HomeMy WebLinkAbout2017-01029 - addn/remodel/repair CITY OF ORONO * z 0 1 7 - 0 1 0 2 9 *
� . 2750 KELLEY PARKWAY DATE ISSUED: 09/12/2017
ORONO,MN 55356-
(952)249-4600 FAX: (952)249-4616
ADDRESS : 4240 NORTH SHORE DR
PIN : 07-117-23-43-0014
LEGAL DESC : SAGA HILL REVISED
: LOT 000 BLOCK 014
PERMIT TYPE : ADDITION/REMODEL/REPAIR
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR �
ACTIVITY : 434-RESIDENTIAL
VALUATION : $ 20,000.00
NOTE: SEPARATE PERMITS REQUIRED: MECHANICAL,ELECTRICAL(STATE)
CONVERT COVERED PORCH TO MUDROOM
APPLICANT PERMIT FEE SCHEDULE 356.22
THOMPSON CONSTRUCTION LLC STATE SURCHARGE(VALUATION) 10.00
505 COIJNTY ROAD 19 TOTAL 366.ZZ
MOUND,MN 55364 Payment(s)
(952)393-5349 CHECK 1391 366.22
Minnesota State License#:BUIL-BC686985
OWNER
SCHWARZKOPF,PETER&JENNIFER
4240 NORTH SHORE DR
MOUND,MN 55364
AGREEMENT AND SWORN STATEMENT
The work for which this permit is issued shall be petformed according to
the appmved 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 addirional or related work which requires separate
permits. All provisions of Iaws and ordinances goveming this type of work
shall be compied with whether or not specified herein.This permit will
�pire 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 use.
�
�/Z -�j�� � � i���7
Applicant Permitee Signature Date Issued By ature Date
C�ty a� �ron�
. � �uildin� R�r��� A���icatian
for t�evv Str�ct�res or elditi��s
Mailing Address:
���j PO Box 66 � (�i� Permit number: ocb/7-D�p 2`�-J
� Crystal Bay, MN 55323-00 � �
Date received: �� $-�'7
Street Address:' � I n� Received by: /�/�
y G��C'' 2750 Kelley Parkway Q W � 2�/ �/
`�t,� �, Orono, MN 55356 J Plan review fee: �� � ���-
xESHo�` Main: 952-249-4600 Total Fee: �d�� d!O 2��
Fax: 952-249-4616 www.ci.orono.mn.us l ,/
This application forrrt must be completed in full and all required information must be submitted.
Incomplete applications wiil be returned. (P/ease print)
GENERAL INFORMATION:
Job Site Address: �t��(� /�,,��,,-f;, �`���,_�., _ rs V�
Wiil this be a Parade of Homes, Remodelers Showcase Home or other Display Home? Yes No
If yes,a specia/event permit is requi�ed with Po/ice Department and City Council approva/60 days prior to the event. Shutt/e bus service wi1/be
required unless applicant demonstrates sufficient on-site parking is availab/e. Non�ermitted evenfs will not be a!lowed.
CONTRACTOR/APPLI�ANT INFORM TION:
Name: ��'►� ' ..� .h �-� c�� �.-l.L
State License # C 3 Expiration Date: 3 -31- 2v i�
Phone: cell 9 5"2-- 3— _S3-� office
Mailing Address: '��� / " Cit : �u„ ZIP:
Contact Person: � �- c�„� ,,,t a, Appiicant is: ontractor Homeowner +
Email and/or Fax: �a , �, � � G,.+,, f,� a �G (Circle One)
PROPERTY OWNER INFORMATION:
Name: ��t� { 'S-��n���er S�,�n�� �r�� f
Phone(day): y5 Z �7 ? '�( 3�
Address: � o i+.�� t�� 5��.�c l�.-�e Ci : ��-�.� ZIP: .5-53L-¢
Email and/or Fax � `, .'� wti rZ ✓� ,� ;w C�%< <�„-�
ARCHITECT/ ENGINEER INFORMATION:
Name:
Phone (day):
Address: Cit : Z�P.
Emaii and/or Fax:
ARCHITECT/ ENGINEER INFORMATION:
Name:
Phone(day):
Address: C�t : Z�P.
Email and/or Fax:
PROJECT INFORMATION: Descri tion of pro"ect: ��.,v�� E c�.�z�L� ��,,,,�� -}� �_,�,.U�;;,�
1.Type of Project 2. Proposed Use 3. Structure Type 4.Sewage Disposal&
❑ New Gonstruction Water Supply
,�Single Family with ❑ Accessory Bldg./Garage
J�'Addition attached garage ❑ Deck
❑Accessory Building ❑ Single Family with ❑ Office/Commercial �Public Sewer
� Relocation detached ara e
I5� Other. s eci �i'b 17 9 9 C� Residence
1�► t P �� `S ��%� ❑ Multiple Family/Condo ❑ Retainin Wall s ❑ Septic
9 ( ) (Compliance certificate
❑ Public 4-feet or greater may be required)
**Any earth movement may require ❑ Commercial ❑ Storage
MCWD review&permits. ❑ Industrial ❑Warehouse
Minnehaha Creek Watershed District(MCWD) ❑ Public Water
15320 Minnetonka Blvd;Minnetonka,MN 55345 � �her. (speCify) ❑ Other(speCify)
Phone: 952-471-0590 / Fax: 952-471-0682 �Private Well
www.m innehahacreelc_oro
Estimated Construction Valuation (excluding land) $ ,��� ��:,�.�
Packet Last Updated.• January 2016
Paqe 21
STRUCTURE IPlFORfVI�lTl01�:
1.Structure Dimensions 1.Structure Dimensions(continued)
a. Length(ft.)= Number of bedrooms= 2. Occupancy:
b.Width(ft.)= Number of garage stalls:
3. Occupant Load:
Areas in sauare feet Attached=
c. Basement= Detached = 4. Type of Construcion:
d. 15t Story =
5. Code Edition:
e.2nd Story=
f. '/�Story =
g.Total Area=
REQUIRED SUBMITfALS:
Atl of the information must be submitted in order for our application to be processed:
Not
Enclosed licable
p O Buildin Permit Escrow A reement and Fees
p ❑ Plan Review Fee
❑ O Com leted A lication Form
❑ ❑ Pro osed Buildin Plans—2 full size sets to scale and 1 reduced 11 x 17 or 8'/�x 11 set
p ❑ Minnesota State Ene Code Calculations and Mechanical Code Re uirements
p ❑ Surve —2 full size,to scale meetin ALL surve re uirements
❑ ❑ Hardcover Calculations
❑ ❑ Se tic S tem 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
❑ ❑ Landsca e Plan
❑ ❑ Stormwater Pollution Prevention Plan SWPPP
❑ ❑ Access Permit
❑ ❑ Data Privac Adviso Form
APPLICANTIOWNER 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 5500;
. Certifies that the information supplied is true and correct to the best of his/her knowledge. The applicant recognizes that they are
solely responsible for submitting a complete application being aware that upon failure to do so,the staff has no aNernative but to
reject it until it is complete;
. Acknowledges the Escrow Agreement is completed and signed;
. Understands some or all of the infortnation 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 infoRnation,the application may not be issued.
o Agrees that in the event that weather or other conditions prevent the comptetion of an as-built survey at the tlme the
Certificat� of Occupancy fs requested, a temporary Certificate of Occupancy may be Issued upon recefpt of a 510,000
escrow to ensure completion of the as-bullt survey and all site improvements.
`���"'���_�"� Date: � " Z�� 2�\ 1
ApplicanYs Signature: �
Owner's Signature: Date:
Packet Last Updated: January 2016
Page 22
�
PLAN REVIEW CHECKLIST FOR NEW STRUCTURES / ADDITIONS �
Address: ��� I v�Y `'1' l (Jr I�JYe– �' Permit No.: �l ( " ��V��
Description of work: l Q11�uQ,�} ��� � 1yV1,1�,� Date Rec'd: �"��� ��
Septic review by: �(�`C�' � W �,V�-- Date Approved:
Zoning review by: Date Approved: � '� ` �� (
Building review by: Date Approved: � `
Grading review by: �� Date Approved: ��
Zoning District: � L.� Zoning File#:
=—�.-�--
Resolution? Yes Reso#: Reso Date: Signed: Yes No Resolution / NAy�
Zo�ing: Lot Area: �J SF/AC Width: Structural Coverage: SF ��� %
;'��r.'F�YI l �
v�y Submitted: �es � No Date of Survey: �Q '��'�� Revised date(?):
Landscape plan submitted? � Yes Landscaper: 0 No one propos �
Proposed Setbacks:
Front(La e) Rear(Street) (� S E W ) ( N� E W l) Other Buildings Wetland
Side Side
N c� 3to' --
Buildin Hei ht Anal sis:
Distance Between First Floor and defined Top of Roof* (See"building heighY' �a� �
definition : �
First Floor Elevation from buildin lans : (b) " `
Highest Existing ground level (per survey) or 10' above lowest ground level, ���
whichever is lower:
Difference between b and c *: (d)
, "
DEFINED HEI�1�1T
*If highest existing adjacent grade is above FFE-Height is(a)-(d): (e)
'If hi hest existin ad�acent rade is below FFE-Hei ht is a + d ,
Shoreland District MCWD Permit Average Lakeshore Setback B�uff =
Met? �
� Yes � No Permit Number: � Yes � No N/A � Yes o
A—see attached Setback:
Stormwater Quality Existing Proposed
Overlay District Tier Hardcover Hardcover Variance Required CUP Required
circle one % and sf % and s
t"�•�a�A , n , 0 Yes o 0 Yes No
1 �2 3 4 5 ^(I( / Type(s): Type(s):
5�n� sf, .�,�..
Updated: June 2017
z:\forms\plan review checklist 06-2017.docx
r,
Fees to be Char ed YES NO
Pet�mit '
Plan Review �
State Surcharge �/
Investigation Fee '
SAC—fdumber of SAC Units
Other(specify) (/��'
S uare Foota e $ er S uare Foota e
Basement X = $
1S' Floor X = $
2nd FI00� X = $
Garage X = $
�O��--�
Estimated Construction Value: $ ,/
Orono Inspections Required Work Requiring Separate Permits
Footing � Site 0 Plumbing � Grading/Filling
� Poured Wall 0 Silt Fence/Erosion Control Mechanical 0 Fire
� Foundation Survey 0 Hardcover Removal � Fireplace 0 Water Connection
� Framing � Other(specify) 0 Masonry � Sewer Gonnection
0 Waterproofing/Drain tile � Mfg. 0 Lawn Irrigation
� Foundation Waterproofing � Other(specify) � Landscaping
Framing � ` � Septic
�Insulation
� As-Built Survey
Final
0 Lathe Required State Permits
O Other(specify)
� Well Electrical "
i �
REMARKS (in-house):
OFFICIAL REMARKS -TO BE NOTED ON PERMIT AND INITIALLED:
� 0 See Builder Acknowledgement Form �
� Prior to release of escrow money an as-built survey and hardcover calculations must be submitted and approved.
�
Updated: June 2017
z:\forms\plan review checklist 06-2017.docx
� � Builder Acknowledgement Form
Permit #2017-01029 / 4240 North Shore Drive
' �o�^'�,�, ���
Builder Representative Name: ���L''�
Permit Conditions: Initials
If applicable, erosion control shall be installed and maintained throughout the entire project �
and must remain until vegetation has been established.
Prior to the release of the escrow funds a final inspection must be completed and all disturbed
areas established with vegetation. Please note established vegetation means perennial cover
with a density of 75%. Seed blankets or sowing grass seed it not considered established
vegetation.
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 '�l-~.
separate Zoning Permit application to be submitted and approved prior to the work
commencing.
Any retaining walls that are 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\north shore dr\4240\builder acknowledgement form 2017-01029.docx
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Existin� Floor Plan �
� Scale: 1/2" = 1'-0" � : „_, �°= ` � �.
Sheet Size: iix17 � �t�4T
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St�'O}CE CETECTOR C��tJPd�CTED TO A SOUND- � `
i1�1G[��'vIC�QR U i��:�;L�.r__TFi:,TOR AUDISLE iN •�
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all sleepinq reoms . �
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Sfte Plan Review Datc� � �
�PWROVED O ✓, Z
❑APP�20VEL`v�nTr�l ��VISI(JNS(c�e nAtes) � �
❑DENIED
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Floor Plan ,�
� Scale: 1/2" = 1'-0" �
Sheet Size: iix17 f -- �
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Remove existing walls f0 Q '�
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Remove existing step � M
and close in wall i Bench w/lockers V L �
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, n �d TREAD 2-9 1/4" �Vl_ header � � � _
7 3/4n Pt1A,X.RISER �0 Mi; . ; �
6'-8" M i N.H E A D R OG M ; '"� Z O
pT LER S T O N E H A�i C R A1�R�GUtRED �
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36" door �
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�/ Removing existing slab �"� 42" deep footing, flared at bottom to 12" a '� �
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Well �..� �
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� Scale: 1/2" = 1'-0" a
Sheet Size: iix17 � �
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Insulate Ceilina � � �
5/8" Drywall(flush w/existing home) �
Tynical Wall Constru _tinn 4 mil poly vabor barrier � nJ
Siding R-38 batt insulation w/2" R-14 foam � �'
Housewrap �
7/16" OSB a
2x6 SPF Studs 16" O.C.
R-21 fiberglass batt insulation
4 mil poly vapor barrier �
1/2" Drywall .-�
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New ^'
Mudroom Area o'
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2 ply 9 1/4" LVL flush beam ' *-� N
New steps �.�
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Tynical Floor Constru .tinn � v �
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New 8" concrete pier for stair support 1/2" CDX plywood x �
R-30 closed cell spray foam insulation ;-+
2x10 SPF floor joists 16" O.C., hangered at ends O �= ?
3/4" subfloor(installed to be flush with adjacent framing/flooring) � � �
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, City of Orono
,
�oNo Hardcover Calculation Worksh�et
,� ` PropertyAddress: /fZl�� ���� Sh�r� f�yiv� !
��KfSHOPE Prepared by: Date: y
t�Ytl,lvl MbSc�t� S> "2 `� ' �/7
Stormwater Quality Overlay District Tier: (Circle one) Tier Tier 2 ier 3 Tier 4 Tier 5
Step 1: EXISTING HARDCOVER
In the following table identify all items of existing hardcover on the property, keyed by letter to Certificate of
Survey (survey must accompany this form). Use as many lines as necessary to accurately depict existing
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 square footage separately for each portion.
Key to Hardcover Item(Describe) Length x Width Total
Surve S uare Feet
Exam le Gara e 24'x 30' 720 S.F.
A !-�z� 'c� 23' �. - S.F.
B „ ,� 3 2.z s.F.
c �� �� s.F.
� ew u 1�: 3 S.F.
E 2' ' ' S.F.
F • , �' S.F.
G ,� � �; ' S.F.
H " ,,,,� .r- • ,3• /2 S.F.
I S.F.
J S.F.
K S.F.
L S.F.
M S.F.
N S.F.
O S.F.
P S.F.
Q S.F.
R S.F.
S S.F.
T S.F.
U S.F.
V S.F.
W S.F.
X S.F.
Y S.F.
Z S.F.
1 Total Existin Hardcover /p S.F.
Excludable Hardcover See Cit Code Sec 78-1684 :
S.F.
S.F.
S.F.
S.F.
S.F.
2 Total Excludable Hardcover S.F.
3 Net Existin Hardcover Subtract line 2 from line 1 S.F.
4 Total Lot Area S.F.
Proposed Hardcover Percentage [(3)=(4)] ��,�� %
(Proposed Hardcover next page)
RECE���w�.��1
This is an information packet regarding Hardcover. Every effort has been made to insure fhe accuracy of the informati ; n�a ed' r in;
however,if any information is not consistent with provisions of the City Code,the Code provisions will prevail. ����` � r-���
Page 8 ot s CITY OF OR4N0
8/30/2017 Thompson Construt�ion LLC Mai!-MCWD No Permit iV�d�:4240 N Shore Drive,Orono
_!L
�T HOM P S ON Dorian Thompson<dortan@ithompsondb.com>
GO N S'I'Rl:G'C I O lY�.�_�
D@316N'BUILO REMODEL
MCWD No Permit Needed: 4240 N Shore Drive, Orono T�^�--�--T_._._._..._�
2 messages
Luke Menden <imenden@minnehahacreek.org> Wed,Aug 30, 2017 at 10:42 AM
To: Melanie Curtis<MCurtis@ci.arono,mn.us>, "Christine Mattson(Orono)"<cmattson@ci.orono.mn.us>
Cc: Dor�an Thompson<dorian@thompsondb.com>
Good Moming,
This email is to inform you that no permit is needed from MCWD for the house addition project located at 4240 N Shore
Dr, Orono.
Have a nice day,
Luke Menden
District Representative
Minnehaha Creek Watershed District
15320 Minnetonka Blvd
Minnetonka, MN 55345
952-641-4586
,m. ..
�-��*����:
u,�-;:_
MlNWEMAMA CREEK
WA4ERSNED OISTRICt
Dorian Thompson<dorlan@thompsondb.cam> Wed,Aug 30,2017 at 10:49 AM
To: Luke Menden�Imenden@minnehahacreek.org>
Cc: Melanie Curtis<MCurtis@c�.orono.mn.us>,"Chr�stine Mattson(Orono)"<cmattson@ci.orono.mn.us>
THANKS LUKEd
Dorian Thompson
Thompson Construction
505 County Rd 19� Mound, MN 55364
C:952-393-5349� dorian@thompsondb.com
www.thompsondb.com
https://mail.google.com/mail/WOf?ui=28�ik--8a92445d99&Jsvar-PX1 Y7GgZj W4.en.8view=pt8search=inbox8dh=15e33d5a0e5b84008�siml=9 5e33ce9c1... 1/2
. Permit Application: 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
,;,
�
Plan Review Fee Paid
Signed Escrow Agreement & Escrow Payment
3
Plans (to scale) x2
Certificate of Survey (to scale) showing the proposed project &
meeting all requirements x2
� Hardcover Calculations (if applicable)
I am aware that Orono will not issue a building permit without a
copy of MCWD permits (or documentation from the MCWD stating
v' the proposed project does not trigger their permitting '
requirements). I will contact the MCWD at 952-471-0590
regarding this project.
Signed by: ~ �
Address: y��0 � ��d�� �/'
Permit #: �o � 7- b/D z-`�
W:\Applications,License or Permit Applications\Zoning Applications\Permit Application Completeness Checklist 2015.docx
� � Hennepin County Property Map
Da te: 8/31/2017
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PARCEL ID: 0711723430014 Comments:
OWNER NAME: Peter H Schwarzkopf EtAI
PARCELADDRESS: 4240 North Shore Dr, Orono MN 55364
PARCELAREA: 0.68 acres, 29,673 sq ft
A-T-B:Abstract
SALE PRICE: $380,500
SALE DATA: 04/2007
SALE CODE: Warranty Deed
This data(i)is furnished'AS IS'with no
representation as to completeness or
ASSESSED 2016, PAYABLE 2017 accuracy;(ii)isfurnished with no
warranty of any kind;and(iii)is notsuitable
PROPERTY TYPE: Residential for legal,engineering or surveying purposes.
HOM ESTEAD: Homestead Hennepin County shall not beliable forany
MARKET VALUE: $304,0�� damage,injury or loss resulting from this data.
TAX TOTAL: $3,174.72
COPYRIGHT OO HENNEPIN
ASSESSED 2017, PAYABLE 2018 couNrv 20��
PROPERTY TYPE: Residential
HOMESTEAD: Homestead
MARKETVALUE: $341,000
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DATE TIME
CITY OF ORONO c�►u�iN ��� �•��
INSPECTION OTICE O��7�� scr+Eou��
PERMIT NO. coMP�
ADDRESS �+d��� S �
�NER TELEPHONE NO�� �� ' �
CONTRACTOR ��� ���
� D SCRIPTION
� TINO ❑ DEMO-FINAL ❑ SEPTIC FINAL
POURED WALL ❑ PLUMBING RI ❑ EXCAV/ORADIN(3/FIWNO
O ❑ FOUNDATION WATERPROOF ❑ PLUMBINO FINAL ❑TREE REMOVAL
� � RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION
� � FRAMINO � MECHANICAL FINAL ❑ RATED WALLS
� ❑ INSULATION �WOOD BURNERlFIREPLACE ❑COMPLAINT
� Q FINAL ❑ WATER HOOK-UP � FOLLOW UP
W 0 AS BUILT-SURVEY ❑SEWER HOOK-UP � FOUNDATION/REMOVAL
_
v ❑ DEMO-SITE 0 SEPTIC INSTALL
Z aIMN�1�RRACTOR 7�MEET 1fC1l:_YES_NO
� coM�� . _
4 ' g �� ��e� �� $�'f ��C� �
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1
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3
� �K 3AT�FACTORY:PROCEED ❑PROJECT COMPLETE
W ❑CQpqC-CT�MpR1(3 PROCEED ❑18SUE CER'TIFlCATE OF OCCUPANCY
O p fpqqECTy11�RK,CALL FOR REINSPECTION TE�APORARY
V BEFORE(�VERIN� PERMANENT
❑(�qpECTUN3AFEWNDITIONWITHIN HOl1F�. ❑p�TOTAKEN
INSPECTOR YVILL RETURN p qTAT10M ISBUED
❑STOP ORQER POSTED.CALL INSPECTOR
O INSPECTION REOUIRED.CALLTO ARRAN(iE ACCESS.
cen rorn���2a no�s��oe. (952) 249-4600
Own�lcoetrector o�sit� �
,,,� ,�., ��
MIMis OoprAn�c�s Ff� Gmry Co�fB�Naaks
i 1 . e.,..„,t"
(7
DATE TIME
CITY OF ORONO CALLED IN
INSPECTION NOTICE SCHEDULED `t✓/a-(-- S` 365
PERMIT NO.C/7-6/0 COMPLETED
ADDRESS :72 90 A SA6 - A- c/
OWNER TELEPHONE O.55T -5.? �T
/
CONTRACTOR Ij��5c,i- e�H Sf Dorf e_"--
E
."-E DESCRIPTION /re- '�-% ode
W 0 FOOTING 0 DEMO- INAL 0 SEPTIC FINAL
Q 0 POURED WALL 0 PLUMBING RI 0 EXCAV/GRADING/FILLING
0 FOUNDATION WATERPROOF 0 PLUMBING FINAL 0 TREE REMOVAL
C
❑ RADON SLAB 0 MECHANICAL RI 0 SITE INSPECTION
Q FRAMING 0 MECHANICAL FINAL 0 RATED WALLS
Z
❑ INSULATION 0 WOOD BURNER/FIREPLACE 0 COMPLAINT
Q ❑ FINAL 0 WATER HOOK-UP 0 FOLLOW-UP
W 0 AS BUILT-SURVEY 0 SEWER HOOK-UP 0 FOUNDATION/REMOVAL
v ❑ DEMO-SITE 0 SEPTIC INSTALL
5 OWNER/CONTRACTOR TO MEET YOU: YES NO 1 / 1 -
53• COMENTS: Elm- �
4 ^ mite() 7l�l,S 7 /o'le,
W
Qs
o fr a,y.K5 - Qer (214,4 - �voK t e0rc
N. 1'o4 VGA/teQ l µ�/� - /
k
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it 0 P(0000 e "c ' ,t - prior- "A /,vccd
Q kes? i'. 1prior-
W
OA — eel rec_t -4 o&._ !sts6,C-
w
it
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a
W ❑ K SATISFACTORY:PROCEED CI PROJECT COMPLETE
a ECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
W
0 El CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
✓ BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑PHOTO TAKEN
INSPECTOR WILL RETURN
ElSTOP ORDER POSTED.CALL INSPECTOR El CITATION ISSUED
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (952) 249-4600
OwnerlContractor on site:
Inspector., ICA" 1 /-
White CopyAnspector'a File Canary Copy/Site Notice
r:
gf►TE TIME
CITY OF ORONO CALLED IN
INSPECTION NOTICE SCHEDULED - /
PERMIT NO. �7 -/ COMPLETED
ADDRESS T C w ._ ' I ,51Atee_4,
OWNER 9;LE HONE NO.
CONTRACTOR / _POI'E l Q�
DESCRIPTION / 1k_. ' kL
W 0 FOOTING 0 DEMO-FINAL 0 SEPTIC FINAL
Q ❑ POURED WALL 0 PLUMBING RI 0 EXCAV/GRADING/FILLING
❑ FOUNDATION WATERPROOF 0 PLUMBING FINAL 0 TREE REMOVAL
❑ RADON SLAB 0 MECHANICAL RI 0 SITE INSPECTION
• 0 FRAMING 0 MECHANICAL FINAL 0 RATED WALLS
t• a INSULATION 0 WOOD BURNER/FIREPLACE 0 COMPLAINT
Q 0 FINAL 0 WATER HOOK-UP 0 FOLLOW-UP
❑ AS BUILT-SURVEY 0 SEWER HOOK-UP 0 FOUNDATION/REMOVAL
❑ DEMO-SITE 0 SEPTIC INSTALL
2 OWNER/CONTRACTOR TO MEET YOU:_YES_NO
• COMMENTS:
a - 5pra X.-6241,n )"'LS 14'11c01, C?k , 7"Q //S
odk 1 a.-
W
cc
Q
ct
W WORK SATISFACTORY:PROCEED ❑PROJECT COMPLETE
CCW
D CORRECT WORK&PROCEED 0 ISSUE CERTIFICATE OF OCCUPANCY
O 0 CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
U BEFORE COVERING PERMANENT
O CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTO TAKEN
INSPECTOR WILL RETURN
O
O STOP ORDER POSTED.CALL INSPECTOR CITATION ISSUED
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (952) 249-4600
Owner/Contractor on site:
Inspector. �-�-
White Copyllnspector's File Canary Copy/Site Notice
583571 �
�� `��' i��-�� � '.
� Certif: i.cate c�r Surv�y
£or [)avid Smith
of L,ots 6 and 7 , Block 1 4 , Saga Ili.l l Revised
}l�nnepin County , M.innc�sota ,
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l,egal 1)escri t� ion
Lots 6 and 7, F31.ock 14 , Saga fiill Revis�d.
'I'l�is survey shows the l.ocation of all existing buil.dings
on th� above described property . It does not purport to
show any other. i.iYi��rov�ments o.r enc.roachrnents .
o : Iron marker found
Q: Judicial Landmark
Bearings shown are based on an assumed datum.
� ORONO C4PY
, I hereby certify that this survey was prepared by me or under my direct super- �ATE 6 - I 5 - 9 4
� 1 � � � � vision, and that I am a duly registered Civil Engineer and Land Surveyor under
�� the laws of the State of Minnesota. �� �
SCAI.E � = �
I i��4�1 O
Mark S. Gronberg Minnesota License Number 12755 loa rvo.
q� No�S�� �►''
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emo
To: Finance Department
From: Christine Mattson, Planning Assistant r�
�
CC: Street File
Date: December 5, 2017
G/L: 101-22205
Re: Escrow Refund
P��q
Building Permit#2017-D�-29�pertaining to 4240 North Shore Drive is complete. Please refund
$700 to the property owner, Peter Schwarckopf.
Mail to: Peter Schwarckopf
4240 North Shore Drive
Mound, MN 55364
w:\street files�north shore dr�4240\escrow refund form 2017-01209.docx
�
ESCROW AGREEMENT
AGREEMENT made this �� day of u�Y , 201 , by a d between the CITY OF ORONO, a Minnesota
municipal corporation ("City") and _ �}er __`c_hu�urlkm• c►h ("Owner(s)").
RECITALS c�l'nr�'��e� �t�V,s�i`�Z�o��
A. The undersigned is/are the Owner(s)of the Subject Property and hereby agrees to and consent to the
terms and conditions of this Escrow Agreement.
B. Owner has: (check one)
o Filed a ioning application#
�—Filed an application for a Building/Zoning Permit# �tl —�� l(S�q
❑ Agreed to comply with Orono City Code Section 78-1432 regarding accessory structures.
❑ Filed an Individual Sewer Treatment System (ISTS) permit application.
❑ Requested to do work within public Right-of-Way
❑ Filed a request for a Temporary Certificate of Occupancy
❑ Other
("Application") on land situated in the City and located at �� N�('t� Si�v� UWi��,
(the"Subject Property°); and
C. The City is willing to review or monitor the Application only if the Owner agrees to reimburse the City
for the actual costs expended by the City on behalf of, or on account of, the Owner.
NOW THEREFORE,THE PARTIES AGREE AS FOLLOWS:
1. DEPOSIT REQUIRED. Contemporaneously with the execution of this Escrow Agreement, the Owner
shall deposit $ �1C'�O ("Escrow") with the City necessary to secure coverage of the total costs
associated with review, approval, and monitoring of the Application. Any Escrow shall be held in a
special escrow account and shall be credited to the Owner.
2. PURPOSE OF ESCROW.
• Zoninq. The purpose of the Escrow is to guarantee reimbursement to the City for expenditures
including but not be limited to staff time, at the rates established by the City Council, in excess of
that covered by the standard application fees, engineering consultant and legal consultant
expenses incurred by the City in reviewing and approving the Application and all other city staff
administrative and consultant services performed in the processing of said review and approval.
■ BuildinQ/Zoning. The purpose of the escrow is to guarantee completion of the site plan as approved
and the provision of the as-built survey as required by the Building official.
■ Accessory Structure. The purpose of the Escrow is to guarantee reimbursement to the City for
expenditures including but not limited to staff time, at the rates established by the City
Administrator, engineering and legal consultant expenses incurred by the City in removing an
accessory building if the Owner fails to perform the obligations in Orono City Code Section 78-1432
and all other City staff administrative and consultant services performed in removing the accessory
building, including land stabilization.
■ ISTS. The purpose of the Escrow is to guarantee reimbursement to the City for expenditures
including but not be limited to staff time, at the rates established by the City Council, in excess of
that covered by the standard application fees, engineering consultant and legal consultant
expenses incurred by the City if Owner for any reason is unable or unwilling to honor the
requirements of Chapter 58 of the Orono City Code, and all other city staff administrative and
consultant services performed in relating to the Application. The City may also reimburse itself for
all engineering and legal expenses associated with the construction, removal, alteration, or repair
of the ISTS if the Owner fails to do so.
• Temporarv Certificate of Occupancv. The purpose of the Escrow is to guarantee completion of
exterior improvements (driveway, grass, etc.) that cannot be accomplished due to weather
conditions.
lanuary 2017 1
�
3. MONTHLY BILLING. The City will monthly forward to the Owner a statement and bill for the
expenditures incurred by the City for staff and consultant services. Such statements shall be due and
payable within 15 days for receipt by the Owner. No statement will be sent if there are no expenses
incurred in the period since the most recent statement. The City shall itemize all time, services, and
materials billed to any Owner and said time, services, and materials shall be in accordance with the
rules, regulations, and fees as promulgated and adopted by the City Council.
4. DISBURSEMENT FROM ESCROW ACCOUNT. In the event the Owner does not make payment the
City as required under paragraph 3, the City may draw from the Escrow without further approval of the
Owner to reimburse the City for eligible expenses the City has incurred. The City shall periodically
notify the Owner of the draws the City has made and the nature of the expense for which the
reimbursement is being made.
5. REIMBURSEMENT OF ESCROW. The Owner shall reimburse the Escrow fund for any deficits caused
if the amount actually expended by, or billed to, the City exceeds the escrow fund balance.
6. RIGHT OF ENTRY.
■ Zonin4. This section is not applicable.
• Buildinq. This section is not applicable.
• Accessory Structure. The Owner hereby grants the City, its agents, employees, officers and
contractors the right to enter the property to remove the accessory building(s) should the Owner
not complete the removal obligations in Orono City Code Section 78-1432.
• ISTS. The Owner hereby grants the City, its agents, employees, officers and contractors the right
to enter the property to perform all work and inspections deemed appropriate by the City in
conjunction with replacement of the septic system, including but not limited to constructing or
completing any and all of the agreed upon improvements should the Owner not complete those
improvements by the date agreed upon.
• Temporarv Certificate of Occupancv This section is not applicable.
7. NO INTEREST PAID. All accrued interest, if any, shal! be paid to the City to reimburse the City for its
cost in administering the Escrow account.
8. CLOSING ESCROW. When the review has been completed or the project has been completed, the
balance of the Escrow, if any, shall be returned to(check one):
�Owner ❑ Applicant ❑ Other
Name: +e�r Sclnwav2KM�f
Street Address/PO Box: �}24c� wl�r-�1n nr DriV
City/State/ZIP: mo��nct�M�l S5��4
9. CERTIfIED UNPAID CHARGES. If the Application 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.
IN WITNESS WHEREOF, the undersigned have executed this Agreement as of the day and year first above written.
CITY OF ORONO: OWNER(s):
�
BY: �t� BY:
I
v'1�t,¢n--7`- �YL°C..7�y' �� �
�
January 2017 z
.
City of Orono
2750 Kelley Parkway
Orono MN 55356 952-2d9-4600
Raceipt No: 3.019087 Aug 31, 2017
IPeter Schwarzkopf
Previous Balance: .00
Permits
Escrow 700.00
. 101-22205
Deferred Rev-Developer Deposit
---------------
Total: 700.00
Check
Check No: 1096 700.00
` Payor:
Peter Schwarzkopf
Total Applied: 700.00
---------------
Change Tendered: .00
OS/31/2017 11:46AM
s r .. .
CITY OF ORONO * 2 0 1 7 — PJ 1 PJ 4 6 *
2750 KELLEY PARKWAY DATE ISSUED: 08/31/2017
� ORONO,NIN 5535Cr
(952)249-4600 FAX: (952 249-4616
ADDRESS : 4240 NORTH SHORE DR
PIN : 07-117-23-43-0014
LEGAL DESC : SAGA HII.,L REVISED
: LOT 000 BLOCK 014
PERMIT TYPE : ESCROW FEE-TIED TO BUILDING PERNIIT
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ESCROW FEE-TIED TO BUILDING PERMIT
NOTE: THIS$700 ESCROW IS'TIED TO BUII.,DING PERMIT 2017-01029 PAID BY PETER SCHWARZKOPF CHECK#1096
APPLICANT ESCROW FEE-BUILDING 700.00
TOTAL 700.00
SCHWARZKOPF,PET'ER&JENNIFER Payment(s)
4240 NORTH SHORE DR CHECK 1096 700.00
MOUND,MN 55364
OWNER
SCHWARZKOPF,PETER&JENNIFER
4240 NORTH SHORE DR
MOUND,NIN 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 does
not grant permission for additional or related work which requires sepatate
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 1 SO days of the date of issuance,or if construcrion is
suspended for a period of 180 days at any time after work has commenced.
The applicant is responsible for assuring all required inspecrions are
requested in conformaace with the State Building Code.This permit may be
revoked at any time for due cause.
/ /
Applicant Permitee Signature Date Issued By Signature Date
DATE TIME
CITY OF ORONO CALLED IN
INSPECTION NOTICE SCHEDULED II# /b 9k00
PERMIT NO. 11- 01 0 2-c1 COMPLETED,
ADDRESS 12-46 1404-- 3� (-e Dv C
OWNER TELEPHONE NO.'162-393-53Lj`
CONTRACTOR OYI&I*
RJ /DESCRIPTION 1 a ��
3:: �
�-1c� — M4f
W ❑ FOOTING 0 DEMO-FINAL 0 SEPTIC FINAL
.0- ❑ POURED WALL 0 PLUMBING RI 0 EXCAV/GRADING/FILLING
Q ❑ FOUNDATION DRAIN TILE 0 PLUMBING FINAL 0 TREE REMOVAL
• ❑ LATHE 0 MECHANICAL RI 0 SITE INSPECTION
Q 0 FRAMING 0 MECHANICAL FINAL 0 RATED WALLS
• ❑ INSULATION 0 WOOD BURNER/FIREPLACE 0 COMPLAINT
FINAL 0 WATER HOOK-UP 0 FOLLOW-UP
W 0 AS BUILT-SURVEY 0 SEWER HOOK-UP 0 FOUNDATION/REMOVAL
r ❑ DEMO-SITE 0 SEPTIC INSTALL
OWNERICONTRACTOR TO MEET YOU:_YES_NO
COMMENTS: 1 l w or k cowl ple4--ca-i ll I'n 5 p�-�� t
ar'or
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Gr+'+ ple.432 [ nG�Udi ►�q s ±t el eC.e—Y !G
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12
CC
W 0 WORK SATISFACTORY:PROCEED PROJECT COMPLETE
❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
O 0 CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
C.1 BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. 0 PHOTO TAKEN
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. (952) 249-4600
Owner/Contractor on site:
Inspector. q Son
White Copyllnspector's File Canary Copy/Site Notice