HomeMy WebLinkAbout2014-00898 - retaining wall CITY OF ORONO * 2 0 1 4 - 0 0 8 9 B *
� � 2750 KELLEY PARKWAY DATE ISSUED: 08✓15/2014
ORONO,MN 55356-
(952)249-4600 FAX: (952)249-4616
ADDRESS : 980 NORTH ARM DR
pIN : 07-117-23-11-0016
LEGAL DESC : PIRATES COVE
: LOT 012 BLOCK 001
PERMIT TYPE : ZONING PERMIT
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : RETAINING WALL<4 FEET
ACTIVITY : 434-RESIDENTIAL
NOTE: REBUILD RETAINING WALLS
ESCROW FUNDS WILL BE RELEASED AFTER PROJECT IS COMPLETE AND ALL DISTURBED AREAS ARE RE-VEGETATED.
INITIAL
APPLICANT RETAINING WALL<4' S0.00
ENGINEERING REVIEW COSTS
LANDCRAFTERS INC TOTAL 50.00
7341 COUNT'Y ROAD 15 Payment(s)
MINNETRISTA,MN 55364- CHECK 3055 50.00
(612)910-8111
OWNER
BICKNELL,MR.&MRS.
980 NORTH ARM DR
MOLJND,MN 55364-
AGREEMENT AND SWORN STATEMENT
The work for which this permit is issued shall be performed according to
the approved plans and specifications,applicable City approvals,and the
State Building Code. This permit is for only the work described and dces
not grant permission for additional or related work which requires separate
permits. All provisions of laws and ordinances goveming this type of work
shall be compied with whether or not specified herein.This permit will
expire and become null and void if 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.
T'he 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.
�/ / i /
pphcant Permitee Signatu e Date Issued By g ature Date
t � DATE TIME
CITY OF ORONO CALLED IN
INSPECTION NOTICE scHe�u�e� -� �� ���
PERMIT NO. COMPLETED
ADDRESS �S b ND/Z� /�'��/�'�'�
OWNER TELEPHONE NO.
CONTRACTOR
� DESCRIPTION L�1'��G�•NS ��a P�=�`�T �
� D FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILUNG
Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS
y ❑ FRAMING ❑ MECHANICAL FINAL
Q ❑ TREE REMOVAL
Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION
Q ❑ RADON SLAB ❑ WATER HOOK-UP p PROGRESS
� ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT
v ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP
_ ❑ DEMO-FINAL O SEPTIC INSTALL ❑ HARD COVER REMOVAL
J ❑ PLUMBING RI ❑ SEPTIC FINAL O FOUNDATION/REMOVAL
2 OWNERICONTRACTOR TO MEET YOU:_YES_NO
y COMMENTS:
aWorK be.•�.c �o h.e �s rc��r�K�
� �4<<,hs r�,:c�Kc wti�t c� ex�� Sa�.r�
o . .
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Q " j�UcS yot �p/e*� � �i Q 4 KY 1,�,�s�_o�t5�/�
2 f��C4yc C4d �'�i r•5 � Oro�c C ' �.'��Tc�,
� ell �6 G�,�D�..� dJorlG - '�l�S a� "��T��7Ga7�
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W O WORK SATISFACTORY:PROCEED ❑PROJECT COMPLETE
� ❑CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
W
O ❑CARRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. p pH0T0 TAKEN
INSPECTOR WILL RETURN ❑CITATION ISSUED
❑STOP ORDER POSTED.CAII INSPECTOR
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Cail for the next inspection 2a hours in adva�ce. (g52) 249-4600
Owner rrtractoron site: � ��- �i G�K e!/
Inspector.
White Copyllnspector's File Cenary CopylSfte Notiee
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Q� N�t�I1'1 �n� �Y• ��
. _ �� ��
ity of Orono -Z,o�
� �� �
Building Pe pplication
for Ne uctures or 'tions
Ma�ling Addness: Permit number: O ��g �
�O A TO PO Box 66 _
f w Crystal Bay, MN 55323-0066 Date received: �'/
StreetAddress:' Received by:
y 2750 Kelley Parkway Plan review fee:
e� ��� Orono, MN 55356
�'�kFSHo�`` Main: 952-259-4600 Total Fee:
Fax: 952-249-4616 www.ci.orono.mn.us
This application form must be completed in full and all required information must be submitted.
Incomplete applications will be returned. (Please print)
GENERAL INFORMATION:
Job Site Address: ��0 Il��'t� �},.� �r-IvP
Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? Yes No
If yes,a special event pe►mit is required with Police Department and City Counal approval 60 days prior to the event. Shuttle bus service will be
required unless applicant demonstrates sutFicient on-site parking is available. Non pem►itted events will not be allowed.
CONTRACTOR!APPLICANT INFO MATION:
Name: �Q.�at r--��� �-� �� ^ L�►�.��r�-�1-er s �,..�.
State License# Expiration Date:
Phone: (cell) fa�Z-�(i o-- �l I I (o��)
Mailing Address: 3 " c- Ci : ' n ' ZIP: 5��6
Contact Person: Sw.-.-�-e. Applicant is: ontractor Homeowner �ci�ie o�e�
Email and/or Fax: v,1� ��r C L�.-#�w.��( cb..-�
PROPERTY OWNER INFORMATION:
Name: '�,r� �,���(,�
Phone(day): ��2--�'-��3• �.s'o
Address: �i ' N �'M C� � a��� Z�P� ��
Email and/or Fax �,rbL��(( � -I-1`er}�P f aP 1�
ARCHITECT/ENGINEER INFORMATION:
Name:
Phone(day):
Address: City: ZIP:
Email and/or Fax:
PROJECT INFORMATION: Descri tion of pro�ect:
1.Type of Project 2. Proposed Use 3.Structure Type 4.Sewage Disposal 8
Water Supply
❑ New Construction [�Single Family with �Residence
❑Addition attached garage ❑Garage/Accessory Bldg. 0 Public Sewer
❑Accessory Building ❑ Single Family with ❑ Deck
❑ Relocation � detached garage ❑Office/Commercial ❑ Private Sewer
�'Other: (specify) �1Z�cn� ❑ Multiple Family/Condo ❑Warehouse
❑ Public ❑ Storage ❑ Public Water
"*Any earth movement may require ❑ Commercial ❑ Other(specify)
MCWD review 8 permits. ❑ Industrial ❑ Private Well
Minnehaha Creek Watershed Dist�ct(MCWD) ❑ Othe�: (Specify)
18202 Minnetonka Blvd
Deephaven,MN 55391
Phone: 952-471-0590
Fax: 952-471-0682
www.minneh ha ek.
Estimated Construction Valuation (excluding land) $ ��164�
Padcet Last Updated: 04119/2013
Page 22 of 23
. .
STRUCTURE INFORMATION:
1.Structure Dimensions 1.Structure Dimensions(continued) 2.Type of Construction
a. Length (ft.)= Number of bedrooms=
❑Wood/Frame
b.Width (ft.)= Number of garage stalls: ❑ Masonry
Areas in sauare feet Attached= ❑ Metal
❑ Pole Bldg.
c. Basement= Detached= ❑ ICF
d. 1�Story = ❑ On-site Prefab
e.2nd Story= ❑Off-site Prefab
f. '/z Story = ❑ Other(please specify):
g.Total Area=
REQUIRED SUBMITTALS:
All of the information must be submitted in order for your application to be processed:
Not
Enclosed A licable
❑ ❑ Permit A lication
❑ ❑ Pro osed Buildin Plans
❑ ❑ MN State Ener Code Calculations and Mechanical Code Re uirements Form
❑ ❑ Surve meetin all r 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
❑ ❑ Minnehaha Creek Watershed District Permit s
❑ ❑ Plan Review Fee
❑ ❑ Other:
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 a500;
• Certifies that the information supplied is true and correct to the best of his/her knowledge. The applicant recognizes that they
are solely responsible for submitting a complete application being aware that upon failure to do so, the staff has no altemative
but to reject it until it is complete;
• 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 Certfficate of Occupancy may be issued upon receipt of a$10,000
escrow to ensure completion of the as-buflt survey and all sibe improvements.
Applicant's Signature: ��` l � � Date: � r� /r l /
Owner's Signature: Date:
Packet Last Updated: 04/192013
Page 23 of 23
, ���� �.��'�E�' �E�������� ��� �E� �T�E�GT�F�E� � �,E��t�°����
J�dcfres�/Permit t�un�eber: �. ►
Description o#work: '`
; c,,��� `/� ...__.
. Sepfic revieHr by: e3�lUYt�' Date Approved:
Zoning r�vie�nr by: 1�,,���!'� D�te Approved: �' ��'��
Building review by: IN Date Approved: �' ��-E�
Gr��ling review by: Date Appr�ved: '���
' Zoning District: Zoning fi{e#: Re�o#: Resa Date: -
Zoning: Lat Ar�a: - SF/AC t+�idth: Lot Coverage: SF'�`_%
Survey SubmitEed: �Yes �o Date of Survey: Revisetl date(?):
F�ro osed SEtbacksc
� front(Lakej Rear(�treet) (` �" S' E, 1AE ) ( N S � t�! � 0ther BuEtciin�s 1Netland
: , Sicle Sic4e �
;
� . _
. Defined Height: Peak Helght: FFE: �FE minus 6 fest=_,�(Existing Contou�
; Perimeter(linear fe+et)_ . 58°k= #of Stories Ok? G YES
fOR A BUILDIkG WITH A BASHMEI+IT OR�CRAWL SPACE:
.;
; Tltedist8nce'4etweenRl��owest . FORABUIGDING;QN:�'-'�� ION: .� > `
STRRT WITH propoSeQ.floor(of the basement or crawl
space)and thb highest point ot the roof. � nce bbNveen the top ot slab anC
If you h�re a . ��h�,,, t poiM of the rooL
• GABLE OR HIePED RbOF(no �•w� � e a..:
( � LE OR I�IPFED ROOF(no
i � � � � w1�iilows): S�titraG h�lf,the ' � ���� �!!U��/ wvsj Sulstract half thetlistant
� distance between the fiighest poiM; � �'�'"" een the highe�t point of ttie ro�
� of the roof ta Yh�loinr pcirit ot the -� f�
; � SUBTRACTION ' car�e§poriding gable or hipped ioof.
arr poiM of fifie cortespondin
ofh�pped"roof
� (BASED ON ROOF . �LE QR HIPPED ROOF(wi4h ` - E Qtt HIPP�D ROOF{wah
TYPE) .: wi�dt�w's): Su6Vectfialf.the' - )• �ubtr�cth�Iff.Uiadfatanc
8i�a�ce beiween the top of the n f�e top of the hiph�t .:
': hi�hest win�ativ and the highest ; .. - ; w n w arJd t#ie high�st poirit of the
: -- R¢int of�he roof : _ - rouf - � :-
� . • AL�,OThfER•FfOi�F TYPES(fl�t, ' • AtI.,QTNER ft00F TYP�&{flat,
,. rt�nsard',�t�):.No Sub�raction. ADDIT�ON Atld:td��d'�YanCe Nds���slat
Si1BTt?ACTIOM Sut>trac�the distanc�tietween;the �B,ASED ON , suul;the�iahest e�cisting�rade�adje�M t
; (BASED ON EaC�STING basemer#/cravul space lfoor ahtl�ttie ' - - �XISTlNG' the�uhdaUort. ", -
� _GRADES) highest Axisting gratle adjaCent to ti�e ' G DES .,
� foundatiqn OFt 10 feet(whtchever is I�ss� ` F.QUALS; Defi�necl bu Iding heiaht.
.. . . .
� QUALS ' Defin.. .buildfng heig : . .,. . . ,., ,.
. ,
. r ,.: .
' ShQ and District MCWD P�rmit Re�eived � Av�rao e!a#cesh�r.e Setback Met2 � Sluf�
0 Yes � No pf N/A: � Ye� Mc
Yes � No � Yes G No� N/A .
; Permit Number:� � ,. ' : , .�etback; -
:,tR��i `"
Stormwater Quaffty Existing Pr�posed Variance Required CUP Required
� Over�a Distriat Tier - Kardcoder Ffarcicover
•. .Q Yes No 6 Yes No .
�'"" TYPe�s)� TYpe(s):
' Updated: January 2013
v:\forms�plan review checkiist 2013.doac
RENfARKS (in-house):
Fees to be Cha ed YES , ��
pet�in�t
P1an Review
'�Stuct�at�e
' inves#igation Fee _
�►�—N�tbAr of 3A �e .
Other(specliy)
, S uare Fao� e $ er S uare Faota e
Basement X ' $ _
1�Floor X ' $
2"d Fioor X , $ .
Garage X _ . $
:Estim�ted Construation Yatue: $
Oronc Inspections ReQuired Work Requiting Separats Permits �tequlred State Qermi�s
Q �ite � Plumbing G Grading/Filling � Well .
!� Hardcover Removat Q Mechanical ['J Fire � Electrical `
� Footing Q Septic . G Water Connection
Q Poured NVall G Fireplace . G SewEr Connecfion _ .
G Four�dation Survey CP Masonry � Cawn Irrigation
C3 Radon Rock-Bed CE Nf#g.
� Framing a Qther(speci#y) -
tllnsulation . . : ,
0 A�:Bt�itt Survey
:
ir�a1 ,
13 Wetl�r�d Buff�r '
�dther(specify) ` :
. .
� : ,
, REMARK�{in-h�use): _ ;
Other Revisw: Reviewed tZyc. Date Approved:: , 1 - , �
Accsss: Existing: � Y�S Q NO New: `t3 YES II NO
OFFIC{ALREM S -TO BE NpTED Ot� PERMiT AND INITIAL �
�
- ��
Updated: January 2013
v:lfortns�plan review checkiisi 2013.docx
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CITY OF ORONO CALLED IN =�� :�
INSPECTION O /� SCHEDULED
PERMIT NO. �� v' COMPLETED
ADDRESS 9�D ND���1"!!'J� �
OWNER TELEPHONE NO.�o�a 9ro 8���
CONTRACTOR -������C��".s �
� DESCRIPTION ����— /��-�/��j��"�G'
�
� ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FIWNG
Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORENVETLANDS
y ❑ FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL
Z ❑ IN LATION ❑ WOOD BURNER/FIFEPLACE ❑ SITE INSPECTION
Q ❑ ADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS
� FINAL O SEWER HOOK-UP ❑ COMPLAINT
v O DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP
_ � DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL
J 0 PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL
2 01NNERICONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
�
j
0
�
0
W
QC
Q
z � " a ,
W
�
W
�
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J
O
W ❑WORKSATISFACTOR�PROCEED PROJECT COMPLETE
� ❑CORRECT WORK 8 PROCEED ❑1 UE CERTIFICATE OF OCCUPANCY
W
� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE COVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN
INSPECTOR WILL RETURN
�STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (J52� 2 -46��
OwnerlContractor on site:
Inspector. '�
White Copyllnspector's File anary CopylSite Notiee
DATE TIME '✓
CITY OF ORONO CALLED IN
INSPECTION NO C v SCHEDULED
PERMIT NO. �����o COMP EfE Z�� �
ADDRESS ��� �� ' /P'/ri' ��`J .�+.�'
OWNER TELEPHONE NO.
CONTRACTOR
� DESCRIPTION /� ��� �� `
�
� ❑ FOOTING ❑ PLUMBING FINAL ❑ RADING/FI G
Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORENVETLANDS
y ❑ FRAMING ❑ MECHANICAL FINAL
❑ TREE REMOVAL
� ❑ INSULATION ❑ WOOD BUFiNER/FIfiEPLACE ❑ E INSPECTION
❑ RADON SLAB ❑ WATER HOOK-UP r�ROGRESS
� ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT
J ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP
_ ❑ DEMO-FINAL � SEPTIC INSTALL ❑ HARD COVER REMOVAL
� ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNbATION/REMOVAL
2 OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
�
a
�
J �
0
�.
�
0
� �
W
�
Q
�
2
W
�
W
�
�
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W RKSATISFACTORY:PROCEED ❑ PROJECT COMPLEfE
❑C RRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORE COVERING
PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ pHOTO TAKEN
INSPECTOR WILL REfURN ❑CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Cail for the next inspection 2a hours in ance. 952� 2 9-4600
OwnerlContractor on site:
Inspector.
White Copyllnspector's File Canary CopylSite Notice
• t
• •
• • ♦ � •
1 • �
emo
.
To: Finance Department
From: Christine Mattson, Planning Assistant
CC: Street File �
Date: October 27, 2014
G/L: 101-22205
Re: Escrow Refund
Building Permit#201400898 pertaining to 980 North Arm Drive is complete. Please refund
$2,500 to the applicant, Bruce Bicknell.
The following is attached:
• Original signed escrow agreement
• Copy of cash register receipt showing escrow amount received
Mail to: Bruce Bicknell
980 North Arm Drive
Mound, MN 55364
w:�.street files�north arm dr�980�escxow refund memo 201400898.doac
BUILDING PERMIT ESCROW AGREEMENT
Orono Building Permit#2014-00898
AGREEMENT made this�day of v , 20�, by and between the CITY OF ORONO,
a Minnesota municipal corporation ( C y") Bruce Bicknell ("Owners").
Recitals
1. A building permit application has been flled for replacement in-kind of retaining walls which
exceed 4-feet located at 980 North Arm Drive the ("Subject Property"), legally described as Lot 12, Block 1,
Pirates Cove, Hennepin County, Minnesota.
2. Owners request the City to review this application.
3. The City will commence its review of the application and incur costs associated with said review
only if the Owner establishes an escrow to ensure reimbursement to the City of its costs.
NOW THEREFORE,THE PARTIES AGREE AS FOLLOWS:
1. DEPOSIT OF ESCROW FUNDS. Contemporaneously with the execution of this Escrow
Agreement, the Owners shall deposit$2,500 with the City. All accrued interest, if any, shall be paid to the City to
reimburse the City for its cost in administering the escrow account.
2. PURPOSE OF ESCROW. The purpose of the escrow is to guarantee reimbursement to the City
for all out-of-pocket costs the City has incurred (including planning, engineering, in excess of $500, or legal
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 #2014-00898 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 property pursuant to Minn. Stat. §§415.01 and 366.012.
y
CITY: CITY OF ORONO OW R:
By: �1�IVY�w�
�ts:�laru�ar�► �SI�—`
i
�
' City of Orono ��
2750 Kelley Parkway
Orono MN 55356 �
952-249-4600
Receipt No. 3.011571�
Aug 14, 2014
Bruce Bicknell
Previous Balance:
Permits .00
2014-00901 980 North Arm 2,500.00
. Dr
101-22205
Deferred Rev-Developer Deposit
Total:
---------------
2,500.00
Check =____�________
Check No: 11664
Payor: 2.500.00
Bruce Bicknell
Total Applied:
2.500.00
Change 7endered: .00
08/14/2014 03:57PM ��_________
� � CITY OF ORONO * Z pJ 1 4 - 0 0 9 0 1 *
2 7 5 0 K E L L E Y P A R K WA Y DATE ISSUED: 08/14/2014
ORONO, MN 55356-
(952) 249-4600 FAX: (952)249-4616
ADDRESS : 980 NORTH ARM DR
PIN : 07-117-23-11-0016
LEGAL DESC : PIRATES COVE
: LOT 012 BLOCK 001
PERMIT TYPE : ESCROW FEE-TIED TO BUILDING PERMIT
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ESCROW FEE-TIED TO BUILDING PERMIT
NOTE: TIED TO BUILDING PERMIT 201400898
APPLICANT ESCROW FEE-BUILDING 2,500.00
TOTAL 2,500.00
BICKNELL,MR.&MRS. Payment(s)
980 NORTH ARM DR CHECK 11664 2,500.00
MOIJND,MN 55364-
OWNER
BICKNELL,MR.&MRS.
980 NORTH ARM DR
MOLTND,MN 55364-
AGREEMENT AND SWORN STATEMENT
The work for which this permit is issued shall be performed according to
the approved plans and specifications,applicable City approvals,and the
State Building Code. This pertnit is for only the work described and does
not grant permission for additional or related work which requires sepazate
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 cons,truction 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 y time for due caus
��� / /
Applicant Permitee Signature Date Issued By S' ature Date
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