i7 ,..:'"W�- .�s ,::
a^ a, �„ �.q�. � 'n, t 9 �...0 �
i�r-�; � ^.. ���S a�- Z �. �.�:: �N r., r �a r y�$ - t x�.
���r��-� ,�+�W,rtk+3 ,f'd"x..�...C4Y's�k'� .�'. _ ��.��� M'�s '.�'`� � �71 �` Y��„ �..�� ��'' � >�� � ��� °'` ,-.t � :�-vr.. �
�.' w ., �� . : � .� ..
�_ �<s...�µ� 3 .�, � �� 'a.d ' pr i ,� y ,� %�,� ,5 ��:t ��' �'�" xc�.•�'x '�i�i �� `P�,r�,. _ � '" :�, �: �k �-�� �r �..
# • � ���.f z' �'., �,-E � �'�,-x 'a�'� '��c+,r, � @�� � . 4 ' p ,a� t � � -fs � �.
� � �e� ' `�i � r i�-a�� �e `3"�' u .- n yr r t .
'� ,a �.
a. � � a, x.� 3�.t�v, � ��#�"�� �,��t e'��€ � �� ',x� .:��
"�+.'`��r ���, v � � �,+�r,.E;�'�m� 'w < �r,,,`�-�f� .�„�- ,, �r. �6t ,�,. 4y
,L � '+.'�,'�'�,A'� .- '�+� �, �'��� �i' �h' �`'t�'�R �"� z'a°�5&�' �� +, � ,s' �3 �.' cEy,X:
g .y � u�-� �� . e"'�.'��'g s �Xzu � �'�'h +r .�#�q,a>t''�''4 p��� t'�% ��� �. ��` - + � v9�Y� - :� �"'%
t .�'.. >�t ;� L t -_w . .�, x �, ��„�,� w, .3' ty� �. �r
� k"y�,�, 1n', i. �^Ta, , � "��:t ,� .'�xr.. i�u � �+ 4s j H''�^'^E5 Ml�;} 'a�i-4�k�... �R'C"'T'" A r x;�1.�A'�F �` �k � f :��� .s.,
} s �`�9: >:i. � '- ' . . ,. . ..
,�e ��i. .�
'�� trrf `a ^ 3`$", �"�. '�`� "3 ;:f `�✓s� h �, ."^. .�� ,�#. {.��.a� *,� �a'!�'�� .;,y�� :,� "e( 's� �Y. �S„4'
'� �,s., �� k
' ,."� � m�N .a r di',t A '� � �k �'i 4
' },� � - 14 �/i .i � A^
���s �.� ,, � ���.c�r y; s �R:. *��,-"�,� 3 �.�' � .�.� �� � ,c �� �§y � k � y � �,j.:,� �� . , 7�,�`�...
�, � ' .. .� � Ygs - , . .�
,'�}�:. �'�`� �--c��; �. _ ;� € .�.. �f��.�;� t'u��'����y, p��'r�'at��`x`e.a,y''�,�A ��r,�a��.�^ `� , � ����it'�.^� ,� ��,,.'`�' � " ��§ �"�" � �-
� .• � .� '� s . . ��� # .; �S F � .s«. , rv. �w.i, '� � .��� F�.v'L� � ;.
li+,���� � d r xs-.L ' -^' i�`3�g 5r� �� }k�',� Y �i ��
�y' .K; ..„ i�� 'i'�- 4.f�� "a. - 7� ;� 4 :� ,„'� � ax;�*P r>���- �, � , g'�'�,a�cs.{�.��%'s�.:,.
��3�' � � '�.'r. i:x � �.n .�} .,: L # 7 �'�-"'h_ :' � 't�1 . i�'�"�' _ }d, .. �1!R��'48 "`
����}`�f't� w t 4.0 �'� u r.$ � Y _��, � A � Ae[7.-+^ �s•- >Y Y •S'�F,..� x`� as :�`�F '`'` �I �� �r,ay.� 5�`�,�•
sr
�.aS,iT. i'7, §� '�1 jl .�.. � 4>�� d .r �'A ..�
s�a
�.a� w, {�', .� Y �' '.�
����a�' # " .. i �>'" Y .l'r�4�b�£��„�'.+TF��r.� �� !k '� �� � • tY � �.
2 y��, � rc4�#"a'p .{ y �
����� � a at�:� ��iSi�f�*�#-��yxYa'cXg �'N+,+'�t'��. a� � �s '�` ��+ '� 4.�. ,4� � 2�.wr,,�'"�',
��t ; �4� �sl+ "�-; � �-� 4 r .�'.x r;. #T t� s"�, 3� ;.* ' �r m w�3�€ ;,
_n n Q. . x t. �.. r'�`�'-.�',�. s
g � � � t � �� � �i .
�-i ?', - � a ,�C'�i #y;, w '�,�"r � � '$�� t'' ..
,� �� � � � � �,
�' a, e � '�i� i �a�y �r� ."� �
� a�-.� Y �� �S� "� � �� ���� .n ',. _ . �P`�
, ,� ,r� �`�z *�- ,�j1y a+ .t`; pb' +z�������"�'1 ��'a.,, �* .� { .'A� � . r a :
� � _ s i' _' t`s �a{�.'�'��a�`., �. -
r
�,#�, { -�r .. ' ta
"'a` ;,�. � q,i'a'.�t�"�� 4 � '�- .-#�� '�X
r� �� a�."„�,s � �"� . �' €
�4��'�• ' +v � .. ,�iSwY`k" �'�i `w'�.'�°f�.,�s��� � ,e� '_ .�� a,c,�,� r .. ��" '�, .;yy ; �.
3 � � Y
` . +fr"+�� � �
�'` v„ ' s� ^# , 3 a c 'ty,��: z'� �� � Y
��
�; � x���^�"�'„�,t ��a �r� '�rr d�� ��� �; .W� �� �`'�'' � � ' �' "�'��i � °�-�, "� � x d
� K�"T"� A �.>.�°IC� /.LG- .� '�-'f �
�,. '�,�n; �" o-gF.�^„�•� �:,,. ,...` }� `'�Y�`k' � ��.d`��'.'�..�c.;i�- ��.;�,�,'�"��"r�,�� s p�,k�a�.
� -v� .k�{{�tif���P��3�°'r�}�, a ��'� �� Cf � S`a��y�"+�' � `' �t 'a �:
""-a .�,; vk�: "�`a5yyt, r s�,t ?4��y�' �t sy`-'�� `1 y ,`:,�i �����p�p ��-�'-_ .'� �:y��y 4:i.
- -�' .r ,��'s i d�:Va"Y-�'u`� g''Yrx&�'" :y, ��L ,� -��'n� �tCi a Tm" .; s- -�,z G',
� ' `
,� 4� ✓R ri# � ns u ,}�w i^a � :xF � �} �vs� ;g+��,+�'�2+ - ,
�R,�;�� ,y $$�:;,�r �� �w€" 1 i� .� `�se. �� '�S 3�r �{ �:
:m �:4 � � a, p s �,�ar; "�+la ����f'`t +�������� 't�`�a�' s h�m'��' .'+� � ,., � ; �.
� ,���� N � ffi�+" c+A v ` - �, �r "Yp�'�, r�„�-����;r "a #�`��4� '�� �'y ';M,�`� �' S5 ��p� .
��: � ��� .e�k.y, `'� ,��, a �t x,�4«,� ��s�,`�.' "� =s#,.�� ,: .�`'. ' n>,-%;`" ��a"�..: � ��^'-�° � ��k�... �3`_� �,
�rt �m'`'� �'�'�'�'2 �3'Y t �� �a�'" ��`�`�"�r d` ,eq;�,c'`n 2' �ffi�,-x- g {..��'A;k�w�� .;, ��"iv�y��� ? µ- �' ,:� y 'l' � �.'� ?�,
� � �r � �
��`'�P��*' 4-'� ;#�. �� ,r �� + '-�'t �- +� '�, a x�",� k, F�'� } 't.
� '�'��a-�" A ��`� �`_ � '� ,'- ;�'�5f �r�y; � ��;sa.�.�g �..� '� �l' � f� �d�..� ti-' �:
�e �.y �„,. �` t S �
� a .4.;: +{�'+ ����� �".� �*z�'.�� �¢t.�'.�'���: �v,x'�.."'�,��'�'� � ��'sP�'�' Y ��� � ..{ f. ,, � � `t�� :� � '�:.
.�r� � �"� #,.� Y � �,u #
d'M�l; R �.'"k +�'�k� `�a '"is. .��' .Y':�'�
�i� .;Y'�` _,ts.. ' v,��,,,, rA"��ve��` s 5 q•�»,`�k��.Li Y �`"�+�"' ��`'�� �r'��_ ,�����'�`'� � e t
��� r.% i� �+ �`�Z}�yc. '-"�4 �'� ';n i�.� �` at+,' � � •-" � S�.a�a°St1r `���'.� $ +�Fx ,����� �� r�q. ,���:
�� a .�i �47��ri!�� ,, � : �.r"'����'�t _. �� _='� #�. �';; j ; "+ "q' � ,� 'u �' �3'' z' �'^� ,
�� ;� ���c i -r � �v� }�'- '� � "" i'�s�� S�� r ��`z�4 t�`'�"" ���k''i»h u* a.
�� � v�. 'gy� " s ✓ � "�} � ��Y�6u��`'a`}4.�I �,�' 9 �W�,. '�t- � . .�.°� �r.'''�
�,�, �. "� '�.,�.'sm. z-.'�' � �,3 � t�' #`r� t�."5 c��. .�,r �
�Ly;� s � � �� ,.g�,,.�'�,r�a� s� �' �,: °A�4 4 t x� °'��F�� � � µ :,.s- i. i�,;, �s ��'� „�g ��'li�,�'�r t����'��.
� � ��. �,�M q;.� .� ;y� � � r a:, y�3 0.�� ;.. � r ::1 ,� � +p t `rd`� �mt�.'":�'� a75 i y"`, � r i M;,�S r 4:.
..^"C:r 4...-h,R� x„ 9
� a.,� , 1,,. ..N i S M - yL =�+5 "�� :.j t-y #� �.' � ...2 3 ,
J}(� t' 3 L R ' � � �-� A .��a .€.� lY .f �.5
S !; Y� _ Y F � y�Xd it�#�w t f A
r . : 1 � �.i. : �.: .
i }
� `llptlated Qctobet'�01�5 ' , . _ `g
_ ,��#�tfnr',�nclydan'�-Pcf_rs�wl>h�artkUct.1(;Y:?fl1Fr�l�rv a- �,., �, � - - �;�
PLAN REVIE�IV CHECKLIS�' FOR NEW STRUCTURES/ ADDITIONS :
i Address: �� iYi�'��� � Permit No.; �.�+�, �`1�
� � :� - - � (�+ � ' `
Description of work: Date Rec'd 't '��'�� �
; L-� _.�.;._ ; ,;,► ,
. Septic review by . _'J��l/�Q.Ir� `�=�.�(�TU''.� �:Date Approved: •
s �oning;rev��w.by Date Apprt�ved
, ; .. �
,;:
f �uilding;rev�evv by. �( ,; �: Da�e,ApPr�ved� �� f
� �' Grading'r��riew by s fl�#e�►pprov�d; � � `
� � � - : � ' �.� ; �� ��� ��¢� r �.
�� ,� , � ,r �- � �
' "` �4r�lrt�bistrict �' "�' ,� Zonit����l�a.�� �,,�� �'�'��� �te�+r�#. •��, ~ >} �2�fl,�5at+�; � '�. �.,�
• ."` . . a r a ,��� �
w .
, Zbnmg��ot Area, - /AC �iNiclth`��, ��Lat�Co > ge ,'� '��� ����� �:;�/a�
�r
� Suivs�r Subro�tted .�d'Yes� �1 Nq Dat�o�'Survey � �� �R�V�sed ��'�
� Prb= os�d.Set�i�ckg `�`� � �f� z�§ �`
� � _ �''J� � , r � _
f Fr�sflt�� ,: ��tr��� � ,=�1 S,; � "V� ( N�; �;. h0t��`��ild�r�� '- ��$t�anc� `
r j `
- ` � '��� -.-SW�. �-s r x +t..
, . , >�, ..�.; , . ,,�,
.
-., ,,. <... � _ _�=� a.., _. , __" ..
Y .
��. . . ,- , N. � . ��,. ._,
..
r � � Y ��J :5 � ���.. .:'`a.c R��
� '" �.� .+R��' k Y �e'£.�`,.rw�'��* � �.
�j ` +'� _ � , a �f . "`' ..: ,: .; .:m' � :. .•1 t „ ~; `.
�. �. " �i � � . .. . ! z^. 1 - � ��
3-
a A Detinstl�lei�ht � : £ ` ���i��#��igh«�„���� �� E ����� F�E trtir�us�6�'e+�t{�`° ����x�st�r����aritour
� _ r , �� s � ,� , ; " ; ` '
� Per�rneter�Ym�ar'�'�t�- ' �' 450�/�¢4 � 't L F� b�1ow g�a�te� ��of�tdris� �
; ,
,
. . �� �, �
, ' ;» r, ;� _ _ .. _ ,. . .. . ,
a FOR A�U QI G W17H A� ���NY OI�GRAINL S�J�CE�; `� � �
� �"� ; p � : R�; � � t . � . �e Myrf�euuood �
�r �yfr� � � r , ti3he df�R�g,�s� thq# Rropo58tl
�
�� , > � ;_ ��n�`�i'ir+���� ����r���,$ s�m`�� ��5����hdl
� � �'� , � �11e hi�hest po�ntx�f�,�� f �
E � � 5 �, s, :If yb�,h�v�a, „?�
� `; �i� . • GABL£L1�PPEb ROO�(nd� (��, �� �
�' wi�dows� ubUact�ialf;he dist,�Hcej 1�' ___ n,1.YV`� � �/� S'
' t ' ; �y betWeen e hlgktest poiht�E the roof� �L� •q
� r. � � �' ' �` , �`, T:� �o4T�e� �oi�t�of�s�rC6�r��4,,nding. U
;�UgTl�AC'T10�1 gabl� �ht�pet!r�bf � I � � .�j�� ��(� /�� �
z ,�, � �; �f ��AS�D Q� �� ,''' �� �.�G�t�IfP�P��?�4tDF(vyl�h �� {t/V`'I`V�tI��V I y
� ��'� ' ���'�? � csw ,,�}�Suls ac k�a t�e d nce c /�
� .�,x,�.r a }�c�r'�� �� n`'� ���, ��kA'�Il���tQ�����ll�tf�� • � Cu�b �/ J • /\
s� �� � ;, '�� � s _ � °�. �win�owarSd'1fie'}��h�S�Po�1���. � �W�
F s•r�. '§,� t i r -":' s-`ia� �.�7 �'00�s `�� .�+`". "` - ` (�„J�(('/� h, jn �
���' � � � � �� �. �� r� � �►4L5���� .e c��71�E�d��+ . �4,►V�-��J�1�- (�Wl�
, �; f � � �'ar�s��slr�Co�'�o�uts�rdc{id�v � 1
' � y, �,SU �RA�T1Q�1 �5ubua�#�th�BJ'ta bg �1�ihe � � �'��' �
� �'�� �.f����N bas�4t�e�X�spa�`� �nd theh
`�- ' ' ,; �X�TIN(�., iaighest�ex(st��g�tac1��djaCenf to the
r �
� �� . .���;����., GR�►P�S�=� � �foun�Atid�Of3 3-0#eet(YvTii�f�euer is less):;
� �`r ���,k � �{ EQUAL'S _, � �eRi�ed bi�i�i ��h,I��ht
'iI r r '� �;�
�•y y,4���,i�� _ 'r .,y ^ rty ,
Y . �l �
�
� -�;�'� � ` 3 � , � <� �� � � �p '
� s � ti � � ��,„ � �U
�, � /
;K �. :E .t;' ° ` •
� ���� � s�i,������� t�� 4'�`� h` �iwcw�ay�,����t' .;�'' Gc/,-t� �ra��'�O �
r � � '��rttmt Nt�mb�er�� / C� ;
�1 Y�s No, r � '�`�� lm�S al ��
� � ��.- �A...�;��e-�tf�ched,` � � � �������C,� �
' : _ ., , c , �,,�� .
� 5tormwa r ualit�y - �:y ; � ' x��roj�osed " � ' yt �l�s�q
Ez�stfrg�Hardc�ver �� �
Ove�la ; istrict ; #�ardcover
� �- (°1b�-and s� .•; �
�.Tfer� i� e one� � 7��, --°la�and" ����W��
% ` ' � �
` 1 " 2 3 ,4`� 5 `...�� �""'�'"'�""""
[ ,. Upiia�ed: January 20i5
i:\formsiplan review checklist 2015,docx ,
, :
_ _ _ ,
�
r ' �tEMAItlCS(in-house):
� a
,. - .�. � � _ �
-� -
.
... , ,.
. . ,-: ,� _ - � ':
,x , , ,
,.
, ._� . ���: .
4, . . .. . :, ._ -' ' -. '- - .
� , �;. .- . _ ... , , -
� ;
q. �
�., i !"ee$ 10.f/��Ila� �d �� � � � ,� y .' t� K�'�� 4� '�'„?�. . . .
� 3�'`T✓�`.> ,�;# ��Ci�''�>�, � t,� :k: s ���
� �'f<"5.'K&' �i, �� ��L"CY..' t.Sb �+` } '.
r Plan R��iew � ' 1i-� ," t` '
i ', �'. ,'. � . ,i .��:. � Y
i .44 �V ,E�h7,,` { � t;� �F �� ? 4�� ,.
� � � i � a`
� ' It'1�8S�g�#,1�1A,��@ ; �'�' �' ,� {
� l ry � � ^3 � y � �x 3 l
•��> ' - 1'1� � �Cil '� t t � ; "rR 's
r � � �` p '�).
� '1�.R- - � �� � � d Y.�J �� -T f �W `v } �t 1
^� r � ,� �_ .¢ ���" r� ._: `�': �'�E ., � 'r a � ,.9z �5.;w x r��:� � � ,
� �" ��ya F� "�a y t��8�.�� Q 8��` U �'�3� 8 i".' t� }1 z{� ,� � �-:� �¢� r�� i
L* M �
� , � �j ��Nl+�EZ��S d « � i � +$ t �t 7 ;C �., yfu,>'�..y,� }
S'�`''"' ai f e•a r y�' �' € '{�- £ "'4 ✓•¢��dk' . }'�W�.
� .� �' e. "��V-" `Sa -�.i -`x � �r F:� � m,. E�V ��t � �;� �
� � �����oor��� � � � '� � � �
� � � � @ �� � .� �
�"��IQ�f'�� '�/ { �Y' � � .� �5
1 i 6 J� .Ki F `^+➢ w '�' "t' �.„�, �` g
� .. ... .� w �..� s� -.
�� ,�. :�d1"d��� r X X � r<
[t F+ �S '� - � � � - �,
! � ' �Y� yc. F "�* � ,�P �,� . �$.3.
� `����T�'�14��������`1Y�O������` `F������-� ! �� -" � �� #
F
r �ai ,� .- ?"s ,� �.� - � � �-. � a '�' �t .; �' ��'`�. . s k E�...� .�',� � _.
ar >„a� � x ��y1���'���'dt8�rinil'�$� HP,_:
� � ��on��'nsp �orr�.�t� �t� �� ,;�� �N'ork Re�{��r���S�ar,ate��e'rr��� �r : e � ,
��q� fi „r� .: s �� ,�:_�y r .��� ,. �.r� � ;„y ,:� .� ,�� � s ^� .���'T� �b '�h�% F� ��. �"�t��§�t��n <
E t � y '�� -s*�-y�. t i ,. r ' t '�i �/1�`Jt �- Fp1L '� + �1{l1 y;�,�7<� a ,� ��er�} ��1 '�fK- h'^yx ;.�'� .
p� ��.�(�t� ��.�I(��� 5�� �.:.*^ �p�� '� 1 �������� < � ..T-l��'���1y.'1J1�� t 'M � ��4F. iSar�ifl� �yk�1L'+i��'�M'''�Sp��l' 4y�L, :� �
� v'y ax'. r 3� . a� f , -t � �y � ,-�.'.� f '` $ 3.'� -"l R a A`� <.
�"�{�'���'1�.�,��r1't�!$f0�1�'��J��4� r+ � „��:t"y��Y'1�C�dl �a'.. �, ��,dl'2 � ; � �' ���tG�C�I " $" '*�x �n���� � %
� �� ardcov�r R��ov�i r�- � ,�a.����c� �'iVate�F�orar�e�tio.t� � " �� r 4`�� w' :`-
�, �F t� �" ' �� � s { � ' °Fir�pia�ce ���a,ewer L�o�ne��r��� � ; � '�f , �4� � .�� :
, p{ ;, ,� � +;i� � ��
✓>• � X�� �.f y r . � ��S k. '..r S� x� �.7 n 1 -� .�^ � ^�s - t� � .�� ',�°.�`��' "' .w^k ��; �. x ,
� �bl1�+E����l� , r ��,1 ��9Qf11')I 'fl ��W���L�.�B�'klOt� �� F � �, ,�, �^ �
' :; ��i�nt��a i ����r�y'' � M�f � �7 C�n�is�,�ar�g � �� � ' 't �� �`�� � ..c.
��� ; � �„ 4 �� �
�s A ������ ��IVA��i���r�r��ll�� g �tt�er.(;����f�i) � � "n P ���� ,� ��,
�ti���"���� � � - - . ��., '� A, �� :
� t y ���� � tr- .-. � ,�.a r ��.�e . �#. u :"� .�«`+ -�.�'�'a
+���,,.� a4.���+��y�r .��s. e�s x � �. �, �r' r r �� Z�,�"� ��,F�'�r . �., s-.,�3` y
l�'3„,'�'3': �7�"JWid� '� �k _'s �' ��y, r'-+ ¢.. � .+ ��r �.;. � �� .. , a s �A A$S�/�'�� ���'�'w�- 'k.
C' '< `S L'K..n .� �. '};�:� t . t , �' � ... y `� k"�' fr'S;,i�, .
� �� i�,���Q�� 1,�.3� ��`���� 6 .� ; s � x aF�, " t� ;t k ?.' �� .x m•q,��.�,,ry t�,a��,�"�'�; �,'�c;
�3"'"'�. �'R.i�^-�' i - � � �' x`t;`*s � , �t k.3'`i ,` x�-gt� .. k�.- h. �,a�,x3� �"�:.a�5��': 'a.e -� �
"s":. '�������.?��� r s;�� �c�i� "�'a'�-"`" 4�� ,� � �f a � ,��F z>�r-;, �,a.�-� ��s �s �+� �, ��-y�d f� �.� �+r'*�#"�#�Yc� � ��':a.
•^�-�. ,�.}� � it �� 4 � � a ,�,a `-,�''� � y � z� r r r' � ��'3 z«3s`,+``;i �� � �, � # ,
��.-�5.�'�` �;IIQ��'�'` �s,�'� =,�,7" � -�� e. � .:'"�,� '� 4-��y ��a � `3 .ar.'.� � �,� x�'�" „��_ ��"'
.�� ,: a. � z. "�c}' � � �r t � ,, � ''g-t _ �'ya� � r'�.'"' �- �",�,��� a�'..��t�."s�'°�3� ..
� '"�'��1,���l�,��y�����i�w���` �� � # 3 � 4' � i� ��1 x . '� _� * ' t"� �T�'�"��.y �,��"� ,�.$. .
€ a �" . ,�, r ;r '_ � . � � �=�' ' r �Y* t ,r�'�
� ; t�..'� r} a?,r�,.� 3.s'�'-.s •��' � "� } ? _,i�. �'3s �� k _'�,� <;.d' { ��, �,`�^€ `h.�xs '` ,y�,�.v�.+,�,- r� ��' �� ,'.
� � �,sfc y - yk ,i q �: }) � � Y c.
r � ;,,� � ` � `1 � : � ��-- 1 �` ze. � �"��^�"g'�'��' � � {z` d�*' �.
F� _; .�y '� � ; � ' -� � 5 ; -s r '� ",� .� :��' y� �� t :f � .p ; �.*" ,�,c...��;�,��+�°„�:x�tr _ �
� � ���R������������� � z � ':� * r . .d ,c� -,z � �; �i€NS� ' � �t�i.s , �; .3. . �;'u� r,
� . u .���� �' h . �t ��
-s-. ? , �� � ' -
� ., q.x ��T � �._� �� �� .�' �� . 1 �° .�, a �� zr.c��� ' � � r �%���s o't��* ����m`_���
Y y
�� �� ,� � -.q,q .. 'F' � J,.£� X ¢'� 5 f �rT w3�' F �t6` 'v��'Lr'� :'�'''�"t
4ma, �.t���s a��h x'. � jY" .�,��_ � t �r '� .-3 f �u.�, i-b �.. f�� : w�'�'�'� �.t �.+..
�^ �. �t . C � ' '"� ��' r�y '`� '"�' � r :
� � s e ��:t J .�, �' , � �� . 8 . �, �� � �,�� . x f -
3 y, � d'�. � �.6 -x e ., E; ;. k� ,�- � -. ° ` �' .w ¢ J� S,� �[,d.�`RP �' � .3` 'A i.
Rr �'t-y��. �,ei c °'a �" t �r�.� ,{ �y, ' z �„ �
'S 'Y+ `I`� '�" ��� �� '�� 4 � � �ti� s } t �� r� d� '�"�. T '�' �t„»� z .-Rk'`s`�'F ro �s" .
> `!`� �� � �� ? a �l�F� � �� � � ,
d i�= t. ��y � t�'��n A^ 3'.i. � t .6 A � 0 4F i ;A �c.i��'
� J �� 1 � �yq {7,' ... � ."Y, �'F." }r e�
r ��,�,`, �9" :��; i h � * � '� 1" �t ��; � 3 >^�tb r t � d,,,;'�
� ' Acci���� F`�x�#m�/yi����]`,�� w�}°_�p �lew D-"'Y�S t'��1�(� � � � �` �� "� � '
� �' ` Z .0 g . '-k ;,� S af' 4 � Y y ' 2 h.� � '� � J Y Y
� w *r��r .�� i � :�sm� `?.-s �' �' ,.,, :.� i _ ... '< rr �.. f Y', �^"{ k 't � r' � ,�xr ~ F,�_
' , r aw
r� ,:u,�����1�..,�tEAQ�C$��R��'� �t!�,�T { ' y �" ri - ��.� '.�
A � � � � (�T��AI��'�RMIT��r�l�#� ��1�LEQ ��, ti �� � �� �� �
�y '��� '��y 1� �L y.G ,3,f:�: � p. `4�
�� �� � � �� '[s
�, T��' _ 'tY..:' �{�J # {.. 1
�� j; � ,. " r 4 "2�''�, b�w ( �'�
, � �
.
� _,r � - ,.�
�; , _ . . �� r . _. ,_ ��
f.• - '-
" P . .. . � ,.,
k l�pti�ted January,2035 :
r
z:\forr'rislp�an r�v+ew checiclist 2015.docic:
,r. A ..< ,
. �, .
, , .
� �� � 4 ,�
t ; ` ` : t. - .
t��:�� � � . �- ��� � �_ � � - � �- � �
_
. -
� � CHAMBERLAIN RECEIVED
� F�ne C:,stom Homes
O�T 2 9 2015
October 28, 2015
CITY OF ORONO
Christine Mattson
Planning Assistant
City of Orono
2750 Kelley Parkway
Orono, MN 55356
Re: Building Permit Application #2015-01198 — 10 Myrtlewood Road
This letter is written in response to the preliminary review perFormed on the building
permit application submitted on September 17, 2015 and documented in your letter of
October 13, 2015.
• Certificate of Survey. Please find enclosed with this submittal two scaled copies
of the revised Certificate of Survey addressing the top of foundation issue raised
by your review. Also included is the revised hardcover calculation worksheet as
the driveway layout was also revised to fit the new elevation.
• Number of Stories. Please find enclosed with this submittal two new sets of
plans addressing the three versus two story calculations. The plans have been
revised to reflect your suggested approach of lowering the home into the existing
grade sufficient to meet the max altowed basement wall exposure as measure
from the first floor elevation and the existing contour. A complete new set of plans
seemed appropriate to deliver as multiple pages were modified to reflect new
elevations throughout.
• Landscape Plan —The building permit plan submitted as part of the building
permit application contains the hardscape plan you requested. Specifically, it
shows the location of all retaining walls, patios, grading, and sidewalks you
requested in your letter. The information is contained either on the certificate of
survey or on individual building plan sheets including the foundation plan, lower
level detail plan and elevation sheet. The patio is laid out and dimensioned to
PaulC�Chamberlaincap.com
11578 Chamberlain Court Eden Prairie, Minnesota 55344 Phone: (952)649-7653 Fax: (952) 232-6573
scale with a note of stone or concrete material (the decision of materials has not
yet been made). The plan also shows the patio consisting of a cedar pergola with
cedar posts supported by concrete footings on the foundation plan and a natural
gas fueled fire pit. The foundation plan also notes that the patio will be at grade so
there will not be a required railing on the perimeter. The hardscape plan does in
fact match what is shown on the survey. The only item missing from the original
submittal that you requested is the individual performing the work. The plan is to
have multiple subcontractors involved. They are:
• Ostertag Concrete Inc install/pour he foundational aspects of the
plan including the patio surface should concrete be selected,
pergola footings and planter walls on the right side of the front of the
home.
• Stone Mountain Landscaping will install the paver patio should
pavers be selected.
• Hawkins Tree and Landscape will install boulder walls all of which
will be under 4 foot. Hawkins will also perForm final grade including
black soil placement and importation if necessary preceding
installation of the sod. Hawkins Tree and Landscape will also
prepare, edge, fabric and install all selected plantings and trees.
• T. Holme Contracting LLC will build and install the pergola on site.
• Genz-Ryan HVAC will rough-in natural gas line to natural gas fire
pit. Vendor of the actual burning device has yet to be selected.
• Pro Irrigation Inc— Cologne MN —will install irrigation system
• Tonka Gutters will install the homes gutters
• The sod vendor has yet to be determined.
Softscape planting inventories will be developed next spring when they will be
needed.
• Separate City Permits Required.
• Water disconnect—This home is serviced by a well. So I do not
believe a city water disconnection is required.
• Demolition permi#for septic removal. I am aware of this permit
requirement. It is my understanding the septic company who will
pump it dry will submit for a permit and the inspector must sign-off
prior to excavator crushing and removing the field.
• Sewer &Water Connection. The plan is to hookup to city water and
forced sewer. I use Coppin for water conr�ects and disconnects. He
pulls the permits for this activity. I understand there are connection
charges.
I believe I have covered each of the points raised in your letter. If I have not please let
me know via phone or email.
Respectfully yours,
��1
�
Paul Cameron
Owner of Chamberlain Fine Customer Homes - applicant
Owner of Chamberlain Capital LLC — Property owner
. • .�.•
Mel�nie Curtis
From: Christine Charles<ccharles@designgroupc.com>
Sent: Wednesday, October 14, 2015 9:04 AM
To: Melanie Curtis
Cc: paul
Subject: Fwd: 10 Myrtlewood -Lowering of Foundation
Attachments: Site Plan Revisions-City Working Copy Grading Repsonce 10-14-15.pdf; Site Plan Revisions
- Large View No Scale-City Working Copy Grading Repsonce 10-14-15.pdf
Good Morning Melanie,
I am forwarding to you our reply and attached pdf drawing files to Christine's recommendation yesterday
morning to lower our proposed foundation for this project. Her automatic email response indicated she is out of
the office until noon next Monday, October 19.
My email is to follow up my eazlier voice mail message to you this morning. Please review the attached and
contact me at your earliest convenience. Thank you so much for your attention to my request. . .
---------- Forwarded message ----------
From: Christine Charles <ccharles�n,desi �roupc.com>
Date: Wed, Oct 14, 2015 at 8:24 AM
Subject: 10 Myrtlewood - Lowering of Foundation
To: Christine Mattson<CMattson(c�r�,ci.orono.mn.us>, paul <Paul(a�chamberlaincap.com>
Good Morning Christine,
Thank you once again for clarifying(including additional information) Orono's site plan
requirements. Before requesting the surveyor to modify the survey and grading plan, I have attached a revised
architectural site and grading plan(scaled and large view not to scale), for your review, recommendations and
approval before proceeding further. My thoughts. . .
1. We are proposing lowering the foundation 3'-4" and beginning the full basement starting point at the
grade match(966.80) at the 2'-0" wall jog along the front wall.
2. The plan notation in the upper right corner of the ledger sheet attached explains the proposed
termination of the 140'-0" of full basement which exceeds the 129.56' minimum(50% of the 259.12' of
the total exterior perimeter).
3. With your review and recommendations, and a little fine-tuning, I believe we are close to achieving your
grading requirements.
4. Upon grading/site plan consensus, we will design the retaining walls at the south east corner of the
screen porch/storage below- and around the turn-around/guest parking location.
5. The foundation design will remain the same when lowered the proposed 3'-4" as our original proposal to
add fill created the same foundation profiles and wall height profiles - also,the framed structure above
the foundation and the brace wall plans will remain as designed and submitted for plan review.
6. Accordingly as we redesign the retaining walls and revise the site plan,would you please release the
building plans for permit review while the surveyor completes his revisions? With colder weather
approaching, we would like to excavate and install the foundation as soon as possible.
1
>. • - _, -
7. The�foundation profile,bearing locations and design will not change - other than setting new elevations -
' which should allow plan review to proceed and provide time for us to revise foundation elevation
notations and revise the survey.
Thank you once again for your insight and recommendations -and I look forward to your prompt review and
reply to our revised foundation proposal.
Thank you and enjoy you day. . .
Christine Renae Charles
Design Group C, LLC
(952)250-9980
http://www.desiQ nQroupc.com
ccharles(a�desi n���roupc.com
This e-mail and/or letter and any files or data that is/are transmitted with it are intended solely for the individual or entity to
which they are addressed. This communication should be considered as-containing material that is Design Group C,
LLC and/or sender privileged, confidential and is hereby protected from any type of unauthorized disclosure or distribution
to anyone or any entity, under the law. If you are not or even if you are the intended recipient, please be informed that
any unauthoized disclosure, any distribution, any copying, or any improper use of this information, now or in the future
without the expressed written permission of Design Group C, LLC and/or the sender is hereby strictly prohibited, may be
unlawful and may cause Design Group C, LLC and/or the sender, damages and/or monetary losses for which, you are
and will be liable. If you have received this e-mail and/or letter, data, etc. in error, please notify the sender immediately of,
your name, address, telephone number, etc. and completely delete or destroy this e-mail and/or letter. Thank you.
Christine Renae Charles
Design Group C, LLC
(952)250-9980
http://www.designgroupc.com
ccharles(a�desig��roupc.com
This e-mail and/or letter and any files or data that is/are transmitted with it are intended solely for the individual or entity to
which they are addressed. This communication should be considered as-containing material that is Design Group C,
LLC and/or sender privileged, confidential and is hereby protected from any type of unauthorized disclosure or distribution
to anyone or any entity, under the law. If you are not or even if you are the intended recipient, please be informed that
any unauthoized disclosure, any distribution, any copying, or any improper use of this information, now or in the future
without the expressed written permission of Design Group C, LLC and/or the sender is hereby strictly prohibited, may be
unlawful and may cause Design Group C, LLC and/or the sender, damages and/or monetary losses for which, you are
and will be liable. If you have received this e-mail and/or letter, data, etc. in error, please notify the sender immediately of,
your name, address, telephone number, etc. and completely delete or destroy this e-mail and/or letter. Thank you.
2
. � e�� ���g�a�� �.. ��
Christine Mattson �
From: Christine Mattson
Sent: Tuesday, October 13, 2015 10:29 AM
To: 'paul@chamberlaincap.com'
Cc: 'travis@vannestesurveying.com; 'ccharles@designgro .com'; Roger Peitso; Melanie Curtis
Subject: 10 Myrtlewood Road/#2015-01198
Attachments: illustration.pdf; letter.pdf; definitions.pdf; Survey Requirements-August 2015.pdf; Sewer&
Water Permit-2015 Fees- Updated 07-01-15 New State Surcharge.pdf; Demolotion Permit-
07-2015 New Surcharge Fee.pdf
Paul,
Attached is a copy of the letter and enclosures being mailed today. 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(physical address)
PO Box 66 � Crystal Bay � MN � 55323-0066(mailing addressJ
'� 952.249.4620 � g 952.249.4616
�cmattson@ci.orono.mn.us I � www.ci.orono.mn.us
Office Hours: Monday- Friday 8 am to 4:30 pm
OUR OFFICE WILL BE CLOSED: Wednesday, November 11, 2015
Christine Mattson
Planning Assistant
City of Orono
2750 Kelley Parkway I Orono I MN I 55356(physica/addressJ
PO Box 66 I Crystal Bay I MN I 55323-0066(mailing addressJ
"a" 952.249.4620 I 8 952.249.4616
� cmattson@ci.orono.mn.us � � www.ci.orono.mn.us
Office Hours: Monday- Friday 8 am to 4:30 pm
OUR OFFICE WILL BE CLOSED: Wednesday, November 11,2015
1
. �-0��
C ITY OF ORONO
,a ,�, Street Address: Mailing Address: Telephone(952)249-4600
y G` 2750 Kelley Parkway P.O.Box 66 I Fax (952)249-4616
�� t�, Orono,MN 55356 Crystal Bay,MN 55323 www.ci.orono.mn.us
kESHO�
October 13,2015
Paul Cameron
Chamberlain Fine Custom Homes
11578 Chamberlain Court
Eden Prairie, MN 55344
Re: Building Permit Application#2015-01198
10 Myrtlewood Road
On September 17, 2015 the City received a building permit application for new single family home. Staff conducted a
preliminary review based on the information provided and recommends the following items be submitted or revised in
order for your application to be considered complete and for the plan review to continue:
1. Certificate of Survey. A survey dated 8-28-2015 was submitted. Planning and Zoning staff have reviewed the
survey and noted the following items need to be changed or updated:
a. Top of Foundation. Please show us the top of foundation elevation along with the point or spot where
the top of foundation point referencing on the perimeter of the foundation. We expect this to be
consistent with the top of foundation shown on the foundation as-built survey.
Please provide two copies of an updated, full size certificate of survey which meets all of the City's survey
standards (enclosed)so we can continue our review. Please note our engineer has not reviewed the sunrey
so additional comments may be forthcoming.
2. Number of Stories. Three levels of living space are proposed. Two and a half stories above a basement is the
maximum number of stories permitted in the City of Orono. It appears that the lower level of the home(not
including the unexcavated area) is classified as a "story" and not a "basement" as is needed. Based on my
analysis,the perimeter of the lower level is 259.12 linear feet. See annotated "Working Copy" of the survey
attached.
The first floor elevation is at 976.2 which results in the 970.2'existing contour being the determining elevation
6 feet less the first floor(definitions are enclosed). My calculation of the portions of the lower level at 6' or
more below the first floor is 77 linear feet (shown in red) or 3096 where more than 50% is required (see
illustration). Without modifying the third floor, a possible solution would be to lower the home into existing
grade,3-4' by our estimation. Another option would be to excavate under the garage shown in purple. You
would still need to lower the house,but not by as much. We would be happy to discuss options with you.
October 13,2015
10 Myrtlewood Road
Page 2 of 2
3. Landscape Plan. Prior to the issuance of the building permit a landscape plan must be submitted showing all
the proposed exterior/landscaping improvements,i.e.patios,grading,sidewalks,retaining walls,etc. The plan
should include the name of the individual performing the work. The landscape plan should match what is
shown on the survey.
4. Separate City Permits Required for:
a. Water disconnection
b. Demolition permit for septic removal
c. Sewer&water connection
The above information is required in order for the plan review to continue. Please feel free to contact me at
952.249.4620 or by email at cmattson@ci.orono.mn.us if you have any questions on the above requirements.
Sincerely,
CITY OF ORONO
!`� Iv�{Il�
Christine Mattson
Planning Assistant
c Paul Cameron via email
Travis Van Neste via email
Christine Charles via email
Roger Peitso, Building Official
Melanie Curtis,Planner
enclosures �
Sec.78-1. - Definitions. (Excerpts)
The following words, terms and phrases,when used in this chapter, shall have the meanings ascribed
to them in this section, except where the context clearly indicates a different meaning. Unless specifically
defined in this section, the words and phrases used in this chapter shall have the meanings given to them
in chapter 82.
Basement means that portion of a building that is partly or comp/ete/y be/ow the existing ground level.
A basement shaU be considered as a story for purposes of determining the number of stories in a building,
when the finished surtace of the floor above the basement is more than six feet above the existing ground
leve/for more than 50 percent of the basemenYs perimeter. The perimeter of the basement does not include
portions of the house or garage that do not have a /ower leve/but are merely "unexcavated" Art�cially
raising the grade adjacent to the foundation of a structure (by filling or by a combination of filling and
retaining walls) above the surrounding natura/ terrain shall not be allowed as a method for converting a
defined story to a defined basement, regard/ess of any other benefits to the property of such action.Finished
grade that increases more than one foot from existing ground/eve/shall be considered as artificially raising
the grade. However, artificia/ly raising the grade when such action mere/y restores a previously excavated
site to its origina/natura/grade may used as a method for converting a defined story to a defined basement
Building height means the vertica/distance between the highest adjoining ground/eve/at the building
or ten feet above the lowest ground level, whichever is/ower, and the top of the comice of a flat roof, or the
deck line of a mansard roof, or the uppermost point on a round or other arch-type roof, or the median height
of the highest gab/e of a pitched or hipped roof. Topographic changes which e/evate the adjoining ground
leve/ above the existing terrain shall not be considered in determining building height. For a pitched or
hipped roof situation, regardless whether the highest living space in a building is a ha/f-story or full story, if
the highest living space contains windows (exc/uding skylights) the upper measuring point for defining
building height shall be the median height of the top of the highest window and the highest peak of the roof.
Half story means the uppermosf floor of a building in which (i) the intersection of the exterior wall and
the roof is not more than three feet above the floor e/evation, and(ii) not mo►�e than 60 percent of the floor
area within the exterior walls of the uppermost floor exceeds five feet in height as measured from the floor
to the rafters. F/oors exceeding these parameters shall be deemed a full story.
Story means that portion of a building included between the upper surface of a floor and the upper
surface of the floor or roof next above. !t is measured as the vertica/ distance from top to top of two
successive tiers of beams or finished floor surtaces and, for the topmost story, from the top of the floor
finish to the top of the ceiling joists or, where there is not a ceiling, fo the top of the roof rafters.A story fhat
meets the definition of a "basement"shall be considered as a basement and not as a story for purposes of
determining the number of stories in a building.
Page 1
Permit A�plication: Self-Checklist for Completeness
Please note, the applicant must initial in the boxes below to acknowledge the minimum
required information is included with the submittal. If not, the application will NOT be
accepted. Call 952.249.4620 to schedule a meeting with staff if you have questions on
application submittal requirements.
��-` Completed Application
C���-'( _,
%
Plan Review Fee Paid �" l ? � �'
� �
� �� ��� �=�I
����� Signed Escrow Agreement & Escrow Payment � ���-{
� B il in Plans to scale x2 _. !� `���0 �S C C�- �E
u d g ( ) �
Certificate of Survey (to scale) showing the proposed project &
"� meeting all requirements x2 �� �.��
� �
� ��� �
�
�;� �c�►�tL �� � -���� es
� Hardcover Calculations if a licable � � � � � ��
� pp )
,�� __� ���L U�� ����.�`�� �Pc� ��,
� �. � 1
��' � �� �r��C����� ,�`�,
I am aware that Orono will not issue a building permit without a
�
copy of MCWD permits (or documentation from the MCWD stating
� GI� V the proposed project does not trigger their permitting
� requirements). I will contact the MCWD at 952-471-0590
rega � g this p oject.
�
Signed by: �
Address: �f-,��fl L.� I� �-�- � � L�`�t�c� � �
Permit #: �� I T�LI � �'
Packet Last Updated. August 2015
Page 2
DATA PRIVACY ADVISORY
In accordance with Minnesota State Statute 13.04 Rights of Subjects of Data, Subd. 2, "Tennessen warning", we
would like to inform you that your request for a permit or license from the City of Orono or any of its departments
may require you to furnish certain private or confidential information.
You are notified that:
1. The information you furnish will be used to determine your qualification for the permit or license
requested.
2. You may refuse to supply data, but refusal may require that the City deny the permit or license.
3. The information may be shared with other local, state or federal agencies to the extent necessary
to process the permit or license.
4. If your requested permit or license requires Council action to approve, some information may
become public.
5. You have certain rights under Minnesota State Statute 13.04(see following page)to review private
data on yourself.
6. Your full name is required to process this application or permit.
Paul Cameron
First Middle Last
11578 chamberlain Ct
Address
Eden Prairie MN 55344 952-649-7653
City State Zip Phone
I understand my rights as stated above.
��r
Signature
Packef Last Updated: August 2015
Page 7
�lew Construction Energy Code Compliance Certificate
Per R401.3 Certifcate.A building certificate shall be posted on or in the electrical distribution Date Cei'tificate Pos
panel.
Place your
Mailing Address of the Dwelling or Dwelling Unit City
10 M rlewood rd Orono logo here
Name of Residential Contractor MN License Number
Chamberlain Fine Custom Homes BC 661410
THERMALENVELOPE RADON CONTROLSYSTEM
Type:Check All That Apply �{ Passive(No Fan)
o � or other system monitoring
j}'�� p � �
[ � ��� � �, N Location(or future location)of Fan:
�y� ��� — � _ _T
� c6 — � � N
� c N � _ � a
o a o � V � o -o @
a m -o U � � �
� Q m m � � � � c
@ � a ` �
> c Z u�'i � ° a ii X O
Insulation Location � ° @ � v O � w N
m o � °1 E E
� -o a
� N p � � � � C �) O)
� � z i� i� � LL � � � Other Please Describe Here
Below Entire Slab X
Foundation Wall I S X X X
Perimeter of Slab on Grade
Rim Joist(1st Floor)
Rim Joist(2nd Floor+) X
Wall 2�
Ceiling,flat 5� X
Cei�ing,vaulted 49 X
Bay Windows or cantilevered areas 49 X
Floors over unconditioned area 5� X X
Describe other insulated areas
Building envelope air tightness: Duct system air tightness:
Windows 8 Doors Heating or Cooling Ducts Outside Conditioned Spaces
Average U-Factor(excludes skylights and one door)U: X Not applicable,all ducts located in conditioned space
Solar Heat Gain Coefficient(SHGC): R-value
MECHANICAL SYSTEMS Make-up Air Select a Type
Domestic Water
Appliances Heating System Heater Cooling System Not required per mech.code
Fuel Type Nat Gas EI2CtfIC Passive
Manufacturer Carrier Carrier Powered
Interlocked with exhaust device.
Model 59SC2B Ca13NA Describe:
Input in 1200�Q Capacity Output 5 Other,describe:
Rating or Size BTUS: in Gallons: in Tons:
AFUE or g2 SEER 13 Location of duct or system:
Efficiency HSPF% /EER
Heating Loss Heating Gain Cooling Load
Residential Load Calculati 98162 39750 39750 59160
Cfm's
"round duct OR
MECHANICAL VENTILATION SYSTEM "metal duct
Describe any additional or combined heating or cooling systems if installed:(e.g.two furnaces or air Combustion Air Select a Type
source heat pump with gas back-up furnace): Not required per mech.code
Select Type Passive
Heat Recover Ventilator(HRV) Capacity in cfms: Low: High: Other,describe:
Energy Recover Ventilator(ERV)Capacity in cfms: Low: 155 High: 311 Location of duct or system:
Balanced Ventilation capacity in cfms:
Location of fan(s),describe: Cfm's
Capacity continuous ventilation rate in cfms: 155 ' "round duct OR
Total ventilation(intermittent+continuous)rate in cfms: 311 "metal duct
Builders Associaton of Minnesota version 101014
� RECEIVED
V City of Oron Ro�O �o■ • q
O OGT 2 .. 2015
�on�o Hardcover Calculation Worksheet
� ,\ `, Property Address: 10 Myrtlewood Rd CITY OF ORONO
"'��i'`\ Prepared by: Date: 9/15/15 Revised 10.28.15
Paul Cameron
,--�-
Stormwater Quality Overlay District Tier: (Circle one) Tier 1 Tier 2 Tier 3 Tier 4 Tier 5 �Exemp
`-,,�.
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 s uare foota e 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 ara e 22' x 34' 748 S.F.
� House 80' x 31.65' S.F.
� Covered Entr � s.F.
E creene orc ' ' S.F.
F S.F.
� 3 700 S.F.
H S.F.
� S.F.
� S.F.
K S.F.
� S.F,
M S.F.
N atio errace x S.F.
o PI nter 4' x 15.75' S.F.
P Walkwa ee surve 150 S.F.
cl Drivewa ircu ar ee urve 2 218 s.F.
R S.F.
S S.F.
T S.F.
� S.F.
V S.F.
W S.F.
X S.F.
Y S.F.
Z S.F.
1 Total Pro osed Hardcover 6 547 s.F.
Excludable Hardcover See Ci Code Sec 78-1684 :
S.F.
S.F.
S.F.
S.F.
S.F.
2 Total Excludable Hardcover S.F.
3 Net Pro osed Hardcover Subtract line 2 from line 1 �� S.F.
4 Total Lot Area 39 O50 S.F.
Proposed Hardcover Percentage [(3�=(4)] 16.765%
Packet Last Updated: January 2015 This is an information packet regarding Hardcover. Every effort has been made to
ensure the accuracy of the informatron contained herein;however,if any information rs
not consistent with provisions of the City Code, the Code provisions wil(prevail.
Page 17
��
��- l/
A TIME
CITY OF ORONO CALLED IN
INSPECTION NOTI�i�_��/C�' SCHEDULED
PERMIT NO. r 4 COMPLEfED
ADDRESS � � f/ l �I�'7��C�P��c� �_
OWNER TELEPF�QN� NO. " 7s `"
CONTRACTOR �—������ �'
� D CRIPTION �71�� //UC-=�
� FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL
Q URED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING
y ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL
Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION
Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ RATED WALLS
� ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT
Q ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP
� ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL
J ❑ DEMO-SITE ❑ PTIC INSTALL
2 OWNERICONTRACTOR TO MEET YOU: YES_NO
c��, CI�MMENTS:
�
W �
C
� I
J
O
�.
�
O /-
W
�
Q
�
2
W
�
W
�
�
d
W ❑ RKSATISFACTORY:PROCEED ❑ PROJECT COMPLEfE
� CORRECT WORK 8 PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY
W
0 ❑ RRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECWERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ pHOTO TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Ca11 for the next inspection 24 hours in advance. (952 9-46��
OwnerlContractor on site:
Inspector.
White Copylinspector's Ffle Canary CopyfSite Notice
�,:� ��.�
DATE TIM
CITY OF ORONO CALLED IN
INSPECTION NOTICE SCHEDULED ► ��.j �J�� `
PERMIT NO. "��!C�-t�I I �� COMPLETED
ADDRESS � �� �1°'l v� r�t i� :�L=c:�� ��
OWNER TELEPHONE NO. �nr z--3�s�
CONTRACTOR �i���������ys�
� DESCRIPTION � � � � ��--�"�-�=
W ❑ FOOTING ❑ DEMO-FINAL J ❑ SEPTIC FINAL
Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING
O ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL
Z ❑ RADON SLAB ❑ MECHANICAL RI �TE INSPECTION
Q ❑ FRAMING ❑ MECHANICAL FINAL �❑ RATED WALLS
� ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT
Q ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP
W ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL
_
J ❑ DEMO-SITE ❑ S PTIC INSTALL
2 OWNERICONTRACTOR TO MEET YOU: '�YES_NO
c�., COMMENTS: 4
�
W
�
�
J
O
�.
�
O
�
W
�
Q
�
2
W
�
W
�
J
d
W WORKSATISFACTORY:PROCEED ❑PROJECT COMPLEfE
� ❑ RECT WORK 8 PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY
W
� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECObERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTO TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
❑INSPECTION REWIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hou in advance. (g5 249-460�
OwnerlContractor on site:
Inspector:
White Copyllnspector's File Canary CopylSfte Notke
�- �� c�
, DATE TIME
r+
ITY OF ORONO CALLED IN
INSPECTION NOTICE SCHEDULED l ` 1�
PERMITNO. G��:i � -(`;�I�(COMPLETED
ADDRESS ����'�1.1�fi���CX"1C'�
OWNER TELEPHONE NO. � �Z �� `C��
CONTRACTOR 'Gl� ��j` �G�f'1 ��1�
� DESCRIPTION 1 " �� 1��� � �.� c�-' C � �
� ❑ OTING ❑ DEMO-FINAL ❑ SEPTIC FINAL
Q P URED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING
y ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL
Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION
Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ RATED WALLS
� ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT
Q ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP
_ ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL
J ❑ DEMO-SITE S PTIC INSTALL
2 OWNERlCONTRACTOR TO MEEf YOU: YES_NO
� COMMENTS: �—
�
W
a
2
J
O
�.
�
O
�
W
�
Q
�
2
W
�
W
�
J
d
W� WORKSATISFACTORY:PROCEED ❑PROJECT COMPLEfE
W ❑ RRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN
INSPECTOR WFLL REfURN O CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
�INSPECTION REQU�RED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in dvance. �9 2 2 - 6QQ
OwnerlContractor on site:
Inspector:
White Copyllnspector's File Cenary CopylSite Notice
-3 ��
� -
o�� nM
CITY OF ORONO cnLLED IN /�I 7
INSPECTION NOTICE /��HEDULED /��l-�.� -'?�
PERMIT NO. ���5 Dl�7<) CgMPLETED
ADDRESS
OWNER TELEPHONE NO. �a�
CONTRACTOR � , �
� DESCRIPTION �/
41 ❑ FOOTING ❑ DEMO-FIN L TIC FINAL
Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING
Vj�FALNDATION WATERPROOF ❑ PLUMBING FINAL ❑TREE REMOVAL
Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION
Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ RATED WALLS
� ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT
e ❑ FINAL ❑WATER HOOK-UP ❑ FOLLOW-UP
W ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL
_
v ❑ DEMO-SITE ❑ SEPTIC INSTALL
? O'WNERICONTRACTOR TO MEET YWI:_YES_NO
y COMMENT'�
� ����ti t�(J���rc�fi'�ss . �sS�G . �—
o �.�I'�Ea v ��/e - � —
�.
�
�O
�
Q DI� �- �a��—
�' ��i'��rJ� P�v�jr`w C�rtt�✓�.G ���o.l�'"-
2 -
� /'J/J��n)i cb„:� c�.%g svn .t�%.�a� �iSr�
� �mn���
3
� �WORK SATISFACTORY:PROCEED ❑PROJECT COMPLETE
W ❑CORRECT W'ORK 8 PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY
0 O CORRECTIIMORK,CALL FOR REINSPECTION TEMpppqpy
V BEFORE CONERING PERMANENT
❑COFiRECT UNSAFE CONDITION WITHIN HOURS_ p pHpTO TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR ❑CITATION ISSUED
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
CaN for the next inspection 24 hours in advance. (952) 249-4600
Owr�eriCoMractor on site•
�� i �-�... ,
White CopyAnspsctor's Fik Gnary CopylSib Notkx
DATE TIME
CITY OF ORONO cnLIED IN
INSPECTION NOTICE �J SCHEDULED
PERMIT NO.��,'d rf�a COMPLETED ��
ADDRESS �b YA�/����.
OWNER TELEPHONE NO.
CONTRACTOR ����r�•w ������! ��'tGJ
� DESCRIPTION �`�"'��t �� �r�'�� ����
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 ❑ RATED WALLS
� -V INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT
� ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP
W ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL
_
v ❑ DEMO-SITE ❑ SEPTIC INSTALL
2 OWNERICONTRACTOR TO MEET YiOU:_YES_NO
y COMMENTS:
W '
� Frawt� �� � �✓ �ro ri� �✓c� -
� _ .
° . -�`�r�c.� � `r����o%..�r — .
� .f�sr.�.c.r��..r�' �sft � ��- �rc1v��J
o -�' n '
� ��1i�✓ S�vo,O /S �P�4red� —
W
�
Q
2 �K !� G�j v e d fe•��.e�S�o G'�
� fio�� ��(
W
�
3
� ,�iAIORKSATISFACTOFlY`.PROCEED ❑PROJECTCOMPLEfE
.
W ❑CORRECT WORK�PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY
0 ❑CORRECT WORK�►LL FOR REINSPECTION TEMPORARY
V BEFORE CdVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS_ p p�pTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR �CRATION ISSUED
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (952) 249-4600
OwneHCoMractor on site:
Inspector.
Capydnsp�cMrs FlN Canary Copy/SIM Notke
� - �
DAT TIME�
CITY OF ORONO CALLED IN � �� ��
INSPECTION N TICE �l ' �CHEDULED — — 7• �'
PERMIT NO. � � cOMPLETED
ADDRESS � Y L.� � � C (,�( �G�
OWNER ELEPHONE NO.�� 2'-��J���
CONTRACTOR � ��-'�
� DESCRIPTION ����- ��� ��C' � �� �� �
4~j ❑ 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 ❑ RATED WALLS
� ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT
Q ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP
? ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL
J ❑ DEMO-SITE ❑ SEPTIC INSTALL
2 OWNERICONTRACTOR TO MEET YiOU:_YES_NO
��., COMMEN
�
W
�
�
J
O
�. �
�
O
� ,
� �
Q /U�� ^ �. � �
� �'
� � — 3
� �
�
a
W ❑YIDORKSATIS ACTORY:P OCEED ❑ PROJECTCOMPLEfE
��CORRECT WORK&PROC D ❑ISSUE CERTIFICATE OF OCCUPANCY
W
O ❑CORRECTVYORK,CALL FO CTI TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHI HOURS. O PHOTO TAKEN
INSPECTOR WlLL REfURN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
❑INSPECTION REQUIRED.CALL TO AHRANGE ACCESS.
Ca11 for the next inspection 2a ho rs in a��. {�52�) 249-46�0
OMmerlContractor on site:
Inspector.
, i�j;,
White Copyllnspector's File j Cenary CopylSite Notice
.`! �/
� C� DATE TIME "
CITY OF ORONO CALLED IN �
INSPECTION NOT E . �//�}'�HEDULED
PERMIT NO. l 7 COMPLETED
ADDRESS � �
OWNER TELEPHONE g�. � � �3
CONTRACTOR �
f-�/3 � ���
� DESCRIPTION �� �
4� ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL
Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING
O ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL
Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION
Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ RATED WALLS
� ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT
Q ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP
W ❑ AS BUILT-SURVEY ❑ SE ER HOOK-UP ❑ FOUNDATION/REMOVAL
_
J ❑ DEMO-SITE ❑ PTIC INSTALL
2 OWNERlCONTRACTOA TO MEEf Y'OU: YES_NO
v�, COMMENTS:
�
W
�
�
J
O
¢
O
�
W
�
Q
�
2
W
�
� � '
� ` �_
J
d
W ❑WORKSATISFACTO •PROCEED ❑PROJECT COMPLETE
� ❑CORRECT WORK�PROCE ❑ ISSUE CERTIFICATE OF OCCUPANCY
W
� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE COVERING
PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. p pHOTO TAKEN
INSPECTOR WFLL REfURN ❑CITATION ISSUED
❑STOP OROER POSTED.CALL INSPECTOR
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. ,
Cail forthe next inspection 24 hours in advancer. (g52) 249-46��
OwnerlContractor on site: �� �' '
Inspector.
White Copyllnspector's File Canary CapylSite Notice
�� ��- ✓
� TIME
CITY OF ORONO cnLLED IN —
INSPECTION NOTIC �HEDULED �' � �
PERMR NO. 6 coMPLETE
ADDRESS �
OWNER T PHONE NO Z� ���
CONTRACTO � '�
� DESCRIPTION
4� ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL
Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING
Q ❑ FOUNDATION WATERPROOF ❑ PLUMB�NG FINAL ❑ TREE REMOVAL
Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION
Q �_FRAMING ❑ MECHANICAL FINAL ❑ RATED WALLS
���❑ NI SULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT
� ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP
41 ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL
_
v ❑ DEMO-SITE ❑ SEPTIC INSTALL
2 OWNEWCOI�fTpACTOR TO MEET Y�OU:_YES_NO
� COMMENTS: �L(�l��l, �Jw`c.'t� G.p�r'vv�.'a[. �.Z-�7—�5
� E��. �e.1 • -a s•�l'6 -
�
�0 y
- �/�' �'�•�if - �j` —
�O
W
aC
Qy
F�
,�'/ . � 4
� `�G �� t 6�.J
�
�
d
W�"A�CRN�4FISFACTORY`.PROCEED ❑PROJECT COMPLETE
°���CORRECT WORK 3 PROCEED ❑ISSUE CERT�FICATE OF OCCUPANCY
w
0 O CORRECT WORK,CAIL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
O CORRECT UNSAFE CONDITION WRHIN HOURS. p pHOTO TAKEN
INSPECTOR YVILL RETURN ❑CITATION ISSUED
❑STOP OROER POSTED.CALL INSPECTOR
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (952) 249-4600
OvmeHContractor on site•
Inspector. Q /M-
White CopyAnspector's File C�nary CopylSite NoNce
DATE TIME
CITY OF ORONO CALLED IN ==i��
INSPECTION N TI 6�%011p SCHEDULED '
PERMIT NO. l�� � COMPL
ADDRESS �
OWNER TELEPHONE NO.
CONTRACTOR
�
� DESCRIPTION
ly ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL
Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING
y ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL
Z ❑ RA N SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION
_ ❑ AMING ❑ MECHANICAL FINAL ❑ RATED WALLS
� INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT
Q ❑ NAL ❑ WATER HOOK-UP ❑ FOLLOW-UP
_ ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL
J ❑ DEMO-SITE ❑ SEPTIC INSTALL
2 OWNERfCONTFiACTOR TO MEET YOU:_YES_NO /
/
y COMMENTS: `
�
a �
j �
o �
�.
�
0
�
W
�
Q
�
2
�
W
�
J 1
d
W ❑ RKSATISFACTORY:PROCEED ❑PROJECT COMPLEfE
� CORRECT WORK&PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY
W
� ❑ RRECT WORK,CALL FOR REINSPECTION TEMPORARY
BEFORE COVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. ❑ pHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Ca11 forthe next inspection 24 rs in adv 52) 249-460�
OwnerlContractor on site:
Inspector.
White Copyllnspector's File Canary CopyfSite Notiee
� Q' � � � �' � � � ' e n ,�X �/ / /�9 / / / �/ /
I � ��9��— � � X N89'1418 VIL � �� ��/ �/ s�O�F i�/ �/ �1�33.70i� �233. �LAT) �
i � � � �
I � � 9 � � 977.4 r. — — � / / / /� / / / � ��9 — — _
� �'��$-�-.. � �yq � / XI TING � / / / /— — — — — — — — — ",�/
! � � S�FF� — — — S D � =— _ � _-c 7- — — — — � --� / �/ � / � �
f , � /� /�-' -- � / / / � —/`- �
I o; '� 1� o /� / �,� -�1�� �__� � \ � �� // /� � ro� � 5 \
�� . ^�, ry :- � �� � �1 / \ j / / / � �
� \ / `
_ f `� � , I// �^ , � � �. � � f,� �,� : s�.o — J �6� `% � �/ �/ // ��`' I
��, \ j _ _�_ � � � � , / / / / � _ _
I �-._. _9 7 � � � I . � � � / � � � /� �C� \\ — �E
� `I�-r � -,.." ' f � // O� �!W DE R �
� � / p 9 - - - - � - - - - 30 FOOT � _ � / G� / -� oF
I D(1S1'II�G � (�Z ' � � �,'� � '� 0 22.00 00 � � �0 15.00 �� S ET BAC K� / � D . . 425
I PAVEMElVT' Tt� � { � _ . � / � \ � �(`O � —
REMAtN A5 4 :}..r��.,� : � �,�!�11�j 2 .00 18.00 � `� / G / G�v
CONSTRUCTlU�l�f �, � -�-�E - $ i � / � / ��J\ —956— �
� = a^, ROPOSED o 969.85 �.! � �6� CR�p�RCt� � / !�� j � � �
I (RELOCAM'I.'E Sit�T~'`` k�� / o � PAVED � 2.00 Y / � �� / '� �\��� �
FENCE AS ''��``' � DRIVEWAY I 5�' TOP OF '� . EXI TING CONCREIE � ���ro`b � �� / Q / /
� w e�.ow ; / ,� � c� Q.�. /� I i
NEEDED DURII�IG �-g7 � I �FOUNDAT10t�i �10USE 10
NEW DR}VE'�tAY 4 � � ?�`�3, o = 970.17 V fJ # /` 6.33 ss 960 �p // -1 P��� // �h° � i �
I CONSTRUCT'ION� a -� V. ( � � � � �
j i �o l ^ f�,F�, � `, � I`cV�'� M� � � \ � 8 w ,�`�/ /� Q'��� /� .� � / Q .
f � / 3 � x� � rn � ,�'' ���`�G�- i J���� i � o � - - - �
I / ( -� - -- _ ,�«, � I � . � � P � p J i , � .- a i ,
� , ^ - - 5o.s ~ s.00 �'" "�� POSEp �� �° � � �`�o°�� � 0 �,� � � �� „ 'J� N i
�' �" `� a. ` a , �._� G� � ;. � � O G /
I ' — _ f � ��"�� o l.0,. ,�� 2.33 � � / �.� J /� � ,
� x jc� o r� P
����� _.�74•�„ ��\ � /' ^ �`. C�� �83 � i r pX� y� 1 .67 �/ � ���� -
I ^ \ 4.� � ~� M� O p 66B \! : �` / �
� : L
�*, �� � \ ! � � �� � {' �� �� p + \ i / /�/ � `, � ° ('.
( � \ _ / `' _� �-+�-s.cM�; � Q GJ� �v '�� � ^ J ' /� TREE / � • '
o. ^V... /
I � �� o �.�. __ ,r- – � w oB� 6.00 � � //PROTECTION / o n .
�� �a � � ' __� �. � , . �r�� w o�� �o � i r / / FENCING / � ,: �: ,
Ia�-�,�--„`�._._'�7,a \�� _ % m �,..:�- � _ `.,-^�t, � � o0 0 � / �'r- �� (TYP., SEE / C��, � � :
�c - - o v •- FFE 3 ^ /� / � \ NOTE) / o �, ; 2 ` _
s;Z� �� � -d�o� 'n,' 2.00 971.0 `� � �� 4 / ; 1 , �, `> r
I z m �. -- 6.00 r / ^ ('� \
,.,�.� � � .�1 8.17 B� - � 1 / / �� �
�� i % �- . �" ._ i � 0 960.4 0 �_ >.�' �j� ' // �(�' 0 0
I � 968 � a� o i ` / , / �`C�' _ ° � � , � �
/'� Y � 11.50'- �� �
` � -.�. !�� _....4.3�,�j� -- .—�— p / .�/ �C� gz ^� � o � ' ii/� �_ \l \i ' , / i r � . �% t; '"
I �Im a 15.50 ' `� / y �� 5 � 0 � ;.
•'�" W 1 �` 966 � .----..oi_w ` °' rn / � P�P a fl i`. ; , ,
i / � �` . o � t , 2 00
I � "�iw'.' � � / /�Q'� f ' / � ` ,
� /
6�. tt� �, / � 1 a 0 0 -
a R � � �J c�f / � 964 I /°��0�, I / �/ �(1 . ��
��� � ; ��� / �snr,rr�r % .�J �� i � I r 2o i �,�; ��
I �� �1,� � / S�HU� � ,,J % ,� / � / �F�,.c�0 / � � ,., , `� 0 0 �
I � � ' � � 1 f -c� l ' _ � � ��i.�`� �T � �� 2 SPR � � L� -, " @
� .....g�g.._ ,!- -4 / � ` �`' / � �F�Q� / i � � • �i C : t 4 (�(1 _;_
rah . .� / \ ` !� �..�' I �� J �/ / �� 1 I ° l��,f -r
� / / �>> -
� �/ / / ' � � i i a 0 i, -:
I / � � t,� � � �� / / i o il O '�
� 30 FOOT � �^, ���L� / �� � WETLAND J I� � � ', y-
BUFFER / � �C � � � �i{; ,
hti 6�' � 4 SETBACK ��� � � aD 12 CEDAR •
I\ \ �� � S (FROM CITY � � — — —� � �°� � MONUMENT I / / / �o ° . ° 0 fa 2 2 ° (1 1' ;
\ � LIMIT LINE) �/ SIGN (1YP.) r � / !y � � -, ��� ,
� � ' � � \ �� �' / � �/ ��T��0�, i 1 �> i, ". -
I / , � � / / / � / ,��,tip Sa.�i � C ('� -:
- ( ot ,
\ � � / oy � � ` - - - / 1 / � l �i� � 9� � r-' , �� �,;
�-` �-�-- f-- � -�--- � � �x CITY OF ORONO �� _
� � ` ^�o' / �/ � / _ , t o i� �� -
I i��,�;. r�6�.- �� / \ �96� � � �/ y°'� , CITY OF WAYZATA \ � — �/�j' �f
�� ,� � / 0 / y 1 i • C./o-' a1fC/
�" S / � � X\9S i � / i � �� (�.��
�e'�" � —�"` �H � � � / 6\ � � � �9`'$ �
^�� � ��� \ X -� � V�
�6 �a"� _t� �H �—— � / W ETLAN D
yh \ �"�pH � ��580, � �� / BUFFER
\\ OH ��=a6 E � � \ � // SIGNU(TYP ) G
��9�2_ � � _ _ _ \��\__ OH � Bi�—� RH �_ � � � - - / /l9�,� �'' _—�� � �
'�r, ' �� �—� _ � �H � OH — �� � /
�..��,..<_r..,.. . . _.. _� _ _. �
- �
' �►
. •
, • • • •
� • ,
emo
To: Finance Department
From: Christine Mattson, Planning Assistant /' '- ^
���r �
CC: Street File
Date: November 3, 2016
C/L: 101-22205
Re: Escrow Refund
Building Permit#2015-01198 pertaining to 10 Myrtlewood Road is complete. Please refund
$2,500 to the property owner, Chamberlain Capital, LLC.
The following is attached:
• Original signed escrow agreement
• Copy of cash register receipt showing escrow amount received
Mail to: Chamberlain Capital, LLC
11578 Chamberlain Ct
Eden Prairie, MN 55344
z:\forms�escrow refund form 2015-01198.docac
. ✓
I BUILDING PERMIT ESCROW AGREEMQ�, R � � � "��+5���
Orono Buiiding Permit# `�f7 I S--
AGREEMENT made this ��day of September , 20 15, by and between the CITY OF ORONO, a
Minnesota municipal corporation("City")and C'hamherlain Fine Custom Homes ("Owners").
Recitals
1. A building permit application has been filed forNew Residential Home Constructionlocated at
� �����_��10 M�rtlewood Rd the ("Subject Property"), legally described as
-� oc c y ewrt1�A33i ion
2. Owners request the City to review this application which requires City approval and may require
consultant legal and/or engineering review.
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 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
#ZD( S�'�Il 4K 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 returned to the Owners
when all requirements related to the project are complete. City Staff shall review the terms of this escrow agreement
two times per year to determine whether the requirements of the project have been successfully completed and whether
it is appropriate to return the funds. Owner may also request the release of the funds, and such funds shall be released
upon City Staff receiving the appropriate verification that all requirements of the project have been successfully
completed.
6. CERTIFY UNPAID CHARGES. If the project is abandoned by Owners, or if the eligible expenses
incurred by the City exceed the amount in escrow,the City shall have the right to certify the unpaid balance to the subject
prope suant to Min . §§415.01 and 366.012.
CITY: CI NO OWNER: Chamberlain Capital LLC
By: I. B : ���'`'�-�""--
au ameron
Its: � �.; anagin� Member/President
Inte�nal Use Only: G driglnai to Fina�ce Department d Copp ta Street Fiie
Packet Last Updated: August 2015
Page 23
� .. °" 3j . ... +kd "�a e b " �""—""' . .
. ' ., �,� � -� e. . .
�.��� , '���!I�''�iT ''t..M 1 a� f a :� _ tf � �1� � . .�W���.
` 3 �".h�/� a���l������i���y ��, �r � ' ; F��"IiA�i' �7�2�1�
nY . J. . �'tI���L��.,:�., d�` � g y� `�����F/�: .
� ` ; ; . ,._ L�a�n��l
I'' I ,�'�, . . ! N � ���. �"`f�'�T��.
�-;! , _ .,'A'a .t•1' J _ i , t a6'1
��*p�FE ���` '� � ���� ���` ,� ' 15���` s� �s=.��� .�.:� '
` � ,,, � � ���Q�
y. � a � �� � �:
�, :a ,� g � ;� a;• r:. .. :'� k u . - i . . -
������'�' ��r.�� � � 4�t'!�'�r�,� �,3 �`�
=� .� � k
�_ : �. , `
�M Y br.4 � � �,`S r f.�.• . i'
.(� �< � tt�• � :ir,� ,�.
�t Y � �� Y 4L $�. : \ ; . ,.
r! Y..."Y� i�, 'S. k • k T'�''d r a .h� ��` i
f � �,".g� � �, � ,. t �; _ a. � � � .. _
.�5 4 � ,",#�, Y.�,�`� r-� 'Y�Y .� '� ,��:µ Yd -s j _. • . . �%�,'�.,�. .. .. . . � :� .-. _ � .. .,_ _ - �'��.
f -. #'�e . �• * �¢� y�. y,�,Q�IY� t � _ :,..
� � , �:� .�.�0►���"���+,�►��� : �'r , �
e.�w�� .._z_.. .� . _._:.��.< e��. ..•:,�,..a�.,_'..�...�.. " � i`:,,� •-
- '• . __ ..,.... . . �n.
�
:: t,,:::
' j i _.
City of Orono
2150 Kelley Parkway
Orono MN 55356 952-249-4600
Receipt No: 3.014246 Sep 17, 2015
Chamberlain Capital LLC
Planning and Zoning
2015-01200 10 Myrtlewood 2,500.00
Rd
101-22205
Deferred Rev-Developer Deposit
Total:
2,500.00
Check
_______________
Check No: 934 2,500.00
Payor:
Chamberlain Capital LLC
7ota1 Applied: 2,500.00
� -----------.00
Change Tendered:
_______________
09/17/2p15 02:43PM
. CITY OF ORONO � 1 5 - 0 1 2 0 0 *
2750 KELLEY PARKWAY DATE ISSUED: 09/17/2015
ORONO, MN 55356-
952 249-4600 FAX: 952 249-4616
ADDRESS : 10 MYRTLEWOOD RD
PIN : 36-118-23-33-0009
LEGAL DESC : MYRTLEWOOD
: LOT 001 BLOCK 001
PERMIT TYPE : ESCROW FEE-TIED TO BUILDING PERMIT
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ESCROW FEE-TIED TO BUILDING PERMIT
NOTE: ESCROW TIED TO BUILDING PERMIT#2015-01198-PD BY CHAMBERLAIN FINE CUSTOM HOMES-CK#934-$2,500.00
APPLICANT ESCROW FEE-BUILDING 2,500.00
CHAMBERLAIN FINE CUSTOM HOMES TOTAL 2,500.00
11578 CHAMBERLAIN CT Payment(s)
EDEN PRAIRIE,MN 55344- CHECK 934 2,500.00
(952)649-7653
Minnesota State License#: BUIL-BC661410
OWNER
Chamberlain Capital LLC
11578 CHAMBERLAIN CT
EDEN PRAIRIE,MN 55344-
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 dces
not grant permission for additional or related work which requires separate
permits. All provisions of laws and ordinances goveming this type of work
shall be compied with whether or not specified herein.T'his 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 are �n
requested in conformance with the State Building Code.This permit may be /
revoked at an 'me for due cause. �
��-� � /7 l� l�'�--�� � �� (� � .
Applicant Permitee Signature Dat Issued By Signa e Date
e39ON el!SIAdOO tieue3 ellj s,joloedsuIIAdoO Wok
ztlA fl- r' }, :JOt�dsuj
f
:ems UO JO1Oe4UO3IJOUMO
009 V-61Z (Z96) -e3uenpe ul sinoy pa uol}oedsul pxeu ell;Jot Ileo
'SS300V 39NVa1!V 0111VO"03HInO3H NO1103dSNI ❑
aanssi NOIlVlIO❑ a0103dSNI 1lVO'031S0d Emu()dOIS❑
Nklf113U 111M E10103dSNI
N3)1V1010Hd ❑ -S1:1f1OH NIHIIMNOLLION003AVSNl1O3HHO0❑
1N3NVWa3d ONtU3A003HOd33
AEIVH0dW31 NOI103dSNI31JHO311V3')I1:1OM1O3UU0O❑
O
AONVdl000 30 31VOId11H3O 311851 ❑ 03300Eld V)11:10M10381:100❑ m
3131dNOD.O3POHd ❑ 03300Hd:A1:1010VASIJVS)IUOM❑ T
0
T
m
V.4
Qi �n ,-void' 0
v �
:S1N3WW00 0
ON—S3A—:f10A 1331101 tl013V1l1NOOAl3NMO
11VISNI 011d3S ❑ 311S-OW3O 0 r
1VAOW3H/NOI1VaNflOd ❑ dfl-)IOOH a3M3S 0 A3AHflS-rine SV 0
dfl-M011Od 0 dfl-)IOOH H31VM ❑ 1VNId 0 r
1NIV1dWO0 ❑ 30V1d3Hld/H3NHfl8 QOOM 0 NOILV1f1SNI 0
S11VM O31VH ❑ 1VNId 1VOINVH031A1 ❑ ONIINVHd 0 n
NOI103dSNI 31IS 0 IH 1VOINVH031A1 0 8V1S NOGVEI 0
1VAOW3a 33a1 0 1VNId ONIBWlld ❑ dOOHdE31VM NOIIVON11Od 0 y
ONI111d/ONIOVHO/AVOX3 0 la ONIOWf11d 0 11VM O3aflOd 0 T
1VNId 011d3S ❑ 1VNH-OW3l 0 ONIlOOd ❑ T
f q_.C/91 Lm,� NOIldW 3S30
"` _[ '", HOIOVH1N00
'ON 3NOHd3131 H3NMO
M'?11))'V Q1 ss iaav
L1-21 03131dINOO „5itO_ OTC 'ON 11WH3d
0311103H35 33110N NO1103dSNI
NI 0371V0 ON0110 AO A113
310411 31VO