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Home My WebLink About2012-00956 - addn/remodel/repair CITY OF ORONO * Z 0 1 2 - 0 0 9 5 6 * 2750 KELLEY PARKWAY DATE ISSUED: 1 U05/2012 ORONO,MN 55356- (952) 249-4600 FAX: (952) 249-4616 ADDRESS : 3520 NORTH SHORE DR PIN : 08-117-23-43-0009 LEGAL DESC : BALDUR PARK : LOT 003 BLOCK 002 PERMIT TYPE : ADDITION/REMODEL/REPAIR PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR ACTIVITY : 434-RESIDENTIAL VALUATION : $ 243,000.00 NOTE: SEPERATE PERMITS REQUIRED: PLUMBING,MECHANICAL,FIREPLACE,ELECTRICAL(STATE) REMODEL-AllDITION * ADD SILT FENCE AND SWALE AS NOTED ON THE SURVEY �� (INITIAL) * AS-BUILT SURVEY AND AS-Bilii,T HARDCOVER CALCULATIONS MUST BE SUBMITTED AND APPROVED PRIOR TO RELEASE OF ESCROW.��_�IrrITI,Ai,� APPLICANT pERMIT FEE SCHEDULE 1,914.75 ROBERTS RESIDENTIAL REMOD INC. STATE SURCHARGE(VALUATION) 121.50 2999 W CTY RD.42-#100 BURNSVILLE,MN 55306- TOTAL 2,036.25 (952)2243680 Minnesota State License#: BC006885 OWNER PETERS ET AL,ANN L 3520 NORTH SHORE DR ,MN 55391- 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 does not grant permission for additional or related work which requires sepazate permits. All provisions of laws and ordinances governing this type of work shall be compied with whether or not specified herein.This permit will expire and become null and void if construction authorized is not commenced within 180 days of the date of issuance,or if construction is suspended for a period of 180 days at any time after work has commenced. The applicant is responsible for assuring all required inspections aze requested in conformance with[he State Building Code.This permit may be revoked at any time for due cause. T{Y"��y_ i!� S � i � l l Applicant P itee Signature Date Issued By S' ture Date SEPARATE PERMITS REQUIRED FOR WORK OTHER AN DESCRIBED A E. City of Orono � a3�, �S Buildin Permit A lication °�� 9 pp for New Structures or Additions �A�o2-c � Mailing Add�ss: �J/a ' U(�j S O��,�.0 PO Box 66 Permit number: � Crystal Bay, MN 55323-0066 Date received: ( �o�.-�� /a a �� , StreetAddress:' --- Recei � �',�, � �•��-.-; Gti�' 2750 Kelley Park y ��' Z Cr Plan review fee: �,/ `S� r�kESH04'� Orono, MN 55356 �� . ' � % — Total Fee: Main: 952-249-4600 Fax: 952-249-4616 www.ci.orono rnn.us �� (� -j0 -0�, This applic�tion 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: �So2Cj j'�/ �)j�- � r i/� Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? Yes No !f yes,a special event permit is required with Pofice Depariment and City Councif approva160 days prior to the event. Shutt e bus service witl be required un/ess applicant demonstrates sufficient on-site parking is availab/e. Non-permitted events will not be a/lowed. CONTRACTOR/A PLICANT INFO ATION: Name: � � �i p � //�� State License# �lj��S` Expiration Date: Phone: �sa =�ff-�!v.(%C� (office) ��`j�' r, 3�?�' (cell) Mailing Address: �` � � �- ' L .Z� <"� ��+ 'D C� Cit : ' ,� � / ZIP: Contact Person: �j�� ` «�,r-� Applicant is: ntr / Homeowner (Circle One) Email and/or Fax: ��p��,C�i �.N 3 �2 C� �c� . C�� / l�� -�.1�/- �la�`%` PROPERTY OWNER INFORMATION: Name: (U�In �! 1G1'yt{'t�{ �C-f�l S Phone(day): ��.- 7�� - �,��;, � Address: .��7 Z� /�j p►-}� �h�►'� {J:- i V f' City: ��v�+y��,, ZIP: 5�3`Y/ Email and/or Fax ��R,/,,.,_Dn t �r'S� GC�rr�ai/. �'v.+� ARCHITECT/ENGINEER INFORMATj�ON: //'C Name: ,��c'G c� t " r'7�c ' /il �C� /ns� Phone(day): - ,� _ -�'� Address: ;J�'l'� ��S ' ,.� i '.� � � � ic>�' Cit : �'� , ZIP: �" " -� . Email and/or Fax: �j r'� (�("�� ,+ 3„ � �J-L��- : C t�i�-�7 PROJECT INFORMATION: 1.Type of Project 2. Proposed Use 3.Structure Type 4.Sewage Disposal 8� Water Supply ❑ �Vew Construction `�Single Family with ' ence ddition � attached garage arag /Accessory Bldg. �.Public Sewer ❑Accessory Building ❑ Single Family with � Relocation detached garage Office/Commercial ❑ Private Sewer Other: (specify) hE'f��!G�«.l I ❑ 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 District(MCWD) ❑ Other: (speCify) 18202 Minnetonka Btvd Deephaven,MN 55391 Phone: 952-471-0590 Fax: 952-471-0682 www.minnehahacreek.or Estimated Construction Valuation (excluding land) � r�y 3, bD C> Packet Last Updated: 03-06-2012 -21 - STRUCTURE INFORMATION: 1.Structure Dimensions 1. Structure Dimensions(continued) 2.Type of Construction a. Length(ft.)= l;�� S�j Number of bedrooms= �� , ;�.Wood/Frame b.Width(ft.)= �'/ G <Z`�� Number of garage stalls: [�,Masonry Areas in square feet Attached= � �Metal �� ❑ Pole Bidg. c. Basement= lu+� Detached= ❑ ICF d. 151 Story = �,�u ` �; ;►v� nd �'�"d�'. ❑ On-site Prefab e.2 Story= �F� !v e ��;��31. - ❑ Off-site Prefab f. '/�Story = �r} ��` � ❑ Other(please specify): g.Total Area= 'r "??r�� j J V REQUIRED SUBMITTALS: All of the information must be submitted in order for our application to be processed: Not Enclosed A licable ❑ ❑ Permit A lication � ❑ Pro osed Buildin Plans � MN State Ener Code Calculations and Mechanical Code Re uirements Form ❑ ❑ Surve meetin all re uirements ❑ Stormwater Pollution Prevention Plan ❑ -' Hardcover Calculation s — - ( � �- ��('c. ❑ Se tic S stem Site Evaluation Re ort ❑ ,C3� Access Permit ❑ Wetland Buffer Im rovement Plan ❑ En ineered Plans for Retainin Walls 4 feet or above ❑ ❑ 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$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 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. • Agrees that in the event that weather or other conditions prevent the completion of an as-built survey at the time the Certificate of Occupancy is requested, a temporary Certificate of Occupancy may be issu�d upon receipt of a $10,000 escrow to ensure completion of the as-built survey and all site improvements. G' .7� ApplicanYs Signature: � Date: � � ��' Owner's Signature: Date: Packet last Updated: 03-06-2012 -22 - �� cs� �� ;�c�� i �.��c�� Address/PID/Legal: �� '�n �� j'�_ Description of work: 6cx=1'✓�� t-`�--- � � 2 �- Septic �evi��r by: Date�pproved: ��,� -- f � Zor�ing revievv by: , � � � �-- Date tapproved: �t' � � �' Bu�lding ceview bY� �ate Appraved: �� '�- Z.ar 2. G�c�ing r�view bY= !� Da�e Approvecf: �' a id Zoning File#: ��^�� Resolution#: � Resolution Date� .� '(� ' �. Zor�oa� Distric� �6re De ar��rnent Post Office School District - Zoning: Lot Area: _SF/AC Wid#h: Depth: Survey Submitted: Yes � No Date of Survey: �'�d'�� Pro osed Setbacks: ont(L�k�) �(Stree�� l � �� W ) ( N� �j�� l�d � Other Builciirt�s Vilet�anc� `'�d 3�` � e .3° � , � Building Defined Height: Building Peak Height: � #of�tories Ok?: YES � FOR A BUILDiNG 1MTH A BASEMEN�'OR CRkVKL 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 highes space floor and the highest roof peak,the top of WITH roof peak,the top of the comice of a fla#roof, the.comice of a flat roof,the deck line of a the deck line of a mansard roof,or the mansard roof,or the upperm�st point on a round upperrnDst point an a round or other�rch-typ� or other arch- e roof roof SUBTRACT half the distance between the highest winiiow and �U�TRACI` half the distance beiween the highes�window hi i�est roof eak pf a itched roof and hi hest roof eak of a itched,roof SUBTRACT the distance hetween the basement flood crawl ADD . the distancebe#ween the slab and the highes space floor arttl the highest exist�ng grade within ercistin rade within the foundation the fqundation or 10 feet,whichever is less. EQUALS Defned buildin hei ht EQUALS f�efined buildin hei ht Lot Coverage: SF % Sharei�nc�Distr�ct ft�C�D Peern@t Received Avera e Lake�hore Setback Bt�ff / 0 Yes � No 0 N/A � Yes No � Yes � No �Yes C] No CE N! — Permit Number: � Setback: Hardcover Zones Existir� Pro osed Vari cE Re �ired CWP I�e uieed 0-75' � es t� No � Yes 0 No 75-250' Z . � � �� TYPe(S)� c Type(s): 250-500' 4 . �'� � 500-1000' ' ' REMARKS (in-house): j Updated: U9/11/2009 z:\forms�plan review checklist.docx �ee�to be Cha ecE YES t+�� Petrxtif t/' Pian RevievN St��e Surch2arg$ Investiga#ioc� Fee S�tC-l�eet�rabec�f��C 11r�9tis Sewer Cann�ction Viiat�r Con�e�fion Park Fee S�te irtspect�on Other(specify) Afiis�sila�eaus F`ees Ca{cuiatec! By: S uare Foota e $ er S uare Foota e Basement X = $ 1� Floor X = $ 2"� Floor X = $ Garage X = $ Estimated Construction Value: $ 2�13,c�u o °° Orono inspeations Rec�uired 1Nlork Requiring Separate Permits Required State Pern�its � Site Plumbing t7 Grading/Filling � Well � Hardcover Removai ,�'Mechanical � Fire Electrical Footing 0 Septic � Water Connection � Poured Wall �Fireplace C Sewer Cannection O �ounciatiaR Survey a Masonry � Lawn Irrigation � Radon Rocic Bed �r7'Mfg. �Framing C] Other(specify) �nsulation As-Built Survey �inal CI Other(specify) REMARKS (in-house): QtF�er Review: Reviewed b�: Date�0.��rovect: Access:Existing: � YES L! NO New: � YES Q NO REMARKS (TO E NOYED O�4 PERMIT f�ND {PE�TIA LEQ BV PERSOt� PULLiNG PER144�tiT) / �f-t nce �t r.v4 z �i o'-, � u�Je �� '�' � �b� $ ' � � • Up dafed: 09/11/2009 �� r"-�r�� z:\forms�plan review checklist.docx Adtek Software Co Colin and Anna Peters 105 S Main St-Toluca, I11 61369 3520 Narth Shore Drive 815-452-2345-sales@adteksoft.com Orono Sales Consultant: � Job#: 2436 Date: 10/01/2012 System I (Average Load Prvicedure) Design Conditions Location: Minneapalis/St Paul AP, Minnesota Elevation: 834 ft Daily Range: Medium Input Data: Outdoor Dry Bulb Indoor Dry Bulb Latitude: 44°N Design Grains: 24 Summer: 88 75 Heated Area 2470 Sq.Ft. Winter: -11 68 Cooled Area 2470 Sq.Ft. HeatfLoss Summary (July Heat Load Calculations) Gross Sensible Latent Area Loss Gain Gain Walis 2304 13194 3238 0 Windaws 200 8376 8454 0 Doors 42 930 306 0 Ceilings 1350 2346 1188 0 Skylights 0 0 0 0 Floors 2470 6753 473 d Room internal Loads 0 3400 4 Blower Load 1707 0 Hot Water Piping Load 0 0 0 �, �.'. �'' ��v Winter Humidificatian Load 0 0 d Infiltration 11499 969 1'106 Approved ACCA Ventilation 0 0 0 M.lB Calculations Duct Loss/Gain EHLF=O ESGF�O 0 0 0 AED Excursion n/a 0 nla Subtotal 43097 19735 1106 Total Heating 43U97 Btuh 13 kw of electric heat Total Cooling 20841 Btuh 85 Linear ft. of Hydronic Baseboard *Calculations are based on the ACCA Manual J 8th Edition and are approved by ACCA. All computed calculations are estimates based on building use, weather data,and inputted values such as R-Values, window types,duct loss,etc. Equipment selection should meet both the laten#and sensible gain as well as RECEIi/�C� OCT 0 4 20i1 CITY 0� O�tONO Adtek AccuLoad Report Version 4.0.0 Page 1 Adtek Software Co Colin and Anna Peters 105 S Main St-Toluca, III 61369 3520 Nvrth Shore Drive 815-452-2345-sales@adteksoft.com Orono Sales Consultant: Job#: 2436 Date. 10/01/2012 System I Load Chart Walis Heat �oss Percentages "� Windows & Skylights 27��0 ��:� � Doors � r��;�� 31% '� '�� Ceilings �� &. �: �. :�,, �� f�� r � Floors �""��'"�� Misc System Loss � Infiltration 16��° . Ventitation �g�� Duct Loss 5%2% � Heat Gain Percentages Wails �1°io i�o�o � Windows & Skylights ��,�� Doors �� '�� Ceilings 18% `� �'; ��a �� . `�; � Fioors � Internal Gains 2�� Infil#ration s°�° ff � Ventilation 2% 44% Duct Loss RECEliOE� OCT 0 4 2012 CITY C�� OHO�VO Adtek AccuLoad Report Version 4.0.0 Page 2 Christine Mattson From: Christine Mattson Sent: Monday, October 29, 2012 11:57 AM To: 'JPAGGEN3R@aol.com'; 'colinpeters2@gmail.com' Cc: Melanie Curtis Subject: 3520 North Shore Drive/ #2012-00956 John The City Engineer reviewed the survey for 3520 North Shore Drive and has the following comments below. Please address his comments and submit an updated survey. Also,the plans and survey show a "patio/deck" on the lakeward side of the house. As you are aware, an average lakeshore setback variance was not granted to allow a deck therefore the area shown as"patio/deck" will have the word deck redlined. Only a grade level atio will be allowed to be permitted within the average lakeshore setback area. If you have any questions, please don't hesitate to contact us. Christine^' I have reviewed the application for the proposed house and garage at 3520 North Shore Dr and have the following comments: • As part of the resolution signed on 10/10/12, item 7 required to work with the City Engineer to implement better stormwater management in the area of the driveway being removed. The survey does not show any proposed improvements in this area. In fact the proposed survey shows water being directed into the neighboring property. • The survey needs to show the existing and proposed contours. • The survey needs to show proposed erosion control measures. Jesse Struve, PE Director of Public Works/City Engineer City of Orono (952) 249-4661- Direct (952) 249-4616- Fax www.ci.orono.mn.us i Jesse Struve From: Jesse Struve Sent: Wednesday, October 24, 2012 2:59 PM To: Melanie Curtis Cc: Christine Mattson Subject: 20121024 3520 North Shore-2012-00956 Melanie, I have reviewed the application for the proposed house and garage at 3520 North Shore Dr and have the following comments: • As part of the resolution signed on 10/10/12, item 7 required to work with the City Engineer to implement better stormwater management in the area of the driveway being removed. The survey does not show any proposed improvements in this area. In fact the proposed survey shows water being directed into the neighboring property. • The survey needs to show the existing and proposed contours. • The survey needs to show proposed erosion control measures. Jesse Struve, PE Director of Public Works/City Engineer City of Orono (952) 249-4661 - Direct (952) 249-4616- Fax www.ci.orono.mn.us � �. P�I� �� .�� .� ��i � S� �afi �� v� �!� � �� c�m . y�s ,�. �k � '� � �-0�0 C ITY OF ORONO .1 � Street Address: Mailing Address: Telephone(952)249-4600 `��, ti 2750 Kelley Parkway P.O.Box 66 I Fax (952)249-4616 �.q �,�' Orono,MN 55356 Crystal Bay,MN 55323 www.ci.orono.mn.us kFsxo� October 5, 2012 John Paggen Roberts' Residential Remodeling, Inc. 2999 West County Road 42#100 Burnsville, MN 55306 Re: 3520 North Shore Drive Building Permit Application#2012-00956 On September 25, 2012 the City received a building permit application for an addition. Your application is incomplete. The following items must be submitted or revised in order for your application to be considered complete and for the plan review to continue: . Resolution. The resolution approved with the variance application has not been signed. Both property � ,n/ owners are required to sign the resolution. They can come in separately or together to sign the ��r�� document. They should bring with them a valid driver's license to confirm their identity. `b. 2. Certificate of Survey. According to the resolution, Item #6 on page 4 of 6 must be shown on the survey submitted with the building plans. Please provide 2 copies of an updated, full size certificate of survey ��" ,l`"�v which meets all of the City's sunrey standards (enclosed) indicating the location of the proposed �"" addition and relocated driveway (and any proposed grading) as well as all existing contours, buildings, structures, lan dscaping, retaining walls and hardcover on the property. The survey submitted should be in accordance with the approved variance. 3. Escrow & Escrow Agreement. Permits involving grading and/or review by the City's engineer require submittal of an escrow and an escrow agreement. The purpose of the escrow is to guarantee ��1� 11 �reimbursement to the City for out-of-pocket costs incurred during the review of your plans. Additionally ,`�� this escrow will guarantee conformance with City Code Chapter 79 relating to erosion control and \� stormwater. The city still holds a $2,500 escrow in conjunction with the variance process. No additional money is needed, but the property owner must sign the updated escrow agreement enclosed. 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. Sincerely, CITY OF ORONO r C ristine Mattson Planning Assistant c Colin&Anna Peters; 3520 North Shore Drive;Wayzata, MN 55391; colinqeters2(��mail.com Lyle Oman, Building Official enclosures �=, Stantec Consulting Services Inc. �`,/� 2335 Highway 36 West ,��'�. St. Paul MN 55113 �� //`� TeL (651)636-4600 � Fax: (651)636-1311 Stantec February 6, 2012 Melanie Curtis Planning &Zoning Coordinator City of Orono Post Office Box 66 Crystal Bay, MN 55323 Re: 3520 North Shore Drive File No. 193800284.538 Plat No. 12-3538 Dear Melanie: We have reviewed the plans for the proposed house and grading plan for 3538 North Shore Drive. The plans are dated 1-30-12. We have the following comments with regards to engineering matters: • The proposed grading along the new addition and driveway, as well as the proposed garage elevation should be shown on the plans. The goal would be to show how additional runoff from the addition does not impact the neighboring properties. • The driveway removal should be used as an opportunity to better manage stormwater runoff within the property to the right of way. • A permit will be required from Hennepin County for work in the right-of-way. • This project will disturb more than 100 CY of material. Sediment and erosion control information meeting the requirements of Orono's City Code 79-7(c)(2) must be submitted. The minimum $2000 sediment and erosion control financial security should be required of the owner for this permit. If you have any questions, please contact me at(651) 604-4894 or darren.amundsen(a�stantec.com. Sincerely, Stantec . � - � �.CCl/�'� ►'�v�� .-� � � Darren Amundsen /�� r�- �� t't' cc. Chris Mattson ��.�.�,eCi ��'(�� (� ,1 �Gv�� Q� Zm�� . DAT TIME v CITY OF ORONO CALLED IN �� INSPECTION O�IC DD`7SG0 SCHEDULED �� PERMIT NO. COMPLETED ADDRESS� S20 f�/D�"� S�-�� " OWNER TELEPHONE NO.�Z Z"�J Z' �p3�� CONTRACTOR ��SC �/6� � DESCRIPTION �OD�/j'C c� � ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI � LAKESHORENVETLANDS y ❑ FRAMING ❑ MECHANICAL FINAL Q ❑ TREE REMOVAL 2 ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS � ❑ FINAL O SEWER HOOK-UP ❑ COMPLAINT v ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP _ ❑ DEMO-FINAL O SEPTIC INSTALL � HARD COVER REMOVAL ,J ❑ PLUMBING RI O SEPTIC FINAL ❑ FOUNDATION/REMOVAL � OWNERICONTRACTOR TO MEET YOU:_YES_NO y COMMENTS: � W a � J O � � O � W � Q � Z W � W � � d W� RKSATISFACTORY:PROCEED ❑ PROJECTCOMPLEfE W ❑CORRECT WORK&PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY 0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN ' INSPECTOR WILL RETUflN ❑CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR O INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. (g52) 249-4600 OwnerlContractor on site: Inspector. White Copy/inspector's Ffle Canary CopylSite Notice � � DAT TIME CITY OF ORONO C D IN ��`� - Z— INSPECTION NOTICE SCHEDULED /L�L� ldt� PERMIT NO. Ol -�COMPLETED ADDRESS �5�� ,�c `1,.�"L�- Yl L`-e- OWNER LEPHONE NO. a��' .3�� CONTRACTOR I — � DESCRIPTION � � ❑ FOOTING ❑ PLUMBING N ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI � LAKESHORENVETLANDS y ❑ FRAMING ❑ MECHANICAL FINAL ❑ 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 i ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ WARD COVER REMOVAL � ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL � OWNERICONTRACTOR TO MEET YOU:_YES_NO v�, COMMENTS: � W a � J O �. � O � W � Q � 2 W � W � � d_� / ��WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY 0 ❑CORRECT WORK,CALI FOR REINSPECTION TEMPORARY V BEFORE COVERING PERMANENT �CORRECTUNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN INSPECTOR WFLL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED ❑INSPECTIONREQUIRED.CALLTOARRANGEACCESS. Cail for the next inspection 24 hours in advance. (952) 249-460� OwnedContractor on it Inspector. � White Copyllnspector's File Canary CopylSite Notice DATE TIME Y CITY OF ORONO CALLED IN INSPECTION NOTICE SCHEDULED PERMIT NO. ae1 a'�� COMPLETED I�'2'r2 ADDRESS 3��`� �� '�'� � OWNER .�5�� TELEPHONE NO. CONTRACTOR � DESCRIPTION � ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAWGRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHOREM/ETLANDS 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 J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATIOWREMOVAL � OWNERICONTRACTOR TO MEET YOU:_YES_NO y COMMENTS: � ��-��S yt�� 5 i' ��e B/La.,e�,r a � �P � � � 0 � 0 � W � Q � 2 W � W � � � W ORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE � ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY 0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT �CORRECTUNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN INSPECTOR WFLL RETl1RN ❑CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS. Ca11 for the next ins ion 24 hours in advance. (g52) 249-46�0 OwnerlConVa o i : Inspector. White Copyllnspector's File Canary CopylSite Notice � ��/`' I D�TE TIME v CITY OF ORONO CALLED IN y INSPECTION NOTICE SCHEDULED - - %�� PERMIT NO.��l�2 -�9510 COMPLETED �� '� ADDRESS S� �''`� �-�-Q �J a7� OWNER TELEPHONE N0��2- �� CONTRACTOR �b�� d�Z�� C�� DESCRIPTION ��`�' v� " � ❑ FOOTING ❑ PLUMB FINAL ❑ EXCAV/GRADING/FILLING Q O 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 ❑ PROGRESS � ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT � ❑ DEMO-SITE ❑ SEPTIC MAINT. O FOLLOW-UP i ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL v ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATIOWREMOVAL � OWNER/CONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W a J o [� .1� —f� �ivSvc� � � 0 � W � Q � Z W � W � � Q��RKSATISFACTORY:PROCEED ❑ PROJECT COMPLEfE W ��CORRECT WORK&PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY 0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. ppHOTOTAKEN INSPECTOR WILL RETURN ❑CITATION ISSUED ❑STOP ORDER POSTED.CAIL INSPECTOR ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Ca11 for the next inspection 2a hours in advance. (g52 j 249-4600 Owner/Contract on ' Inspector. White C yRnspector's File Canary CopylSite Notice � , ' DATE TIME / '�- � 1 V CITY OF ORONO � CALLED IN � � � ��L INSPECTION N��ICE nn SCHEDULED �T`�--��j � PERMIT NO. =�`��I:� —�-�t%'`I.S�OMPLETED ADDRESS �� r�� 1 Vr c��;Q OWNER TELEPHONE N .��.��7` �r�� CONTRACTOR �I'�`7� ��! .r � DESCRIPTION � ��'Tl �� .� I ��-� �7� " ��1'�� ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS y ❑ FRAMING ❑ MECHANICAL FINAL ❑ 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 ❑ SE�FINAL ❑ FOUNDATION/REMOVAL � OWNERICONTRACTOR TO MEET YOU:� YES_NO � COMMENTS: � � � ,�. ��-t--� �� s �' � �� J O / � �� -' ��(ir`�l (�� •1,� (,� `J O � W � Q � Z W �C W � � � �OiQRKSATiSFACTORY:PROCEED ❑ PROJECTCOMPLETE W ❑CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY � ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY � BEFORE COVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pH0T0 TAKEN INSPECTOR WILL REfURN ❑CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. (952) 249-46�� OwnerlContractor on site: Inspector. �,�;�/ ��,?� White Copyllnspector's File Canary Copy/Site Notice - — �—� �`"' D TE TIME ✓ CITY OF ORONO ED IN �- � �,� INSPECTION O IC ✓��CHEDULED ��a i3 /y•CJU PERMIT NO.�� -�/�� ' -'COMP.LETED ADDRESS �� 5a� .�`"1�1'f� OWNER LEP.HONE N �� —��7 CONTRACTOR ��'(�� >; DESCRIPTION �, �v � I � W ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING � ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHOREM/ETLANDS � Q ❑ FRAMING ❑ MECHANICAL FINAL � TREE REMOVAL Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS � ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT � ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP ? ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL � OWNERICONTRACTOR TO MEEf YOU:_YES_NO � COMMENTS: � W a J �e� �L,T_�f� � C.% � � O � � O � W � Q � Z W � W � � d ,,_/�� W� ,%pS�vORK SATISFACTORY:PROCEED ❑ PROJECT COMPLEfE W I O CORRECT WORK&PROCEED Cl ISSUE CERTIFICATE OF OCCUPANCY O �CORRECT WORK,CALI FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. ❑ pHOTOTAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR � CITATION ISSUED ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. (g52) 249-4600 Owner/Contractor on 'te: Inspector. White Copyllnspector's Fiie Canary CopylSite Notice �� DATE ( TIME V CITY OF ORONO �w .3-/.5/3 INSPECTION NOTICE /� �.,/ SCHEDULED � -oZ/-/3 _�� PERMIT NO.�Q��—f J J!/� COMPLETED �_ ADDRESS c�S�D /V, �S�(V� �I�LU�-- OWNER LEP ONE O. ��-��-�"a� CONTRACTO � DESCRIPTION C_r D. •� " � ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS y ❑ FRAMING ❑ MECHANICAL FINAL Q 0 TREE REMOVAL Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS � ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT � ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP i ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL � OWNER/CONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W a j �L/ e f �� O � r2 e� ( � � � � � u � W � Q � z W � W � � d W� ORKSATISFACTORY:PROCEED ❑ PROJECT COMPLETE W ❑CORRECT WORK&PROCEED C ISSUE CERTIFICATE OF OCCUPANCY O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ pH0T0 TAKEN INSPECTOR WILL RETURN ❑CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call forthe next inspection 24 hours in advance. (952� 249-4600 OwnerlContractor on site: Inspector. White Copyllnspector's File Canary Copy/Site Notice �� DAT E TIME ✓ CITY OF ORONO CALLED IN �r( INSPECTION NOTICE SCHEDULED _� '� /D_'O� PERMIT NO. �d�a— DD J'S�pCOMPLETED ADDRESS .3 52 b /��'� Sh-�� '�� OWNER TELEPHONE NO.��Z�� " `�"2 7� CONTRACTOR �n�9�� ,�'l� �: DESCRIPTION ��'`'� � � ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLAA�DS 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 v ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP _ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL � OWNER/CONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: a � N' A t /�r c.l -��--5 � � O v 3 n�.�, � S � � � 1 �- � o 'T-b /` � n � W � Q ti Z W � W � � GW ❑WORKSATISFACTORY:PROCEED ROJECTCOMPLEfE � ❑CORRECT WORK&PROCEED r ISS E CERTIFICATE OF OCCUPANCY W O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR � CITATION ISSUED ❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. �95Z� Z49-46�� OwnerlContractor on site: Inspector. White Copyllnspector's File Canary CopylSite Notice , l , . . , • . • . � • . emo To: Finance Department From: Christine Mattson, Planning Assistant CC: Street File Date: January 6, 2014 G/L: 101-22205 Re: Escrow Refund Building Permit #2012-00956 pertaining to 3520 North Shore Drive is complete. Please refund$2,500 to the Applicant, Colin&Anna Peters. The following is attached: • Email from Bolton &Menk 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 Mail to: Colin &Anna Peters 3520 North Shore Drive Wayzata, MN 55391 w:�,street files�north shore dr\3520�escrow refund memo 2012-00956.doc T Christine Mattson From: David Martini [davidma@bolton-menk.com] Sent: Wednesday, January 08, 2014 12:08 PM To: Christine Mattson Subject: RE: Sorry, one more unbilled WIP question I doesn't look like we have anything for any of the projects you sent me. Thanks. David P. Martini, P.E. Bolton � Menk, Inc. P: (952) 448-8838 ext. 2458 M: (612) 756-4315 email: davidma[c�bolton-menk.com From:Christine Mattson [mailto:CMattson@ci.orono.mn.us] Sent:Wednesday,January 08, 2014 11:07 AM To: 'SherryCharboneau'; David Martini Subject:Sorry,one more unbilled WIP question Do either of you have any unbilled WIP for 3805 North Shore Drive,Applicant&Owner—Low Grove, LLC, Building Permit#2012-01245? Thanks! Christine Mattson Planning Assistant City of Orono 2750 Kelley Parkway '� Orono '' MN ; 55356(physical address) PO Box 66 `:, Crystal Bay ? MN ', 55323-0066(mailinq addressJ '�952.249.4620 � 2, 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: Monday,January 20,2014& Monday, February 17,2014 This email has been scanned by the Symantec Email Security.cloud service. For more information please visit http://www.svmanteccloud.com 1 Christine Mattson From: Sherry Charboneau [SCharboneau@ck-law.com] Sent: Tuesday, January 07, 2014 2:04 PM To: Christine Mattson Subject: RE: Unbilled WIP Christine: No unbilled WIP for matters listed below. Have a good rest of your day. Sherry Sherry L. Charboneau Lsgal Assistant CAMPBELL KNUTSON P.A. 1380 Corporate Center Curve•Suite 317•Eagan,MN 55121 '�(651)234-6230• Fax: (651)452-5550 �scharboneauCa�ck-law.com•www.dc-law.com From: Christine Mattson [mailto:CMattson@ci.orono.mn.us] Sent: Tuesday, January 07, 2014 12:33 PM To: David P. Martini; Sherry Charboneau Subject: Unbilled WIP Hello, Any unbilled WIP for: Address Applicant Name Building Permit# Land Use Number 3520 North Shore Drive Peters,Colin&Anna 2012-00956 450 Old Crystal Bay Road N Bauer Design or 13-3589 Pine Corner Properties 1101 Willowbrook Drive Delaney, Lucia & Mark Wittig 2013-01095 Thanks! Christine Mattson Planning Assistant City of Orono 2750 Kelley Parkway : Orono i MN ; 55356(physical addressJ PO Box 66 Crystal Bay � MN ; 55323-0066(mailing addressJ '�' 952.249.4620 ; 8 952.249.4616 � cmattson@ci.orono.mn.us ' �U www.ci.orono.mn.us � i , i . BUILDING PERMIT ESCROW AGREEMENT Orono Building Permit#2012-00956 and ZONING APPLICATION#12-3538 AGREEMENT made this �(�� day of � , 20 �2-, by and between the CITY OF ORONO, a Minnesota municipal corporation("City')and Colin and Anna Peters("Owners"). Recitals 1. A building permit application has been filed for additions located at 3520 North Shore Drive the ("Subject Propert�'),legally described as Lot 3, Block 2, Baldur Park, 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 #2012-00956 and zoning application 12-3538 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 the review has been completed and written notification is received from the Owners requesting the funds. 6. CERTIFY UNPAID CHARGES. If the project is abandoned by Owners,or if the eligible expenses incurred by the City exceed the amount in escrow,the City shall have the right to certify the unpaid balance to the subject property pursuant to Minn. Stat.§§415.01 and 366.012. CIT ITY SJRONO OW R: By: UV�-t I� �. Its: �� Y V'�-- L ��.___ _ �5� � . ��,,,. . .��`�'►�� ' . ��a�rkyr•C3v�ner ,��►�►��t fii�e APPUCATION ESCROW AGREEMENT Zoning Application# l� - '�S3g AGREEMENT made this "� day of b�'��'✓-�! 20 � � , by and b tween the CiTY OP ORONO, a�M'�n esota�p�rporation("City')and (1�1�Y��_n a ��f"G�.S ;`�'�•� . (a corporation-optionalJ("Applicant"). Recitals 1. Appfcant ha filed Z irtg plication# � 2- - _?'S3 b formally requesting the City to review plans for �� G� �/`�1J�,[q�,vi� located at S ZO ►JD�/ S-(n-m..e 1a-y�.-e the"Subject Property°)as more fuAy shown and described on Exhibit`A"attached hereto. i I �epplicant requests th�to review said plans which requfres City approval including��'��y v 3. The City is willing to commence its review of the application and incur costs associated with said revlew only if the Applicant establishes an escrow to erssure reimburssment to the City of its costs. � NOW THEREFORE,THE PARTIES AGREE AS FOtLOWS: ; 1. DEPOSET OF ESCROW S. Contemporeneously with the execution of this Escrow Agreement, the Applicant shall deposit$��'�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. I � 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, or fegal consultant review)or will ; incur in meeting with the Appficant, reviewing the plans, and preparing agenda packet material for City Council ; review of application# i?� - 3�3� . Eligible expenses shall be consistent with expenses the iApplicant would be responsible for under a zoning and subdivision application. I ; 3. MOfdTHLY BILLING. As the City receives consultant bills#or incurred costs, the City will in tum � send a bif( to the Applicant. Applicant shall be responsible for payment to the City within 30 days of the � ApplicanYs receipt of bi(I. � 4. DISBURSEMEPIT FROM ESCROW ACCOUNT. In the event that the Applicant does not make i payment ta the City within the timeframe outfined in#3 above,the City may draw from the escrow account without f further approval af the Applicant to reimburse the City for eligible expenses the City has incurred. The City shail { no6fy the Applicant of such draw and the nature af the expense for which the reimbursement is being made. If the Escrow amount falls below 75% of the original escrow amount the Appficant shall deposlt additional sums as � directed by the City,or the City shall discontinue a�l review. 5. CLOStNG ESCROW. The Balance on deposit in the escrow, if any, shall be retumed to the Applicant when the review has been completed. 6. CERTIFY UNPAID CHARGES. If the project is abandoned by Applicant, or if the eligible expenses incurred by the City exceed the amount in escrow, the City shall have the right to certify the unpaid bafance to the subject property pursuant ta Minn. Stat.§§49 5.01 and 366.012. / CITY: C ��ONO APPL).E T 1 OWNE . �,% --- �• t ey: �- � gy_ ,:` �ts: (�e'_e ^ � tts: ►r1 -10- i ' ' ' �� ' ' CITY OF ORONO PERMIT NO.: 2011-01557 2750 KELLEY PARKWAY ORONO,MN 55356- DATE ISSUEn: 12/15/2011 952 249-4600 FAX: 952 249-4616 ADDRESS : 3520 NORTH SHORE DR PIN : 08-117-23-43-0009 LEGAL DESC : BALDUR PARK : LOT 003 BLOCK 002 PERMIT TYPE : ESCROW FEE-APPLICANT PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ESCROW FEE-APPLICANT NOTE: THIS$2500 ESCROW IS TIED TO ZONING APPLICATION 12-3538 APPLICANT ESCROW FEE-APPLICANT 2,500.00 PETERS ET AL,ANN L TOTAL 2,500.00 3520 NORTH SHORE DR MN 55391- OWNER PETERS ET AL,ANN L 3520 NORTH SHORE DR ,MN 55391- 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 governing this type of work shall be compied with whether or not specified herein.This permit will expire and become null and void if consWction authorized is not commenced within 180 days of the date of issuance,or if construction is suspended for a period of 180 days at any time after work has commenced. The applicant is responsible for assuring all required inspections aze requested in conformance with the State Building Code.This percr►it may be revoked at any time for due cause. / / / / Applicant Permitee Signature Date Issued By Signature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. -____ __�_�__________ ____.f_��.. � 60 Day Deadline: . .�. , , , Date Incomplete Notice Sent: Copy of Application Sent to: Engineer on County on DNR on MCWD on !� LMCD on �, Date Property Owners Notified: � Date Legal Notice Published: ; PC Meeting(s): � Vote: I Vote: � Vote: i ! Notice of PC Action: i �, City Council Meeting(s): 1 � Vote: ' Vote: ; Vote: � Notice of Council Action: i I I I ' i _, _ , I ; , , t;,;,# �st fir t�� Ci't�� o�r �rr:rt� L ��f rt�?i�y �3:�f!�say '?>`,i► �inl t�� f��r�way , �r�ur�, i�� `�,.�56 �5� c�a'�-�bt}�3 Gr�n�io �!� 5s�5� ��-�?�u �"r7 , ' R�:�i�� ;�e �,�1C�n13c i:�: 1�. �`��1 . 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