HomeMy WebLinkAbout2010-00523 - add false dormer CITY OF ORONO PERMIT NO.: 20�o-oos23
2750 KELLEY PARKWAY
ORONO, MN 55356- DATE ISSUEv: 07/27/2010
*� 952 249-4600 FAX: 952 249-4616
AI'�7l2ESS : 3200 NORTH SHORE DR
PIN : 08-117-23-41-0001
LEGAL DESC : UNPLATTED 08 117 23
: LOT 000 BLOCK 000
PERMIT TYPE : ADDITION/REMODEL/REPAIR
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR
ACTIVITY : 434-RESIDENTIAL
VALUATION : $ 13,720.00
NOTE: ADD FALSE DORMER-CHANGE ROOF LINE OVER TWO EXISTING DORMERS
APPLICANT PERMIT FEE SCHEDULE 250.75
FIRST STREET CONSTRUCTION INC.
PLAN REVIEW 162.99
417 E 1ST ST. STATE SURCHARGE VALUATION 6.86
WACONIA,MN 55387 � �
(952)442-4602 TOTAL 420.60
Minnesota State License#: BG 4141
OWNER
HALPER, BARBARA
3200 NORTH SHORE DR
WAYZATA,MN 55391-
AGREEMENT AND SWORIY 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 d;;scribrd and does
not grant permission for additional or relatc:i work which requires separate
permiu. All provisions of laws and ordmances governing this ty�:,of work
shall be compied with whetiier or not specif�d l�;rein.This perr,�it will
expire and become null a+ 1 void if construction authoriz�d is not
commenced within 180 d>rys of the date uf issuance,or if construction is
suspended for a period ot?80 days at anv tiine after woJc has commenced.
The applicant is responsibi�for assn:�ng all required inspections are
requested in conformance with the State Buildi��Code.This permit may be � �
revo at any time for due� se. � ���
,�,� � �i�"'� �/� �_� � ���CCl�I 7� � 7 �i
i i
ppl' t Permitee Si nature Date Issued By Signature Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
City of Orono � �,�iD
�
Buiiding Permit Application
" for New Structures or Additions
Mailing Address: �r Q/b-
'g 0.� PO Box 66 Permit number: Q��` �
� �� 0 Crystal Bay, MN 55323-0066 Date received: z �l
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� ����-++" �, Received b �
e::>w StreetAddress:' Y� L.�T
�„��
� , y�"�.�, �� 2750 Kelley Parkway Plan review fe �
t'�xEsxo4`'� Orono, MN 55356 Q�7
Total Fee: PT»���� /�
Main: 952 249-4600 Fax: 952-249-4616 www.ci.orono.mn.us (v
This application form must be completed in full and all required information must be submitted.
Incomplete applications will be returned. (P/ease print)
GENERAL INFORMATION:
l��
Job Site Address: 5 LG%�% �(� Y��I(/V� �Y1 1,�J
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 Department and City Council approva!60 days prior to the event. Shuttle bus service will be
required unless applicant demonstrates sufficient on-site parking rs available. Non-permitted evenfs will not be allowed.
CONTRACTOR/APPLICANT INFORMATIQN:
Name: �rS �" � �'U1i c�C�1 C�
State License# Expiration Date: 3 3 j �d
Phone: G S Z� `t 4 — �{- �p Z (office) � Z — ��( 7 - �j (�(� � (cefl)
Mailing Address: � G s� S � Cit : ZIP:
Contact Person: .S�Y �<,. Appficant is: ontractor Homeowner (Circle One)
Emaif and/or Fax:
PROPERTY OWNER INFORMATION:
Name: �iP+(�AY !=� �--�/� ���
Phone (day): 7�j�— � _ �
Address: ���� /�(�. �-.Z. �Y' Citv� C..3�cirtb ZIP� �� � � (��
Email and/or Fax
ARCHfTECT/ ENGINEER II�FORMATI N:
Name: � U fv vnn � �S f ,
Phone (day): �J'S Z _ � 7 3 � 3i
Address: / G1 `f Z� ��-�h i �-� !-+i� C�-i1C� Cit ' ����� �!f-�lrC ZIP� �J�C�I�
Email and/or Fax:
PROJECT INFORMATION:
1. Type of Project 2. Proposed Use 3. Structure Type 4. Sewage Disposal &
Water Supply
❑ New Construction [�Single Family with Residence
❑ Addifion attached ara e
❑ Accesso Buildin 9 g ❑ Garage/Accessory Bldg. [�ublic Sewer
rY 9 �'`��s� ❑ Single Family with ❑ Deck
❑ Relocation detached ara e
9 9 ❑ Office/Commercial ❑ Private Sewer
�ther. (specify) �c.lc� C{cHYn2/' ❑ Multiple Family/Condo ❑Warehouse
L�����Pc- d��%v (��c�'=1� f(�C ❑ Public ❑ Storage ❑ Public Water
�"Any earth movement may requjre�� ❑ Commercial ❑ Other(specify)
MCWD review&permits. �:XrSh ,� ❑ Industrial �ivate Well
Minnehaha Creek Watershed District(MCl/yg� ❑ Other. (specify)
18202 Minnetonka Blvd ('(L� Y��
Deephaven, MN 55391
Phone: 952-471-0590
Fax: 952-471-0682
www.minnehahacreek.or
Estimated Construction Valuation (excluding land) $ �3�1��. �=
Last Updated: 9/29/2009
- 17-
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' STRUCTURE INFORMATION: ��
�};
��� 1. Structure Dimensions 1. Structure Dimensions(continued) 2. Type of Construction • °
a. Length (ft.)= Number of bedrooms= ❑Wood/Frame .
❑ Masonry
b. Width (ft.)= Number of garage stalls: ❑ Metal
Attached = ❑ Pole B�dg.
Areas in souare feet Detached = ❑ tCF
❑ On-site Prefab
c. Basement= ❑ Off-site Prefab
d. 1 S' Story = ❑ Other(please specify):
e. 2"d Story =
f. '/Story =
g. Total Area=
REQUIRED SUBMITTALS:
All of the information must be submitted in order for your application to be processed:
�e Not
Enclo d A plicable
°�` ❑ Permit A lication
��; ❑ Pro osed Buildin Plans
� ❑ MN State Ener Code Calculations and Mechanical Code Re uirements Form
Y', ❑ Surve meetin all re uirements
::..'���:
��,: � 0� Stormwater Pollution Prevention Plan
`.-;s ❑ Hardcover Calculation s
❑ C�1' Se tic S stem Site Evaluation Re ort
❑ Access Permit
� I� Wettand Buffer Im rovement Plan
❑ C3� En ineered Plans for Retainin Walls 4 feet or above
� ❑ I Plan Review Fee
�"# � ❑ Other
�:,.
�<
�^µ .
fi` APPLICANT ACKNOWLEDGEMENT:
• Agrees to provide all information required or requested by the Building Department;
� ` • Agrees to pay the City of Orono for engineering consultant review costs in excess of$500;
��:
�.n
• 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;
_ • Some or all of the information that you are asked to provide on this application is classified by State law as either private or
?' ' confidential. Private data is information which generally cannot be given to the public but can be given to the subject of the data.
Confidential data is information which generally cannot be given to either the public or the subject of the data. Our purpose and
�; intended use of this information is to annually update our records and records of other governmental agencies required by law.
�_:; If you refuse to supply the information,the application may not be issued.
�;'.
�
` r � � �
ApplicanYs Signature: Date: � �� /�
�
Last Updated: 9/29/2009
— 18 —
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Plan Review Checklist for New Structures / Additions
Address/ PID/ Legal: - - �::.`���-�, "•�' �.. �..� "��lt C� r,,� ..�� � ._
.
•Description of work: _.i ��-r'�-�n � '-� - �� -ti� �
• .� �' i , 4�t"�C) �( ✓ v` i.���
�'i�N!� k.. G w�'r�C9�-• v�.�c��-� �i.;t��v' �,-c Y�G L- �'c�i�-,� C�(o l S��'.G,�r S
Septic review by: /�� r�' Date Approved: �2 ` �7�/��
Zoning review by: ' Date Approved: ��Z.-��l(.j
Building review by: Date Approved: �T � 1�+ -J �
Grading review by: /��� Date Approved:
Zoning File#: Resolution#: Resolution Date:
Zonin District Fire Department Post Office School District
Zoning: Lot Area: SF/AC Width: Depth:
Survey Submitted: Cd'Yes ❑ No Date of Survey:
Pro osed Setbacks: �o c�j�-r�r� �
Front(Lake) Rear(Street) ( N S E W ) ( N S E W ) Other Buildings Wetland
Side Side
Building Defined Height: Building Peak Height: #of Stories Ok?: � YES
FOR A BUILDING WITH A BASEMENT OR CRAWL SPACE: FOR A BUILDING ON A SLAB FOUNDATION:
START WITH the distance between the basement floor/crawl START the distance between the slab and the highest
space floor and the highest roof peak, the top of WITH roof peak,the top of the cornice of a flat roof,
the cornice of a flat roof,the deck line of a the deck line of a mansard roof, or the
mansard roof, or the uppermost point on a round uppermost point on a round or other arch-type
or other arch-t e roof roof
SUBTRACT half the distance between the highest window and SUBTRACT half the distance between the highest window
hi hest roof eak of a itched roof and hi hest roof eak of a itched roof
SUBTRACT the distance between the basement floor/crawl ADD the distance between the slab and the highest
space floor and the highest existing grade within existin rade within the foundation
the foundation or 10 feet, whichever is less. EQUALS Defined buildin hei ht
EQUALS Defined buildin hei ht
Lot Coverage: SF %
Shoreland District MCWD Permit Received Avera e Lakeshore Setback Bluff
❑ Yes 0 No N/A / 0 Yes ❑ No
❑ Yes ❑ No �'Yes ❑ No ❑ N/A
Permit Number: Setback:
Hardcover Zones Existin Proposed Vari ce Required CUP Re uired
0-75' G es � No ❑ Yes o
75-250' Type(s): Type(s):
250-500'
500-1000'
REMARKSLn-house): � �' � ^ �� �-
'S e�t`� �� - _' � �— I S l S�C� Cl c,c��i� �
Ps c�c�c >
Updated: 09/11/2009 y �j _� �C� ����
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Fees to be Char ed YES NO
f�er�n�t`., �.A .
Plan Review
;�#ate`Surcharge �, : •
Investigation Fee .
SA�=�I�rirber�T S�4C Units :_ : ; . " `:.
_
Sewer Connection
°1Nater.Connecx�on
.
Park Fee
. �S�te�nspection -.�- : , � < ..,. ..
Other(specify)
`I�I�sce�la��„eo�s�Fe�s;, W : � t{:;,.:,
Calculated By:
S uare Foota e $ er S uare Foota e
Basement X = $
1� Floor X = $
2nd Flool' X = $
Garage X = $
Estimated Construction Value: $ � � .'�2S�
Orono Inspections Required Work Requiring Separate Permits Required State Permits
� Site 0 Plumbing 0 Grading /Filling 0 Well
0 Hardcover Removal � Mechanical � Fire 0 Electrical
� Footing 0 Septic � Water Connection
0 Poured Wall � Fireplace 0 Sewer Connection
� Foundation Survey � Masonry 0 Lawn Irrigation
� Radon Rock Bed � Mfg.
�Framing � Other(specify)
p'Insulation
� As-Built Survey
,p�Final
0 Other(specify)
REMARKS (in-house):
Other Review: Reviewed by: Date Approved:
Access:Existing: 0 YES 0 NO New: 0 YES 0 NO
REMARKS (TO BE NOTED ON PERMIT AND INITIALLED BY PERSON PULLING PERMIT)
Updated: 09/11/2009
z:\fortns�plan review checklist.docx
�
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CITY OF ORONO �L?Z � — C� LED IN ��
INSPECTION NOTICE Vb'CH DULED 'Z �� �
PERMIT NO.�o�4-GG�d79' ��1� �
ADDRESS .3aD0 /�' -S�-�Q ��
OWNER TELEPHONE NO. ��Z Sg� �� �
CONTRACTOR ���� ��" C-11��
>; DESCRIPTION �~ ����������5
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� ❑ FOOTING ❑ PLUMBING FI L ❑ EXCAV/GRADING/FILLING
Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS
y ❑ FRAMING ❑ MECHANICAL FINAL
O ❑ TREE REMOVAL
Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION
Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS
� ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT
J ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP
_ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL
v ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL
� OWNER/CONTRACTOR TO MEET YOU:_YES_NO
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� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWiTHIN HOURS. � pHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
O INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call forthe next inspection 24 hours in advance. (952� 249-46��
Owner/Contractor on site:
�/ �
Inspector. �J (��%;�
White Copyllnspector's File Canary CopylSite Notice
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��pAT��.y TIME
CIN OF ORONO CALLED IN ��' �
INSPECTION TI E SCHEDULED -�
PERMIT NO�/��7� COMPLETED
ADDRESS .��� /V��� �
OWNER TELE HO E N � ' -� �
CONTRACTOR
�
� DESCRIPTION
�
� ❑ FOOTING ❑ LUMBING FINAL ❑ EXCAV/GRADING/FILLING
Q ❑ POURED WALL ❑ MECHANICALRI ❑ LAKESHORENVETLANDS
y ❑ FRAMING ❑ MECHANICAL FINAL
❑ 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 ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL
� ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
y COMMENTS:
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� ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
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� �CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFOREC�IERING PERMANENT
❑CORRECT UNSAFE CANDITION WITHIN HOURS. p pHOTO TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call forthe next inspection 24 hours in advance. (952) 249-46��
OwnedContractor on site:
Inspector.
White Copyllnspector's File Canary CopylSHe Notice
DATE TIME V
CITY OF ORONO CALLED IN
INSPECTION NOTICE SCHEDULED
PERMIT NO. �D!b --pOD79 COMPLETED �-�t-� /V ���
ADDRESS 3'��"'� w�� S�'.,�
OWNER CONTR.
TELEPHONE NO.
�CRIPTION ����n
�
FOOTING ❑ MECHANI AL I ❑ EXCAV/GRADING/FILLING
� ❑ FR,4MING
� ❑ MECHANIC NAL ❑ LAKESHORENVETLANDS
O ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ TREE REMOVAL
Z ❑ WALL BD. ❑ WATER HOOK-UP ❑ SITE INSPECTION
Q ❑ FINAL ❑ SEWER HOOK-UP ❑ PROGRESS
� ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ COMPLAINT
Q ❑ DEMO-FINAL ❑ SEPTIC INSTALL. ❑ FOLLOW-UP
? ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ HARD COVER REMOVAL
J ❑ PLUMBING FINAL ❑ FOUNDATION/REMOVAL
� OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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� O CORRECT WORK,CA�L FOR REINSPECTION TEMPORARY
� BEFORECOVERING
PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ pHOTO TAKEN
INSPECTOR WILL RETURN ❑CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call forthe next inspection 24 hours in advance. �95Z� 249-46QQ
OwnerlContra r te
Inspector.
White Copyllnspector's File Canary Copy/Site Notice
� Z - a ATE TIME �
CITY OF ORONO ��a� �`��ED IN � a �� d
INSPECTION OTICE � SCHEDULED �=g�,t
PERMIT NO. b � OD? COMPLETED
ADDRESS ��O IU� S�O/�'� L�lK .
OWNER TELEPHONE NO. ��� Sg����,�
CONTRACTOR ��-5 f S7�/�ec��
�S,
� DESCRIPTION ��r� � �����22c�P /
ly � FOOTING ❑ PLUMBING FINA ❑ EXCAV/GRADING/FILLING
� ❑ POURED WALL ❑ MECHANICAL RI �� ❑ LAKESHORENVETLANDS
Q ❑ FRAMING ❑ MECHANICAL FI ��� ❑ TREE REMOVAL
Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION
Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS
� ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT
v ❑ DEMO-SITE ❑ SEPTIC MAINT. � FOLLOW-UP
_ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ WARD COVER REMOVAL
J ❑ PLUMBING RI ❑ SEPTIC FINAL p FOUNDATION/REMOVAL
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
y COMMENTS:
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� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. ppHOTOTAKEN
INSPECTOR WFLL RETURN
0 STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
O INSPECTiON REQUIRED.CALLTOARRANGE ACCESS.
Call for the next inspection 2a hours in advance. (g52) 249-4600
OwnerlConVactor on site-
Inspector. < <—�
White Copyllnspector's File Canary CopylSite Notice
' . : • .
1 •
emo
To: Finance Department �, , �
From: Christine Mattson, Planning Assistant ` ; �
CC: Street File N��
I"
Date: 11/10/2010
Re: Building Permit Escrow Refund
Buiiding Permit #2010-00079 and 2010-00523 pertaining to 3200 North Shore Drive is
complete. The Applicant, Barbara Halper, has requested a refund of the escrow.
The following is attached:
• Escrow Refund Request
• Email from Bonestroo indicating no unbilled WIP on this project
• Email from Campbell Knutson indicating no unbilled WIP on this project
• Original signed escrow agreement
• Copy of cash register receipt showing escrow amount received
z:\forms�zoning standard forms�escrow agreement standard forms�escrow refund memo template.doc
Christine Mattson
From: Barbara Halper[barbara@factright.com]
Sent: Tuesday, November 02, 2010 4:20 PM
To: Christine Mattson
Subject: Re: Escrow Refund
Thank you, chris. I believe my project is complete and you have all final inspections completed. Please send
me the refund of my deposit to barbara Halper at 3200 north shore drive, wayzata, mn 55391.
On Nov 2, 2010, at 11:41 AM, "Christine Mattson" <CMattson(ir),ci.orono.mn.us>wrote:
Hi Barbara,
You can reply to this email address, with your request for your escrow refund. Give
your name and address in your email along with confirmation of the address you'd like
the check mailed to.
If you have any further questions, please don't hesitate to contact me.
G..h.1ia-{'v� M.�(f�n.
Planning Assistant
City of Orono
2750 Kelly Parkway , Orono MN 55356 (physical address)
PO Box 66 Crystal Bay MN 55323-0066 (mailing address)
�i 952.249.4620 8 952.249.4616
� cmattson(cr�,ci.orono.mn.us � www.ci.orono.mn.us
Office Hours: Monday - Friday 8:00 am to 4:30 pm
i
Christine Mattson
From: Sherry Charboneau [SCharboneau@ck-law.com]
Sent: Wednesday, November 10, 2010 2:38 PM
To: Christine Mattson
Subject: RE: WIP
Chris:
We have no unbilled WIP on the matters listed below.
Thanks.
Sherry
Sherry L. Charboneau, Legal Assistanr
CAMPBELL KNUTSON, P.A.
317 Eagandale Office Center
1380 Corporate Center Curve
Eagan, MN 55121
Direct Dial: 651-234-6230
Office: 651-452-5000
Fax: 651-452-5550
E-mail: scharboneau@ck-law.com
From: Christine Mattson jmailto:CMattson@ci.orono.mn.usl
Sent: Wednesday, November 10, 2010 2:22 PM
To: Sherry Charboneau; 'Amundsen, Darren T
Subject: WIP
Hello,
Do either of you have any unbilled WIP for the following:
Building Permit 2009-00496 Jack& Pam Safar 980 Ferndale Road W
Building Permit 2010-00079/2010-00523 Barbara Halper 3200 North Shore Drive
Thank you!
Christine Mattson
Planning Assistant
City of Orono
2750 Kelly Parkway ; Orono ; MN ; 55356 (physical addressJ
PO Box 66 j Crystal Bay ; MN ; 55323-0066 (mailing addressJ
1? 952.249.4620 ' 6 952.249.4616
� cmattson@ci.orono.mn.us i ; www.ci.orono.mn.us
Office Hours: Monday- Friday 8:00 am to 4:30 pm
OUR OFFICE WILL BE CLOSED:
Thursday, November 11, 2010(Veterans DayJ
1
Christine Mattson
From: Amundsen, Darren T(Darren.Amundsen@bonestroo.com]
Sent: Wednesday, November 10, 2010 2:44 PM
To: Christine Mattson
Subject: RE: WIP
No WIP from us
Darren Amundsen, PE
Associate
Direct 651-604-4894
Cell 651-775-5623
darren.amundsenC�a bonestroo.com
+��������
_ __ __._._ _
Visit the new Bonestroo.com to sign-up for SourceONE,
our upcoming newsletter.
From: Christine Mattson jmailto:CMattson@ci.orono.mn.us]
Sent: Wednesday, November 10, 2010 2:22 PM
To: 'Sherry Charboneau'; Amundsen, Darren T
Subject: WIP
Hello,
Do either of you have any unbilled WIP for the following:
Building Permit 2009-00496 Jack & Pam Safar 980 Ferndale Road W
Building Permit 2010-00079/2010-00523 Barbara Halper 3200 North Shore Drive
Thank you!
G..�v1i.d-�vu, M.a�aan.
Planning Assistant
City of Orono
2750 Kelly Parkway ; Orono ; MN ; 55356(physical addressJ
PO Box 66 i Crystal Bay i MN ; 55323-0066 (mailing address)
S 952.249.4620 ; r8 952.249.4616
�cmattson@ci.orono.mn.us ; � www.ci.orono.mn.us
O�ce Hours: Monday- Friday 8:00 am to 4:30 pm
OUR OFFICE WILL BE CLOSED:
Thursday, November 11,2010(Veterans Day)
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BUILDING PERMIT ESCROW AGREEMENT
Orono Building Permits 2010-b��q8�2010-�5�3
AGREEMENT made this o��day of , 20�, by and between the CITY OF ORONO,
a Minnesota municipal corporation ("City")and Ba ra Halper("Owner").
Recitals
1. Building permit applications have been filed for additions to the house located at 3200 North
Shore Drive ("Subject Property"), legally described on the attached Exhibit A.
2. Owner requests the City to review these applications.
3. The City will commence its review of the applications 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 SCR FUNDS. Contemporaneously with the execution of this Escrow
Agreement, the Owners shall deposit 2,500 ith the City. All accrued interest, if any, shall be paid to the City to
reimburse the City for its cost in adminis enng 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 permits 2010-do1�and 2010-�5��f 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 Owner. Owner shall be responsible for payment to the City within 30 days of the Owner's receipt
of bill.
4. DISBURSEMENT FROM ESCROW ACCOUNT. In the event that the Owner does not make payment
to the City within the timeframe outlined in#3 above, shall issue a Stop Work Order until the Owner pays all expenses
invoiced pursuant to #3. The City may draw from the escrow account without further approval of the Owner 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
Owner when the review has been completed and written notification is received from the Owner requesting the
funds.
6. CERTIFY UNPAID CHARGES. If the project is abandoned by Owner, or if the eligible expenses
incurred by the City exceed the amount in escrow, the City shall have the right to certify the unpaid balance to the
subject property pursuant to Minn. Stat. §§415.01 and 366.012.
CITY: ITY OF ORO� OWNER:
By:
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� ' � CITY OF ORONO PERMIT NO.: Zoiaoos26
2750 KELLEY PARKWAY
ORONO,MN 55356- DATE ISSUED: 06/24/2010
952 249-4600 FAX: 952 249-4616
ADDRESS : 3200 NORTH SHORE DR
PIN : 08-117-23-41-0001
LEGAL DESC : LJNPLATTED 08 117 23
: LOT 000 BLOCK 000
PERMIT TYPE : ESCROW FEE-TIED TO BUILDING PERMIT
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ESCROW FEE-TIED TO BUILDING PERMIT
NOTE: THIS ESCROW PAYMENT OF$2500.00 IS TIED TO PERMIT#2010-00079 AND 2010-00523-PAID 6/24/]0.
A
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APPLICANT ESCROW FEE-BUILDING 2,500.00
HALPER,BARBARA TOTAL 2,500.00
3200 NORTH SHORE DR
WAYZATA,MN 55391-
OWNER
HALPER,BARBARA
3200 NORTH SHORE DR
WAYZATA,MN 55391-
AGREEMENT AND SWORN STATEMENT
1'he wotk 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 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 construction suthorized 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.
/ / � �
Applicant Permitee Signature Date Issued By Signahue Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
J �
� � � � CITY OF ORONO ���b����S�,�ED IN ! u/� -
INSPECTION OTICE � SCHEDULED l�/ii� —
PERMIT NO. � � 00 7 COMPLETED
ADDRESS _ ��O J• S�J?D�'' /�
OWNER TELEPHONE NO. ��� 'S�7�(,j/
CONTRACTOR .S
: DESCRIPTION ���� l ��d�1�'nr,/P� .
� ❑ FOOTING ❑ PLUMBING FINA Z j/,=�-j ❑ EXCAV/GRADING/FILLING
� ❑ POURED WALL ❑ MECHANICAL RI LY ��7� O LAKESHORFJWETLANDS
� ❑ FRAMING ❑ MECHANICAL FI L/������� � TqEE REMOVAL
� ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION
O RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS
❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT
❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP
❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL
❑ PLUMBING RI � SEPTIC FINAL ❑ FOUNDATION/REMOVAL
OWNERICONTRACTOR TO MEET YOU:_YES_NO
COMMENTS:
.G � ���
❑WORKSATISFACTORY:PROCEED �ROJECTCOMPLEfE
❑CORRECT WORK&PROCEED � � �
❑ISSUE CERTIFICATE OF OCCUPANCY
❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
BEFORE COVERING
PERMANENT
❑CORRECT UNSAFE CONDITI�N WITHIN HOURS. p pHOTO TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL IPISPECTOR 0 CITATION ISSUED
O INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Cail forthe next inspection 24 hours in advance. (g52) 249-4600
OwnerlContractor on site:
Inspector. �,.,� � � < <._.��
White Copyllnspecto�'s File Canary CopyfSite Notice
� o�
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° CITY of ORONO
�,�
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�, �. ,.;;j,`�, ti
� .�� G� Municipal offices
Street Address: Mailing Address:
��xESII�4� 2750 Kelley Parkway P.O. Box 66
Orono, MN 55356 Crystal Bay, MN 55323-0066
October 19, 2010
Barbara Halper
3200 North Shore Drive
Wayzata, MN 55391
RE: Building Permit Inspections at 3200 North Shore Drive
On October 15, 2010, the City received an as-built survey including hardcover calculations for
the address noted above. Thank you for submitting this information. According to our records
the following are remaining open inspections for the permits:
2010-00079 Final
2010-00273 Final
2010-00523 Insulation & Final 'I� �r l.(-1
2010-00630 Air Test & Final `J
Please call 952-249-4600 at your convenience to schedul� , fM ���(� �
ermits. Followin satisfacto com letion of final ins ec �
P 9 rY P P l�Y'
your request to the City to begin processing the refund of y
Sincerely, ��,�Jm�� ' -"' l�
CITY OF ORONO 1� ���
Y �- �
'� �
Christine Mattson (�JV_ `
Planning Assistant �
c 1gt Street Construction; 417 East First Street, Wacor
Orono Building Department
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� I C� VI�- I�'� u��- �
'��� �D�-
C�( lX/1l� � Telephone(952)249-4600 • Fax(952)
:�� www.ci.orono.mn.us
�Rn�v� l�
+ Address: �7 �(� I�,1 d C~-1�C�`1 '��jt�t.U�—P_ �V�"�. ��b��J ate: I() I�I I ( �
Prepared by: � r 1 t"�I—C �/�� � �
HARDCOVER CALCULATION WORKSHEET
SETBACK ZONE: (CIRCLE ONE) 0-75' 75-250' 250-500' 50Q-1000'
EXISTING HARDCOVER IN ZONE '
A. House x = S.F.
Length Width
x = S.F.
x = S.F.
B. Garage x = S.F.
C. Driveway x = S.F.
x = S.F.
D. Sidewalk x = S.F.
x = S.F.
E. Patio/Deck x = S.F.
x = S.F.
F. Weed control x = S.F.
weed barrier x = . S.F.
of any kind x = S.F.
G. Retaining Walls x = S.F.
H. Other x = S.F.
TOTAL HARDCOVER IN ZONE - � S.F. A
TOTAL PROPERTY AREA IN ZONE - '"�'s�l �a—i S.F. B
A = B x 100 = � � C� %
PROPOSED HARDCOVER IN ZONE (including existing hardcover to be retained)
A. House x = S.F.
Length Width
x = S.F.
x = S.F.
B. Garage x = S.F.
C. Driveway x = S.F.
x = S.F.
D. Sidewalk x = S.F.
x = S.F.
E. Patio/Deck x = S.F.
x = S.F.
F. Weed control x = S.F.
weed barrier x = S.F.
of any kind x = S.F.
G. Retaining Walls x = S.F.
H. Other x = S.F.
TOTAL HARDCOVER IN ZONE - S.F. A
TOTAL PROPERTY AREA IN ZONE - S.F. B
A = B x100 = %
Last Updated: 9/29/2009 ������/��
- 11 -
t��� � �%� ��7{�
����� ��Q��
� Address: �7 �(� �d �'-�''�/1 �1,Q,� ���('� Date:
Prepared by: � � 11'"� � !"�'/`) C, ,
HARDCOVER CALCULATION WORKSHEET
SETBACK ZONE: (CIRCLE ONE) 0-75' 5-25 ' 250-500' 500-1000'
EXISTING HARDCOVER IN ZONE �
A. House x = �17 3 S.F.
Len th Width
x = 10�l s.F.
C X = � � s.F.
� � t2.oa� -z��
B. Garage x = S.F.
C. Driveway x = �,�j�7 S.F.
x = S.F.
D. Sidewaik x = CI(� S.F.
x = S.F.
E. Patio/Deck ,t S� x = y� S.F.
b t S;d-� x = "'7�_S.F.
F. Weed control x = S.F.
weed barrier x = . S.F.
of any kind x = S.F.
G. Retaining Wails x = q S.F.
H.Other �t�l�_ X = �"'� S.F.
TOTAL HARDCOVER IN ZONE - Sq..I Z S.F. A
TOTAL PROPERTY AREA IN ZONE - Z Ci5�I9 S.F. B
'°` '' B x 100 = 2..�' . �] %
PROPOSED HARDCOVER IN ZONE(including existing hardcover to be retained)
A. House x = S.F.
Length Width
X = S.F.
X = S.F.
B. Garage x = S.F.
C. Driveway x = S.F.
X = S.F.
D. Sidewalk x = S.F.
X = S.F.
E. Patio/Deck x = S.F.
X = ' S.F.
F. Weed control x = S.F.
weed barrier x = S.F.
of any kind x = S.F.
G. Refaining Walls x = ' S.F.
H.Other X _
S.F.
TOTAL HARDCOVER IN ZONE - S.F. A
TOTAL PROPERTY AREA IN ZONE - S.F. B
p` - B x100 = %
Last Updated: 9/29/2009
- 11 - �►�`�i�����
� OCT 15 �01 il
c��nF n�nN�
� .. ..
.
f Address: �7 �(� IV d ('� ��'LpY-P ��1f'1 V''� Date:
Prepared by: � r 1�2�. �/�� � .
. �
HARDCOVER CALCULATION WORKSHEET
SETBACK ZONE: (CIRCLE ONE) 0-75' 75-250' 250-500' S00-1000'
EXISTING HARDCOVER IN ZONE '
A. House x = S.F.
Length Width
x = S.F.
x = S.F.
B. Garage x = S.F.
C. Driveway x = �'j�.7_ S.F.
x = S.F.
D. Sidewalk x = S.F.
x = S.F.
E. Patio/Deck x = S.F.
x = S.F.
F. Weed control x = S.F.
weed barrier x = . S.F.
of any kind x = S.F.
G. Retaining Walls x = S.F.
H.Other x = S.F.
TOTAL HARDCOVER IN ZONE - S� Z ' S.F. A
TOTAL PROPERTY AREA IN ZONE - 5\ 's 3 S.F. B
A = B x 100 = ��7 .�%
PROPOSED HARDCOVER IN ZONE(including existing hardcover to be retained) �
A. House x = S.F.
Length Width
x = S.F.
x = S.F.
B. Garage x = S.F.
C. Driveway x = S.F.
x = S.F.
D. Sidewalk x = S.F.
x = S.F.
E. Patio/Deck x = S.F.
x = S.F.
F. Weed control x = S.F.
weed barrier x = S.F.
of any kind x = S.F.
G. Retaining Walls x = S.F.
H. Other x = S.F.
TOTAL HARDCOVER IN ZONE - S.F. A
TOTAL PROPERTY AREA IN ZONE - S.F. B
A = B x100 = %
Last Updated: 9/29/2009 ��������
- 11 -
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