HomeMy WebLinkAbout2014-00500 - pool - in ground CITY OF ORONOTil !1 III I ;1 1.1 11
2750 KELLEY PARKWAY * 2 1 4 - 0 0 5 0
DATE ISSUED: 06/06/2014
ORONO,MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 840 OLD CRYSTAL BAY RD S
PIN : 09-117-23-12-0002
LEGAL DESC : UNPLATTED 09 117 23
: LOT 000 BLOCK 000
PERMIT TYPE : ACCESSORY STRUCTURE
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : POOL-IN GROUND
ACTIVITY : 329-STRUCTURES OTHER THAN BUILDINGS
VALUATION : $ 45,000.00
NOTE: ADDITIONAL PERMITS NEEDED:MECHANICAL&ELECTRICAL(STATE)
APPLICANT PERMIT FEE SCHEDULE 628.00
ATLANTIS POOLS STATE SURCHARGE(VALUATION) 22.50
4321 68TH AVE N TOTAL 650.50
BROOKLYN CENTER,MN 55429 Payment(s)
(763)560-0103 CHECK 2079 650.50
OWNER
HEIZMAN-WILLIAMS,JAMES WILLIMAS&HEIDI
840 OLD CRYSTAL BAY RD S
WAYZATA,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 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 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
Applic. t Permitee Signature Date Issue By S ature ile1,( Date
CITY OF ORONO 201`7
BUILDING PERMIT APPLICATION
FOR NEW STRUCTURES OR ADDITIONS
likts
f VOMailing Address: Permit number: c 7/41-Ot�5ot7Received bPO Box 66
Crystal Bay, MN 55323-0066Date received:Street Address:' �y:2750 Kelley Parkway Plan review fee: O,ontO(3 Orono, MN 55356 p 5V
Total Fee: �r�-0�'L9c�
T
ID at,/
952-249-4600 Fax: 952-249-4616 www.ci.orono.mn.us �
This application form must be completed in full and all required information mus :_ •..' d.
Incomplete applications will be returned. (Please print)
GENERAL INFORMATION:
Job Site Address: F'10 OC G:_/2 y 9L. 6.4 y /2 c7 .0
Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes eNT No
If yes, a special event permit is required with Police Department and City Council approval 60 days prior to the event. Shuttle bus service will be
required unless applicant demonstrates sufficient on-site parking is available. Non-permitted events will not be allowed.
CONTRACTOR/APPLICANT INFORMATION:
Name: ,4 GAIT,5 S
State License# Expiration Date:
Phone: (cell)6//. (office) 763 -5-6c) - 0/0 3
Mailing Address: /c c c 73n1•o AJ(' . '-z. roc_) City: ,-74*,z c,cl,ZIP: 5-5-36-F
Contact Person: /0 c j� Applicant is: on ractor / Homeowner (Circle One)
Email and/or Fax: u,:-17 (6meq,—G�9r�.—.�S A, cs
PROPERTY OWNER INFORMATION:
Name: T;`/`—t ,LL,li4/`t S
Phone (day): oG
Address: Cay 5%t L /3A y /2-2 City: C ,'2 ,L-)p ZIP: 3 3 /
Email and/or Fax
ARCHITECT/ ENGINEER INFORMATION:
Name:
Phone (day):
Address: City: ZIP:
Email and/or Fax:
PROJECT INFORMATION: Description of project: &�u0 02 o X Ll S rNG 2.ad/40 Poe) L
1. Type of Project 2. Proposed Use 3. Structure Type 4.Sewage Disposal&
Water Supply
❑ New Construction Single Family with ❑ Residence
❑Addition attached garage ❑ Garage/Accessory Bldg. ❑ Public Sewer
❑Accessory Building ❑ Single Family with ❑ Deck
• Relocation detached garage ❑ Office/Commercial ❑ Private Sewer
IE • her: (specify) Two/c/) ADL ❑ Multiple Family/Condo ❑ Warehouse
0 Public
RI:).torage ❑ Public Water
**Any earth movement may also require ❑ Commercialthey(specify)
MCWD review&permits. 0 Industrial .5'w - i 'o L ❑ Private Well
Minnehaha Creek Watershed District(MCWD) ❑ Other: (specify)
18202 Minnetonka Blvd
Deephaven, MN 55391
Phone: 952-471-0590
Fax: 952-471-0682
www.minnehahacreek.orq
Estimated Construction Valuation (excluding land) $ LI>/ Uov
STRUCTURE INFORMATION:
1.Structure Dimensions 1. Structure Dimensions(continued) 2.Type of Construction
t
a. Length (ft.)= 4:72v Number of bedrooms=
/ El Wood/Frame
b. Width (ft.)= 4�1 S Number of garage stalls: 0 Masonry
Areas in square feet Attached = 0 Metal
❑ Pole Bldg.
c. Basement= Detached = ❑ ICF
d. 1st Story = 0 On-site Prefab
e. 2nd Story= 0 Off-site Prefab
f. %Story = ®-Other(please specify):�/3xT�,.4€ 7 eei
g.Total Area= `c/j ore-t e- 5
REQUIRED SUBMITTALS:
All of the information must be submitted in order for your application to be processed:
Not
Enclosed Applicable
.1t' 0 Permit Application
,r 0 Proposed Building Plans
O ❑ MN State Energy Code Calculations and Mechanical Code Requirements Form
53r-- ❑ Survey(meeting all requirements)
O 0 Stormwater Pollution Prevention Plan
❑ ' 0 Hardcover Calculation(s)
❑ ❑ Septic System Site Evaluation Report
❑ 0 Access Permit
O ❑ Wetland Buffer Improvement Plan
O ❑ Engineered Plans for Retaining Walls 4 feet or above
❑ 0 Minnehaha Creek Watershed District Permit(s)
❑ ❑ Plan Review Fee
O 0 Application Escrow&Agreement
O 0 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 issued upon receipt of a $10,000
escrow to ensure completion of the as-built survey and all site improvements.
Applicant's Signatu e: Date: S/2-,: /V
Owner's Signature: \ _. ' (b--=----_ Date: (-2 /k
FLAN REVLEIT C EC (U T FOR MEtkr STRUCTURES I ADEHT14US
Address/Permit Number: L1 0 OC.D 5 (-- 43 AO 5
Description of work: Poo ,
IIIMONOMmammialalla
�msommoy Septic review by: — Date Approved:
Zoning review by: A A A d Li,/ Date Approved: 0005( if
LBuilding review by � ��%,,_ _ Date Approved: 6- —1 Grading review by: t Date Approved: .
Zoning District: Zoning File#: Reso#: Reso Date:
Zoning: Lot Area: SF/AC Width: Lot Coovera e: N SF _%
Survey Submitted: Yes No Date of Survey: 5.1q • I Revised date(?):
Proposed Setbacks:
Front(Lake) Rear(Street) ( N i E W ) ( N S E W ) Other Buildings Wetland
Side / Side
Lk, tL,i f(4eck---- (c22-,
Defined Height: Peak Height: FFE: FFE minus 6 feet= (Existing Contour
Perimeter(linear feet)= 50%= #of Stories Ok? ® YES
FOR A BUILDING WITH A BASEMENT OR CRAWL SPACE:
The distance between the lowest 1 r— 1 A SLAB FOUNDATION:
START WITH proposed floor(of the basement or crawl ,
space)and the highest point of the roN &t �I,I:H The distance between the top of slab and
If you have a S j j p�\ �, the highest point of the roof.
• GABGABLE OR HIPPED ROOF 0 ��ii`�� if you have a...
LE ): Subtract alfthe /`° , GABLE OR HIPPED ROOF(no
windows): act half the distant
distance betwee a highest p betw a highest point of the roc
of the roof to low point of the
SUBTRACTION correspo g gable or hipped rc t or low point roof eortespondin�
(BASED ON ROOF • )N ,¢`�tiable or hipped roof
TYPE) GAEL' OR HIPPED ROOF(with GABLE: OR HIPPED ROOF(with
,windows): Subtract half the . windows) Subtract half the distanc
" distance between the top of the between the top of the highest
r-" highest window and the highest window and the highest point of the
/ point of the roof roof
'
c ALL OTHER ROOF TYPES(flat • ALL OTHER ROOF TYPES(flat,
mansard,etc):No subtraction. mansard,etc):No subtraction.
DITION Add the distance between the top of slab
Subtract the distance between the
SUB ION (BASED ON and the highest existing grade adjacent t<
(BAS ON EXISTING basement/crawl space floor and the EXISTING the foundation.
G ES) highest existing grade adjacent to the GRADES)
foundation OR 10 feet(whichever is less). EQUALS Defihed building height
QUALS Defined building height
Shoreiand District fiICWD Permit Received Average Lakeshore Setback(Viet? Bluff 4
0 Yes ® No ® N/A ® Yes !O
13 Yes No ® Yes f3 No N/A O"
Permit Number: Setback:
Stormwater Quality Existing Proposed
Overlay District Tier Hardcover Kardcovey° Variance Required CUP Required
® Yes f i No D Yes ® No
Type(s): Type(s):
Updated: January 2013
v:\forms\plan review checklist 2013.docx
REMARKS (in-house):
Fees to be Charged YES NO
Penn
Plan Review
State Surcharge 1.----
Investigation Fee
SAC—Number of SAC Units
Other(specify)
Square Footage $per Square Footage
Basement X $
1st Floor X = $
2"d Floor X = $
Garage X =
$
Estimated Construction Value: $ (i� ®v a
Orono Inspections Required Work Requiring Separate Permits Required State Permits
O Site 0 Plumbing 0 Grading/Filling 0 Well
O Hardcover Removal0 Mechanical 0 Fire Electrical
O Footing Septic 0 Water Connection
O Poured Wall 0 Fireplace 0 Sewer Connection
O Foundation Survey 0 Masonry 0 Lawn Irrigation
O Radon Rock Bed 0 Mfg.
O Framing 0 Other(specify)
0.nsulation
',Er/Xs-Built Survey
Final
O Wetland Buffer
O Other(specify)
REMARKS (in-house):
Other Review: Reviewed by: Date Approved:
Access: Existing: 0 YES 0 NO New: I] YES 0 NO
OFFICIAL REMARKS-TO BE NOTED ON PERMIT AND INITIALLED
Updated- January 2013
v\forms\plan review checklist 2013 docx
6X/1—
DTE TIME
CITY OF ORONO CALLED IN / – .
INSPECTION NOTICE SCHEDULED Esztm .
PERMIT NO.°20/41-6 O Ste" COMPLETED
ADDRESS Vo b ld . c
OWNER T EPHONENO. 5461 O X03
CONTRACTOR Al1 —i-SJ�Pc 6 I
�`DE RIPTION Pco i 1�Oo
-ti/wg
W FOOTING ❑ PLUMBING FINAL EXCAV/GRADIN I
❑ G/F WNG
U.
Q ❑ URED WALL ❑ MECHANICAL RI ❑ LAKESHORENVETLANDS
v0
3 ❑ FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL
❑ 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
taj ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL
v ❑ PLUMBING RI 0 SEPTIC FINAL ❑ FOUNOAT1ON/REMOVAL
Z OWNERICONTRACTOR TO MEET YOU:_YES NO
y COMMENTS:
cc
W
0
CC
�///
0
cc
0
u. :–...- --);1 I 1/1-1(
W
CC
Q
W
W
cc
J
0
LU e, ' '•RK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE
W A ••RRECT WORK&PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY
0 CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE COVERING
PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑PHOTO TAKEN
INSPECTOR WILL RETURN ❑CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hou in advance. ,_' -r ) 249-4600
OwnedContractor on site:
Inspector. /�/
White Copyllnspector's File Canary Copy/Site Notice
Planning & Zoning
Department
Memo
To: Finance Department
From: Christine Mattson, Planning Assistant
CC: Street File
Date: November 2, 2015
G/L: 101-22205
Re: Escrow Refund
Building permit numbers 2014-00500, 2011-00977 and 2011-01003 pertaining to 840 Old
Crystal Bay Road South are complete. Please refund$2,500 to the property owner, James&
Heidi Williams.
The following is attached:
• Original signed escrow agreement
• Copy of cash register receipt showing escrow amount received
Mail to: James&Heidi Williams
840 Old Crystal Bay Road S
Wayzata, MN 55391
w:\street filesbld crystal bay rd s\8401escrow refund 2011-00977,2011-01003&2014-00500.dooc
BUILDING PERMIT ESCROW AGREEMENT
Orono Building Permit#2014-00500
qAGREEMENT made this ',"^day of J GI%-)e ,201 q by and between the CITY OF ORONO,
a Minnesota municipal corporation("City')James&Heidi Williams('Owners').
Recitals
1. A building permit application has been filed for an in-ground pool located at 840 Old Crystal Bay
Road S the("Subject Property"), legally described as the South 226.8 feet of the North 391.8 feet of the West 60
Rods of the Northeast Quarter of Section 9,Township 117,Range 23, 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 ture that is caused by the work(including planning,
engineering, or legal consultant review) associated with building permit #2014-00500 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 expanses
invoiced pursuant to #3. The City may draw from the escrow account without further approval of the Owners to
reimburse the City for eligible expenses the City has incurred.
5. CLOSING ESCROW. The Balance on deposit in the escrow, if any, shall be returned to the
Owners when all requirements related to the project are complete. City Staff shall review the terms of this escrow
agreement two times per year to determine whether the requirements of the project have been successfully
completed and whether it is appropriate to return the funds. Owner may also request the release of the funds,
and such funds shall be released upon City Staff receiving the appropriate verification that all requirements of the
project have been successfully completed.
8. 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. \.
Cl : C ,•F O t O OWNER:
4/(r�d.
By: 1 �
Its: IL it L I :
CITY OF ORONO tI'
*
2750 KELLEY PARKWAY 'K 2 0 1 - 005
4
DATE ISS4 UED: 06/05/22 014
ORONO,MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 840 OLD CRYSTAL BAY RD S
PIN : 09-117-23-12-0002
LEGAL DESC : UNPLATTED 09 117 23
: LOT 000 BLOCK 000
PERMIT TYPE : ESCROW FEE-APPLICANT
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ESCROW FEE-APPLICANT
NOTE: ADDITIONAL$1,500.00 ESCROW FOR POOL-PERMIT#2014-00500-PD CK#8726 BY OWNER
PER MELANIE EXISTING$1,000.00 ESCROW ON FILE.
APPLICANT ESCROW FEE-APPLICANT 1,500.00
TOTAL 1,500.00
HEIZMAN-WILLIAMS,JAMES WILLIMAS&HEIDI Payment(s)
840 OLD CRYSTAL BAY RD S CHECK 8726 1,500.00
WAYZATA,MN 55391-
OWNER
HEIZMAN-WILLIAMS,JAMES WILLIMAS&HEIDI
840 OLD CRYSTAL BAY RD S
WAYZATA,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 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 construction authorized is not
commenced within 180 days of the date of issuance,or if construction is
suspended for a period of 180 days at any time after work has commenced.
The applicant is responsible for assuring all required inspections are
requested in conformance with the State Building Code.This permit may be
revoked at any time for due cause.
Applicant Permitee Signature Date Issued By Signature Date
r
City of Orono
2750 Kelley Parkway
Orono MN 55356 952-249-4600
Receipt No: 3.011068 Jun 5, 2014
James Willima & Heidi Heizman-Williams
Planning and Zoning
Additional Escrow deposit 1,500.00
for Pool
101-22205
Deferred Rev-Developer Deposit
Total: 1,500.00
Check
Check No: 8726 1,500.00
Payor:
James Willima & Heidi Heizman-Williams
Total Applied: 1,500.00
Change Tendered: .00
06/05/2014 01:49PM D�
fG‘2-
DEMO, BUILDING PERMIT AND WETLAND BUFFER ESTABLISHMENT ESCROW AGREEMENT
Orono Building Permit#s 2011-00977 and 2011-01003
AGREEMENT made this day of , 20 7/, by and between the CITY OF ORONO,
a Minnesota municipal corporation ("City")and : '' ] ` ("Owners").
Recitals
1. A building permit application has been filed for a building permit located at 840 Old Crystal Bay
Road South, the ("Subject Property"), legally described as the South 226.8 feet of the North 391.8 feet of the
West 60 Rods of the Northeast Quarter of Section 9,Township 117, Range 23, 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.
4. The scope of the project which is the subject of building permit #2011-01003 triggers the
application of the City's wetland buffer requirement as established by City Zoning Code Article XI Wetlands
Protection 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. Contemptdid f this Escrow
Agreement, the Owners shall deposit$5,500 with the City. All ac Ito the Cityto
reimburse the City for its cost in administering the escrow account.
2. PURPOSE OF ESCROW. The purpose of the e Ibr shment and
development of the required native wetland buffer and reimbursen /� t costs the
City has incurred (including planning, engineering, in excess of$& G. 1' _ �'!/ ill incur in
reviewing the plan. Eligible expenses shall be consistent with exp 1 responsible for
under a building permit application and as part of the establishmen .. ',utter. The escrow will also
guarantee reimbursement to the City for all out-of-pocket costs the .. y nas 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 #2011-01003 if compliance
with the approved building permit and wetland buffer establishment 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 bale•ce • the
s -c p .•erty pursuant to Minn. Stat.§§415.01 and 366.012.
CITY: �; OF iv,O ER: .- o
By: It�1 .
Its: 1.``�► ; PPP"
°r �; ' ,,. s�i { °' `: cG �' ) ,.'a,4,° } S'.=.. s#, .. r.i. ie.-
CITY OF ORONO PERMIT NO.: 2011-01138
2750 KELLEY PARKWAY
ORONO,MN 55356- DATE ISSUED: 09/28/2011
(952) 249-4600 FAX: (952)249-4616
ADDRESS : 840 OLD CRYSTAL BAY RD S
PIN : 09-117-23-12-0002
LEGAL DESC : UNPLATTED 09 117 23
: LOT 000 BLOCK 000
PERMIT TYPE : ESCROW FEE-WETLAND
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ESCROW FEE-WETLAND
NOTE: THIS$1,000.00 ESCROW IS FOR A WETLAND BUFFER IN CONNECTION WITH PERMIT#2011-00977 AND#2011-01003.
APPLICANT ESCROW FEE-WETLAND 1,000.00
CHARLES CUDD LLC TOTAL 1,000.00
15050 23RD AVENUE N
PLYMOUTH,MN 55447-
0 i city of Orono2750.Kelley Parkway
Minnesota State License#:20635245 - Orono pe M 952-245_4600
Receipt No: 3.05 Sep 28, 2011
OWNER
WILLIAMS,JAMES&HEIDI
Charles Cutd LLC
840 OLD CRYSTAL BAY RD S
WAYZATA,MN 55391- Planning andZoning
Wetland Escrow - 00
2011-01003 t,000,
101-22
AGREEMENT AND SWORN STATEMENT Deferred Rev-Developer Deposit
The work for which this permit is issued shall be performed according to Total: 1,000.i4
the approved plans and specifications,applicable City approvals,and the
State Building Code. This permit is for only the work described and does I Credit Card
not grant permission for additional or related work which requires separate f Cheek Nor 022261 i,000.00
permits. All provisions of laws and ordinances governing this type of work Payor:
shall be compied with whether or not specified herein.This permit will Charles Cudd LLC
expire and become null and void if construction authorized is not - Total *lied; 1,004.00
commenced within 180 days of the date of issuance,or if construction is i •
suspended for a period of 180 days at any time after work has commenced. Change Tendered: .00
The applicant is responsible for assuring all required inspections are
requested in conformance with the State Building Code.This permit may be I 09/28/2011 02:13PK
revoked at any time for due cause.
Applicant Permitee Signature Date Issued By Signature Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
• CITY OF ORONO PERMIT NO.: 2011-01001
2750 KELLEY PARKWAY
ORONO,MN 55356- DATE ISSUED: 09/06/2011
(952) 249-4600 FAX: (952) 249-4616
REPRINTED ON 9/6/2011
ADDRESS : 840 OLD CRYSTAL BAY RD S
PIN : 09-117-23-12-0002
LEGAL DESC : UNPLATTED 09 117 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$2500 ESCROW IS TIED TO BUILDING PERMIT 2011-01003
APPLICANT ESCROW FEE-BUILDING 2,500.00
CHARLES CUDD LLC TOTAL 2,500.00
15050 23RD AVENUE N
PLYMOUTH,MN 55447-
0
Minnesota State License#:20635245
OWNER
WILLIAMS,JAMES&HEIDI
840 OLD CRYSTAL BAY RD S
WAYZATA,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 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 construction authorized is not
commenced within 180 days of the date of issuance,or if construction is
suspended for a period of 180 days at any time after work has commenced.
The applicant is responsible for assuring all required inspections are
requested in conformance with the State Building Code.This permit may be
revoked at any time for due cause.
l l9, l
Applicant Permitee Signature Date Iss ,/ty Sign ® Dat
�
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
City of Orono
Kelley Parkway
OronO I C 2011
Receipt No; 3.005395 Sep
Charles Cudd LLC .00
previous Balance: `.g0U,U0
2.011- s
tUii-6{€501 840 Old
Crystal BRy
101-22055
Deferred Rev-Developer _
Deposit . .,OG
Total: 22.5 000-
New Balance: __._._--._--==--
Check 2,500.00
Check No: 6015
Charles Cudd LL
2,50U,UG
Total Applied; __�___.___.r
.UU
Chance Tendered: =r______00-
09/06/2011 11:33All
DEMOLITION PERMIT 2011-00947
E CROW AGREEMENT
AGREEMENT made this 3 day of , 20// , by and between the CITY OF ORONO, a
Minnesota municipal corporation("City")and Jam &Heidi Williams("Owners").
Recitals
1. An application for a demolition permit has been filed for the principal structure and one(1)accessory
structure located at 840 Old Crystal Bay Road S ("Subject Property") legally described as described on Exhibit "A"
attached hereto.
2. In conjunction with the demolition erosion control measures are required as shown on attached
Exhibit"B"
NOW,THEREOFRE,THE PARTIES AGREE AS FOLLOWS:
1. DEPOSIT OF ESCROW FUNDS. Contemporaneously with the execution of this Escrow Agreement,
the Owners shall deposit$2,000 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 (including planning, engineering, or legal consultant review)the City has incurred to assure that
the erosion control measures are installed and maintained so the property complies with 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. If
compliance with the approved Land Disturbance Permit is not accomplished within the allowable time period, the City
may bring the project into compliance by use of the security.
3. RIGHT OF ENTRY. The Owners hereby grant 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 the required erosion control measures, including but not limited to constructing or completing any and
all of the agreed upon improvements should the Owners' contractor not complete those improvements by the date
specified herein.
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. Any remaining amount of the financial security deposited with the City for
faithful performance of the plans and specifications and any related remedial work will be released after the
completion and inspection of all such measures and the establishment of final stabilization for the Subject Property.
6. CERTIFY UNPAID CHARGES. If the project is abandoned by Owners, or if the eligible expenses
incurred City exceed the amount in escrow, the City shall have the right to certify the unpaid balance to the
subj property ursuant to Minn. Stat.§§415.01 and 366.012.
CITY: CI - • • •_, • OWNERS.
*14'k . '‘to 414 I:14 ta.
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LEGAL DESCRIPTION: Q
THE SOUTH 226.8 FEET OF THE NORTH 391.8 FEET < I< 0
OF WEST 60 RODS OF NE 1/4 SEC 9, T. 117, R.23. ( C
HENNEPIN CO., MN. LI
.�j
ADDRESS 840 OLD CRYSTAL BAY ROAD f -
PID#09 117--23--12-0002 �-. -J 1-•.
LIJ
LOT AREA = 220950 SF/ 5.07 AC Ng
SURVEY IS SUBJECT TO CHANGE PER i
TITLE OR EASEMENT INFORMATION
VERIFY ALL DIMENSIONS AND <iPt g
ELEVATIONS WITH HOUSE PLANS o l � g
ai
VERIFY ALL SETBACKS WITH CITY. N t
i .)i. i 159 t4
N4 iE
CITY OF ORONO PERMIT NO.: 2011-00977
2750 KELLEY PARKWAY
ORONO,MN 55356- DATE ISSUED: 08/31/2011
(952)249-4600 FAX: (952)249-4616
ADDRESS : 840 OLD CRYSTAL BAY RD S
PIN : 09-117-23-12-0002
LEGAL DESC : UNPLATTED 09 117 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$2,000.00 ESCROW IS TIED TO DEMO PERMIT#2011-00947
APPLICANT ESCROW FEE-BUILDING 2,000.00
CHARLES CUDD LLC TOTAL 2,000.00
15050 23RD AVENUE N
PLYMOUTH,MN 55447-0 City of Orono
2750 Kelley Parkway
Minnesota State License#:20635245 Orono /1141 55356 952-249-4600
Receipt No: 3.005366 Aug 31, 2011
OWNER
WILLIAMS,JAMES&HEIDI
2011-00947 / 840 MB Rd N
840 OLD CRYSTAL BAY RD S
WAYZATA,MN 55391- Previous Balance: .00
Permits
Escrow - Demo 2,000.00
101-22205
AGREEMENT AND SWORN STATEMENT Deferred Rev-Developer Deposit
-
The work for which this permit is issued shall be performed according to Total: 2.000.00
the approved plans and specifications,applicable City approvals,and the New Balance: 2,000.00-
State Building Code. This permit is for only the work described and does
not grant permission for additional or related work which requires separate Check
permits. All provisions of laws and ordinances governing this type of work Check No: 021871 2,000.00
shall be compied with whether or not specified herein.This permit will Payor:
expire and become null and void if construction authorized is not 2011-00947 / 840 DCB Rd N
commenced within 180 days of the date of issuance,or if construction is Total Applied: 2,000.00
suspended for a period of 180 days at any time after work has commenced. --------------
The applicant is responsible for assuring all required inspections are Change Tendered: .00
requested in conformance with the State Building Code.This permit may be 08/31/2011 03:04Pbf
revoked at any time for due cause.
Applicant Permitee Signature Date Issued By Signature Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
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