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HomeMy WebLinkAbout2014-01376 - addn/remodel/repair CITY OF ORONO 11111 It rI II! Till r I' 2750 KELLEY PARKWAY * 20 1 4 - 0 1 3 7 6 DATE ISSUED: 12/29/2014 ORONO, MN 55356- (952)249-4600 FAX: (952) 249-4616 ADDRESS : 450 OLD LONG LAKE RD PIN : 36-118-23-34-0014 LEGAL DESC : SUMMIT STATION : LOT 007 BLOCK 001 PERMIT TYPE : ADDITION/REMODEL/REPAIR PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR ACTIVITY : 434-RESIDENTIAL VALUATION : $ 250,000.00 NOTE: SEPARATE PERMITS REQUIRED: MECHANICAL,ELECTRICAL(STATE) (SMALL ADDITION WITH SMALL ATTACHED DECK) APPLICANT PERMIT FEE SCHEDULE 1,956.75 STATE SURCHARGE(VALUATION) 125.00 SCHWARZ BUILDERS INC. TOTAL 2,081.75 240 MINNETONKA AVE S, SUITE 2 WAYZATA, MN 55391 Payment(s) (952)476-6768 CREDIT CARD 1993 2,081.75 Minnesota State License#: BUIL-BC003922 OWNER POLICINSKI,CHRISTOPHER&ANNE 450 OLD LONG LAKE RD 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 assurin_all required inspections are requested in conformance with e % - ui ding Code.This permit may be revoked at any ti - or due c.f / 4 / bc11)1! 2 /g / I Applicant Permitee Signature Date Issue By Signature Date City of Orono Building Permit Application for New Structures or Additions Mailing Address: Permit number: a0/��/?J 7, ' 0A, PO Box 66 l VO Crystal Bay, MN 55323-0066 Date received: l/— h"/'`/ Street Address:' Received by: !7/j A 2750 Kelley Parkway Plan review fee: �� -- F C` Orono, MN 55356 _ t�'�ESHO�ti Main: 952-259-4600 Total Fee: ./37�-- -� Fax: 952-249-4616 www.ci.orono.mn.us a`GVnVf/ Irtc 1 {- , This application form must be completed in full and all required information must be submitted.2/ A v7S- Incomplete applications will be returned. (Please print) GENERAL INFORMATION: Job Site Address: ys& OL& LOI1J6 ,U4KE Roc) l-t,ilz af4 in Al SST' Will this be a Parade of Homes, Remodelers Showcase Home or other Disay Home? ❑ Yes 3 o /f 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: SCA war-z_ DcciIckerS -TAC_ State License# gc oo 9a o1 Expiration Date: 3/31/ 0/49 Phone: (cell) WV- 38Ce-b'vq3 Y.Vr-\-. (office) 951 -117( - - 76,(s--- Mailing Address: a4/0 Mi ncj•toAkq X vc S , rte. )0 Cit g ZIP: 5539/ Contact Person: k r-t SeK.aeu—r.. Applicant is: ontracto / Homeowner (Circle One) Email and/or Fax: kurt (6) 5du-Jar Z) 106rS . C o Y1'1 PROPERTY OWNER INFORMATION: • Name: ('_i.r(St ('e r Poi, c/n ski Phone(day): S - 3 5-aS00 Address: 4'50 OloL Loveq za4 go( City: L.Jaft-z.a,144 ZIP: 553`? Email and/or Fax c;p(id.i Ask( Q /l ndo[ s &carv'l_ ARCHITECT/ ENGINEER INFORMATION Name: s/},L j1r" % dS L 7" Phone(day): 9,5-, - j' t, - 7gq/ Address: .21-EDini/14ata .4 f9Uc S.) Surfc ..1.p/ City: (it)4 z�,fet ZIP: 5 5- 39 J Email and/or Fax: Sa 14 rc_k 97 Co gr a.i l . cart-1/4_ / 1 PROJECT INFORMATION: Descri.tion of .roject: 1.Type of Project 2. Proposed Use 3.Structure Type 4.Sewage Disposal& Water Supply ❑New Construction Single Family withResidence 2 ,ddition attached garage [Garage/Accessory Bldg. ,Public Sewer ❑ •ccessory Building ❑ Single Family with ❑Deck ❑ Relocation detached garage 0 Office/Commercial El Private Sewer ❑Other: (specify) 0 Multiple Family/Condo 0 Warehouse 0 Public 0 Storage 0 Public Water **Any earth movement may require 0 Commercial 0 Other(specify) MCWD review&permits. 0 Industrial :Private Well Minnehaha Creek Watershed District(MCWD) ❑Other: (specify) 18202 Minnetonka Blvd Deephaven,MN 55391 Phone: 952-471-0590 Fax: 952-471-0682 www.mi nnehahacreek.orq Estimated Construction Valuation (excluding land) $ c7.53-0i COO Packet Last Updated: 04/19/2013 Page 22 of 23 STRUCTURE INFORMATION: 1.Structure Dimensions 1.Structure Dimensions(continued) 2.Type of Construction a. Length(ft.)= Number of bedrooms= ood/Frame b.Width(ft.)= Number of garage stalls: ❑ asonry Areas in square feet Attached= 3 ❑Metal 0 Pole Bldg. c. Basement= //3 A Detached= ICF d. 1st Story = ,2c '511 ❑On-site Prefab e.2"d Story= ( 3D ❑Off-site Prefab f. %Story = ��4 ❑Other(please specify): g.Total Area= qq3(e REQUIRED SUBMITTALS: All of the information must be submitted in order for your application to be processed: Not Enclosed Applicable fel 0 Permit Application ,0" ❑ Proposed Building Plans ❑ �' MN State Energy Code Calculations and Mechanical Code Requirements Form )' 0 Survey(meeting all requirements) ❑ ,0 Stormwater Pollution Prevention Plan ❑ �0' Hardcover Calculation(s) ❑ Septic System Site Evaluation Report ❑ ,� Access Permit ❑ 0� Wetland Buffer Improvement Plan ❑ Engineered Plans for Retaining Walls 4 feet or above ❑ Minnehaha Creek Watershed District Permit(s) ❑ .11 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 tempo Ce ificate of Occupancy may be issued upon receipt of a$10,000 escrow to ensure completion of the as-built sury y a all site improvements. Applicant's Signature: //'Date: // Owner's Signature: Date: Packet Last Updated: 04/19/2013 Page 23 of 23 Iv Lis IT J :1-019-.-0,4 PLAN REVIEW' CHECKLIST FOR P4EVii STRUCTURES I ADDITIONS • Address/Permit Number: 41S-0 Oe-a GO 'SS Description of work: A 4161-r io Septic review by: :. :A, Date Approved: Zoning review by: / Date Approved: I Z/ / Building review by: s /. Li Date Approved: 12- - 111 Grading review by: /' Date Approved: 422- ;DI-c- / Zoning District: P Zoning File#: Reso#: Reso Date: Zoning:Lot Area: SF/AC ,�° Width: Lot Coverage: SF _% Survey Submitted: D Yes No Date of Survey: i •L' fY'1 Revised date(?): Proposed Setbacks: Front(Lake) Rear(Street) ( N Side W ) ( N S E Side W ) Other Buildings Wetland Defined Height: Peak Height: FFE: FFE minus 6 feet (Existing Contour Perimeter(linear feet)= 50%= #of Stories Ok? D YES FOR A BUILDING WITH A BASEMENT OR CRAWL SPACE: _ The distance between the lowest FOR A BUILDING ON A SLAB FOUNDATION: START WITH proposed floor(of the basement or crawl space)and the highest point of the roof. START WITH The distance between the top of slab.and If you have a the highest point of the roof. • GABLE OR HIPPED ROOF(no If you have a... windows). Subtract half the • GABLE OR HIPPED ROOF(no distance between the highest point bet een the Shighe t half the dietano of the roof to the low point of the to=between int highestpoint co s the roc SUBTRACTION corresponding gable or hipped roof SUBTRACTION g the low point of the corresponding ` gable Or him roof (BASED ON ROOF ' . GABLE OR HIPPED ROOF(with (BASED ON • GABLE OR HIPPED ROOF(with windows): Subtract half the ROOF TYPE) windows): Subtract half the distana distance between the top of the between the top of the highest highest window and the highest Window and the highest point of the point of the roof `hiaf • ALL OTHER ROOF TYPES(flat ALL OTHER ROOF TYPES{flat, mansard,.etc).No subtraction rd,etc).No sutrtradion. Subtract the distance between the ADDITION Add e diefance between the top of slab SUBTRACTION (BASED ON and the highest existing grade`adjacent to basement/crawl space floor and the (BASED ON.EXISTING highest existing grade adjacent to the GRAD EXISTING the foundation GRADES) GRADES). foundation OR 10 feet(whichever is less). EQUALS Defined building height EQUALS Defined building height Shoreland`District MCWD Permit Received Average Lakeshore Setback Met? Bluff D Yes D No N/A D Yes N D Yes No D Yes D No N/A Permit Number: ,, _ I Setback: Stormwater Quality Existing Proposed Variance Required CUP Required Overlay District Tier Hardcover Hardcover D Yes D No D Yes 13 No Type(s): Type(s): Updated: January 2013 v:\forms\plan review checklist 2013.docx REMARKS (in-house)- Fees to be Charged Y NO Permit �,. Plan Review State Surcharge investigation Fee SAC -Number of SAC Units Other(specify) Square Footage $per Square Footage Basement X = $ 1st Floor X 2"°Floor X = $ Garage X $ Estimated Construction Value: $ Z 60,606) Orono Inspections Required Work Requiring Separate Permits Required State Permits Q Site 0 Plumbing fl Grading/Filling 0 Well O Hardcover Removal eii- Mechanical 0 Fire ,%Electrical ,Footing 0 Septic D Water Connection U Poured Wall 0 Fireplace 0 Sewer Connection O Foundation Survey 0 Masonry G Lawn Irrigation O Radon Rock Bed 0 Mfg. J'a framing O Other(specify) nsulation t7 .As:Bui Survey ,p'F.inat a Wetland Buffer J Other(specify) Fo0NP e>J w1/4PILoo Fw REMARKS (in-house): Other Review: Reviewed by: Date Approved: Access: Existing: 0 YES 0 NO New: 0 YES 17 NO OFFICIAL REMARKS-TO BE NOTED ON PERMIT AND INITIALLED Updated January 2013 v:\forms'plan review checklist 2013 docx Christine Mattson From: Amanda Bednar[abednar@minnehahacreek.org] Sent: Thursday, December 18, 2014 4:22 PM To: Christine Mattson; Melanie Curtis Cc: Kurt Schwarz Subject: 450 Old Long Lake Rd- no permit required Attachments: 450 OLD LAKE RD ORONO-CERT.PDF Hello, Kurt Schwarz emailed in the attached site plan for a proposed addition located at 450 Old Long Lake Rd and plans to remove 36-40 cubic yards of material. Based on this information provided, no Minnehaha Creek Watershed District permit is required for this project. Please let me know of any questions or concerns at this time. Thank you, Amanda Bednar District Representative 15320 Minnetonka Blvd. Minnetonka, MN 55345 952-641-4581 MINNEHAHA CREEK WATERSHED DISTRICT 1 AzLOA/ CITY OF ORONO Street Address: Mailing Address: Telephone(952)249-4600 << G` 2750 Kelley Parkway P.O.Box 66 Fax (952)249-4616 ly F Orono,MN 55356 Crystal Bay,MN 55323 www.ci.orono.mn.us kESHO� December 11,2014 Kurt Schwarz Schwarz Builders, Inc. 240 Minnetonka Ave S#201 Wayzata, MN 55391 Re: Building Permit Application#2014-01376 450 Old Long Lake Road On November 26, 2014 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: 1. Certificate of Survey. A Key Plan is shown on building plans submitted; however a certificate of survey is required. Please provide two copies of an updated,full size certificate of survey which meets all of the City's survey standards(enclosed)indicating the location of the proposed additions(and any proposed grading). 2. 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 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 required escrow amount for this project is $2,500. The escrow agreement is enclosed. The property owner must sign the escrow agreement and submit a check for$2,500. Your project may trigger the Minnehaha Creek Watershed District's(MCWD) permitting requirements; please contact the MCWD directly at 952-471-0590 regarding your project. Please note, the City of Orono will not issue a building permit without a copy of MCWD permits or documentation from the MCWD stating the proposed project does not trigger any of their permitting requirements. 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 on the above requirements. Sincerely, CITY OF ORONO IBJ144:50\___" Christine Mattson Planning Assistant c Kurt Schwarz via email Christopher Policinski,via email Lyle Oman, Building Official enclosures • • RESOLUTION W. 848 RE90LUrIQt APPROVING THE PLAT OF SU'tUT STATION IMMO, the City of Orono is a municipal corporation organized and existing under the laws of the State of Minnesota; and 1IEREAS, the City Council of the City of Orono has adopted subdivision regulations for the orderly, economic and safe development of land within the City; WEAS, the City Council has considered the application for a sublivisian plat for Summit Station by Norman Nafstad; NON, 'ARE, BE IT RESOLVED, that the City Council of the City of Orono hereby approves the plat for Summit Station, Hennepin County, Minnesota, subject to the following: 1. The reimbursement to the City of engineering, legal and administrative costs incurred in reviewing and accepting the Summit Station sewer project and the plat of Suerit Station, to be satisfied by a letter of credit in the amount of $1,000.00. 2. the provisions of Resolutions 662, 726 and 826. 3. Approval of the sanitary sewer agreement. 4. The granting to the City of Orono, road and utility ea::r seats to Lot 2. S. The granting to the Citf of Orono, flowage and open space easements to Lots 1 and 2. 6. The understanding that all current zoning settick requirements are met by the open space easements on Lot 2 thereby allowing construction to the limits of Lots 3-8. 7. The payment of a park dedication fee of $6,000.00. This resolution will expire on May 1, 1978, if the aforesaid subdivision plat has not been filed with the Hennepin County Recorder's Office. In that event, it will be necessary to file a new application with the City of Orono for subdivision approval. Adopted by the City Council at their meeting of Octc')er 11, 1977. IPA /• i . . ✓i 4111. .a L.✓ William B. ' ' Nest, Mayor ATL'ESr: Walter on, ClerkfAdministrator Hennepin County GIS - Printable Map Page 1 of 1 ` Interactive Property Hennepin Maps Map 6 -,-,c-, .r ii 1r ti'_ !`' .ai .i .•, „X � i '.� ,,-;,...'i '.....41' ,„._,11' ,-4. •< 4F h.. "ICS- • . � /',..'...d4'�t ' - - /ia` ,'i'A ♦ Ali ,y _ M L , , p ryF d' r.^."4,e ^.• `.. - i ,O - r, F , w'15+ -. u "9 .4tir x , r// ♦�-(�� r v e• y i' • yid d - _ , by r ori,. Parcel 36-118-23-34-0009 A-T-B: Abstract Map Scale: 1"=100 ft. N ID: 4_ Print Date: 12/2/2014 I Owner Market Summit Station Hmownrs Assoc $0 Name: Total: Parcel 38 Address Unassigned Tax $0.00 Address: Orono, MN 00000 Total: (Payable: 2014) Property Sale Common Area Type: Price: This map is a compilation of data from various sources and is furnished"AS IS"with no Home- Sale representation or warranty expressed or stead: Non-Homestead Date• implied,including fitness of any particular purpose,merchantability,or the accuracy and completeness of the information shown. Parcel 3.73 acres Sale Area: 162,604 sq ft Code: COPYRIGHT©HENNEPIN COUNTY 2014 IA Think Green! http://gis.hennepin.us/Property/print/default.aspx?C=457934.112696343 04,4980955.31777... 12/2/2014 From: Lyle Oman LOman@ci.orononn.us ci.orono.mn.us B Subject: FW:450 Old long lake road Date: September 2,2014 at 11:10 AM To: jalarch97@gmail.com Andre, per the attached resolution the are no setback or lot coverage requirements.The only limitation is building height. Lyle Oman Building Official City of Orono TO SCHEDULE AN INSPECTION,CALL: 952.249.4600 952.249.4625-Direct Dial 952.249.4600-Main 952.249.4616-Fax www.ci.orono.mn.us Unice Hours: Monaay-rnaay u:uu am to 4:;iu pm Physical Address: 2750 Kelley Parkway Orono, MN 55356 Mailing Address: PO Box 66 Crystal Bay,MN 55323-0066 I' h1 9� DO _ • a Lir SURREY FOR: PILLAR HOMES 'R 6249 —006 193/68 ctii SCHOEU. & MADSON) INC. 1 (77-60) • wataas ••$Nn+R V s •• q ppt•S SOIL I$1 .0•• tNPOutto ,L unSC.AI IOSIO rMT?ATA 0011IZMAO. sun i / oRoNo ow M11ttKTONtA, fIM Sa703 (N!) 3+e-7eet fwltyt{-1x4$ / t; ls 1001.5* (0 6%.%),T 'N. • --..` ss 010 *�,I ,,00 ``4/ 1 (!001.3) ti -, ill , At& 9 �4 3 fo 1 $ W v $ .t '0` iif:0042j •7 ."---,--. ...af DM -6-'1, V, ei 7 . SYS s1002.b /j'- $ !!003.9; o / 1 21003.3 iv I iv 6 ' • •si • 6 • \ . — 6ilutninovs . J O ..co ... „ pJ1 v z �6' G,. A, , *' ) • 1 . .... „ -„, , Of J 1 9f• 4 d' 997.0x T�" e4, .` c;%lc fi\1'9 ), I."' , 43'•ryij I j ? .G5 "", .V.4'4; eye o► o +9. "`'7•f RETAIN/NG 1 400 (9.0' , 1 r. �....�..- .0�'* WALL. °t/i_ ?j 0 41%4" ; .��► • ' INTY OF Orit'.10 414. 4.:,-: ` ;tt••. )C , . =" . "• :• t •• t' L GI ` 4 t�. - PCU l / !�d� + S`6 e?8 E9 �� .- ---��.. —:.. ---•-- -... . '- :1002.0 . 8.5 0402.4 ' 1` ... D GENCfW. NOTES: ,gS I COMM; ' I I. • - Denotes Trott monument 7. abet I. UAW' STATION 2. *090.0 - Denotes adsting spot atevotlon. . 11¢AiARK 3. x(990.0) - Denotes proposed spot s*rwuUon. Top nut of hydrant es shown 4.�,,.-- - Denotes direction et swim s dfeinoys. v. Devotion . 1003.69 (NOVO-1929 Datum) S. Proposed wogs hoof . 1003-5 6. Proposed possallant Noor - 991.0 I Iwrspy cattily that this survey twos7. Proposed top of block • 1005.0 I Kam e UcPored s f my eve monde met tows of me Stote of k ihnefot • This domino hos been checked and :n dliitahit 49- rsr:•.ed tM !� tit day of iiii„ 1424. v Theodora D. Kerma by ."r 01 fi Otto: Oct 3. 1996 Ucense No. 17006 . • 30 0 .30 60 SO Fest ¢ t MEMORANDUM Date: December 22, 2014 To: Adam Edwards, City Engineer From: Christine Mattson, Planning Assistant c Melanie Curtis, Planning & Zoning Coordinator RE: Building Permit Number 2014-01376 Attached are building plans and survey for an addition at 450 Old Long Lake Road. Please review the attached information and provide comments by Tuesday, December 29, 2014. Please contact me or Melanie Curtis if you need additional information or if you have any questions. Thank you V�� DATE TIM CITY OF ORONO CALLED IN INSPECTIO TIC // __SCHEDULED t Cgi `\ ; ''i PERMIT N 3 It/COMPLETED ADDRESS CIS-t) G ki Lavi OWNER TELEPHONE NO.001, Sw ' d`ik- 3 CONTRACTOR 7_L..-7 R JrQ, cbbk, DESCRIPTION AtMASICh crcuy\ci5 LU ❑ FOOTING - 0 DEMO-FINAL 0 SEPTIC FINAL Q0 POUR WALL 0 PLUMBING RI 0 EXCAV/GRADING/FILLING Q ❑ FO DATION WATERPROOF 0 PLUMBING FINAL 0 TREE REMOVAL Z ADON SLAB 0 MECHANICAL RI 0 SITE INSPECTION Q FRAMING 0 MECHANICAL FINAL ❑ PROGRESS • ❑ I SULATION 0 WOOD BURNER/FIREPLACE 0 COMPLAINT Q ❑ FINAL 1:1WATER HOOK-UP 0 FOLLOW-UP W ❑ AS BUILT-SURVEY 0 SEWER HOOK-UP 0 HARD COVER REMOVAL v ❑ DEMO-SITE 0 SEPTIC INSTALL 1:1FOUNDATION/REMOVAL Z OWNER/CONTRACTOR TO MEET YOU:_YES NO c0.) COMMENTS: cc a •. j O /` O •/ u. W 2 Q 2 W Z W 5WW CI SATISFACTORY:PROCEED PROJECT COMPLETE RRECT WORK 8 PROCEED CIISSUE CERTIFICATE OF OCCUPANCY 0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY C.1 BEFORE COVERING _ PERMANENT o CORRECT UNSAFE CONDITION WITHIN HOURS- ❑ PHOTO TAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR CI CITATION ISSUED ❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 2. hours in adv. I - ,,: 2) 249-4600 Owner/Contractor on site: Inspector. White Copy/Inspector's File Canary Copy/Site Notice DATE TIME t. \k----(1- ITY OF ORONO CALLED IN i /� INSPECTIO IC SCHEDULED b�I[q Ih era) Ci) PERMIT NO S0I�r I 376, COMPLETED_ _ ADDRESS 1-45DC « LES\y (cc'-„Q Eara_ OWNER TELEPHONE� NO. Cott '. 801.N CONTRACTOR SCh(tai . , r t• DESCRIPTIONSCA- lCL-F\ W ❑ FOOTING 0 DEMO-FINAL 0 SEPTIC FINAL c ❑ POURED WALL 0 PLUMBING RI 0 EXCAV/GRADING/FILLING Q ❑ FOUNDATION WATERPROOF 0 PLUMBING FINAL 0 TREE REMOVAL ❑ RADON SLAB 0 MECHANICAL RI 0 SITE INSPECTION _ 0 FRAMING 0 MECHANICAL FINAL 0 PROGRESS i+A INSULATION 0 WOOD BURNER/FIREPLACE 0 COMPLAINT Q 0 FINAL 0 WATER HOOK-UP 0 FOLLOW-UP W ❑ AS BUILT-SURVEY 0 SEWER HOOK-UP 0 HARD COVER REMOVAL Z ❑ DEMO-SITE 0 SEPTIC INSTALL 0 FOUNDATION/REMOVAL IT 2 OWNERICONTRACTOR TO MEET YOU:_YES_NO r(., COMMENTS: cc W Q.. o115*it to . .f / ISS �- c�*/c f r cc 4T,,4eZ l o w cX r e i44.oGQal - 4A, 0 W cc die- `19 Cate / Q rkiu/f , /c deo :1is// PLOiG- f W cc iilec`i. 'Cot a frw�eo:t 4- 0 14J "PdA/ORK GWAIORK SATISFACTORY:PROCEED ❑PROJECT COMPLETE CC /CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY W 0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORE COVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTO TAKEN INSPECTOR WILL RETURN LISTOP 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: t Inspector.c-i.--- - White Copyllnspector's File Canary CopylSite Notice 7 DATE TIME CITY OF ORONO CALLED IN I• '— INSPECTION —INSPECTION NOTICE SCHEDULED 1/ —,. ..2.'/S-z) PERMIT NO. ,37k7 OMPLETED ADDRESS 50 L t / /�Q k_ OWNER /,, TE '•H/NE NO4./2 3g�1143 CONTRACTOR L� ir 4 . 5 -t— >: DESCRIPTION g tr. FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING ct ❑ POURED WALL LI MECHANICAL RI ❑ LAKESHORE/WETLANDS ❑ FRAMING ❑ MECHANICAL FINAL ❑ 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 2 ❑ DEMO-FINAL 0 SEPTIC INSTALL ❑ HARD COVER REMOVAL v 0 PLUMBING RI ❑ SEPTIC FINAL 0 FOUNDATION/REMOVAL IL Z OWNER/CONTRACTOR TO MEET YOU:_YES_NO /v� o COMMENTS: SCt>�J4cies - 6�, iz Lk▪! 11..- , ec Oro " xlVa t,I(Ael # 7 tG - - i0eiV H 0 cc a SDG - 54K0 7i"er/2t W cc Q 76E E - O/Slee-`� La oCl � 7-/OwL Gni in Z r05-5 J,,,4-6 6-1. seee' W CC 0 ❑WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE CCW ❑CORRECT WORK&PROCEED CI ISSUE CERTIFICATE OF OCCUPANCY OO 0 CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORE COVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTO TAKEN INSPECTOR WILL RETURN ❑CITATION ISSUED El STOP ORDER POSTED.CALL INSPECTOR ❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. (952) 249-4600 OwnerlContractor on site: -2&______ Inspector. /`w White Copy/Inspector's File Canary Copy/Site Notice K....: 5.,.....t____ DA E TIME CITY OF ORONO CALLED IN /✓ - — /.? INSPECTION NOTICE, / REDUCED - /5 ! • 3O PERMIT NO.c�C/ `Y—�l3 PLETED ADDRESS /5) 6L ! ! - . 7,0_,.,e, OWNER � TE ;; 0 NE NO.4(.2-- +� CONTRACTOR airb- . tr, 4 G DESCRIPTION -! ' ' 1 W 1.. ❑ FOOTING 0 DEMO-FINAL SEPTIC FINAL 14. ❑ POURED WALL 0 PLUMBING RI EXCAV/GRADING/FILLING - ❑ FOUNDATION WATERPROOF 0 PLUMBING FINAL 0 TREE REMOVAL ❑ RADON SLAB 0 MECHANICAL RI 0 SITE INSPECTION El FRAM! El MECHANICAL FINAL 0 RATED WALLS is ❑ ILATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT FINAL 0 WATER HOOK-UP 0 FOLLOW-UP ❑ S BUILT-SURVEY 0 SEWER HOOK-UP 0 FOUNDATION/REMOVAL si0 DEMO-SPTIC INSTALL 2 OW NTRACTOR MEET YDU YES NO r0.) CO MENTS: cc W a J O ). cc O W CC Q 1 irillarlf,alar cc /Idol'- ' — Ir LU0 WORK SATISFACTORY:PROCEED t<PROJECT COMPLETE W 0 CORRECT WORK&PROCEED 0 ISSUE CERTIFICATE OF OCCUPANCY 9 0 CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORE COVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. 0 PHOTO TAKEN INSPECTOR WILL RETURN ❑CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 ho in advance. (952 249-4600 OwnerlContractor on site: Inspector. �41/ White Copylnspector's File Canary CopylSite Notice 5 7,70 DESCRIPTION OF PROPERTY SURVEYED 99 • . PRw 65.00 Lot 7, Block 1, SUMMIT STATION, according to the recorded plat thereof, Hennepin I� "i.T� R „ County,MN. _ R 47 15 D o6 Z�.�`\` , �9 �'qp� r 7.70 1) Parcel Area Information:The Gross land area is 11,994+/-square feet or 0.28+/- 0, 1 964 I 9 919•/ �. i_Li 1 �- C= , ,, / acres. ��,�� �� C B =N 26.45 41 E 2) Site Elevation: Elevations are based on MN/DOT Geodetic Station Name:ELWELL Nr`09'18"E 117.50 which has an elevation of:980.362 feet(NAVD88). I 0004 o0 i BIR 2L' ,� _ 3) Zoning Information:The current Zoning for the subject property is PRD(Planned 2 �� 'C+ LE. FND IP 4374 LEAN NE. IN 3) Residential District)per the City of Orono's zoning map dated March 2011. a 0 00 +/ /0, `?Zit �' 0 4) Existing utilities shown are shown in an approximate way only. The contractor shall 9 a / .17 / determine the exact location of any and all existing utilities before commencing 9�3 0 0 o!s -' /o ., o work. He agrees to be fully responsible for any and all damages arising out of his 7- z I .. oq / /0 02� _ / S. 'y, \ failure to exactly locate and preserve any and all existing utilities. \99.), PAD IC \ l O,, • 002 r�` •¢ N ' � o/003.0 "v i ,l 5) Must maintain a minimum 2%slope gradient to accommodate positive drainage. .#700 F/ 2 1 OT „ \ /1 0024 �l CO � _ Ii / 6) All offset irons are measured to hundredths of a foot and can be used as L"`J 1 _I benchmarks. • ��.6 CONC 2 t.X9.1_ a `�� OD �+ 35.3/ WAL 4.7 7) A title opinion was not furnished to the surveyor. / .9e6 \ 0) I o,� w (� � BFE= ./5.8 °j - z J l[ 995.9 FFE='7,i.): T 8) This is a full boundary and partial topography survey. / O Q (( 1006.0 i n r / vi3 L_�/ 1 \_ P� ` 99a2 X99. RECEIVED Lu D BUSH �fi' BUSH Q 99Re O" EX. HOUSE X998, °�:BµSH 9984 Li Z M DEC 1 9 2014 LA BAS i6;1 BUSH 995.4 + > v Co 1000.2 � �� BLOCK c� CITY OF ORONO BUSH r BUSH °��' LOE= Z ��gg ' BUSH ��83 9184 999.1 s 3II /- ra-9.5/" 0 3.7/ 9985 00�VI �`" BUSH ':::-_;-,,;--,2 <r\ -- Pati lo' �' PROPt D ORU9 COPY r a IO 5 _17.241-- z Z �s �l j I hereby certi that this surve Ian or report was prepared by me or under my direct .; s supervision an that I am a du icensed Land Surveyor under the laws of the State PIN 15° 99 ��= +99aa99o,`� 13.0 �00� of Minnesota. :, I E 128.81 _ O �!s FND IP I/2" STS C /0030 N 26.25'16" Dated this 18th�ia of Decemb ,2 14. 1002.9 �� p3 4 Off^ �) /0, 39 C �o � +� ------ PIN David B.Pemberton,PLS Minnesota License No.40344 •0026 .1- /O S\ o4W ALL /0913 .�. pemberton@sathre.com CITY OF ORONO � 03 DECIDUOUS 4" PIN 6" o� •9 1005.0 SURVEY LEGEND l003.3,0 _SITE PLAN PV GRADING PIAN-- 1 ^T ` O• CAST IRON MONUMENT E A/C UNIT '� ..:<Z BITUMINOUS _i- -f7 L_ I I ® CATCH BASIN 1 CABLE TV PEDESTAL Cu-CABLE TV _/ / /00S oOS <1 FLARED END SECTION ELECTRIC TRANSFORMER CONCRETE CURB 2 3 -K!AP I�� Hr PROVED 99 GATE VALVE ® ELECTRIC MANHOLE DECIDUOUS 4' / 1006.6 A < GUY WIRE O ELECTRIC METER I CONCRETE / 0 A PEEO.VED ' 0 --CONTOUR EXISTING yJSS► (J H REVISIONS b HYDRANT ® GAS METER ��CONTOUR PROPOSED PIN 10 1005.` ------1:1 DISAPPROVED 0 IRON PIPE SET ® GAS VALVE _ DRAIN TILE � � 1004.5 / f`�BIF IRI r/ � • IRON PIPE FOUND - HAND HOLE L. ELECTRIC UNDERGROUND F 5 BUSH OV 0 LIGHT POLE y° SOIL BORING -A-a-FENCE HN L)" -� OOJ... ALL BUSH 2,0 -, POWER POLE I TREE CONIFEROUS V GASRLNDERGROUND OPTIC CROWD © SANITARY MANHOLE ) TREE DECIDUOUS \\ TELEPHONE MANHOLE -OM OVERHEAD UTILITY 1004.? / ^/� n/ / 5 sG CD DATE �C)i',G • Y A//"s GROUND ELEVATION m TELEPHONE PEDESTAL " SANITARY SEWER ® STORM DRAIN ® UTILITY MANHOLE STORM SEWER © STORM MANHOLE © UTILITY PEDESTAL -TIL TELEPHONE UNDERGROUND / O YARD LIGHT 1773)SANITARY SEWER ELEVATION 99- UTILITY UNDERGROUND -T.•PROPOSED SILT FENCE (972.5)PROPOSED ELEVATIONI WATERMAIN JOB#:79718-001 REVISIONS ��RS suR` CERTIFICATE OF SURVEY FIELD CREW:CL,AT CT '6 SATHRE-BERGQUIST, INC. PREPARED FOR W -"' SCHWARZ BUILDERS INC. Zo �o 0 10 20 40 DRAWN BY: JJA IN _•_ _MI m y 150 SOUTH BROADWAY WAYZATA,MN.55391 (952)476 6000IIMI CHECKED BY: DBP Nc �.i' 450 OLD LAKE ROAD DATE: 12-18-14 tiFRs P`P CITY OF ORONO,MINNESOTA SCALE IN FEET P t •=20/4/- 6/ 37-6 Planning & Zoning Department Memo To: Finance Department From: Christine Mattson, Planning Assistant CC: Street File Date: March 24, 2016 G/L: 101-22205 Re: Escrow Refund Building Permit #201401376 pertaining to 450 Old Long Lake Road is complete. Please refund $2,500 to the applicant, Christopher Policinski. The following is attached: • Original signed escrow agreement • Copy of cash register receipt showing escrow amount received Mail to: Christopher Policinski 450 Old Long Lake Road Wayzata, MN 55391 w:\street files\old long lake rd\450\escrow refund form 2014-01376.docx BUILDING PERMIT ESCROW AGREEMENT • Orono Building Permit#2014-01376 t 3, '1 AGREEMENT made this I� day of beCQ( , 2014, by and between the CITY OF ORONO, a Minnesota municipal corporation ("City") Christopher Policinski ("Owners"). Recitals 1. A building permit application has been filed for a deck and an addition. located at 450 Old Long Lake Road the ("Subject Property"), legally described as Lot 7, Block 1, Summit Station, Hennepin County, Minnesota. 2. Owners request the City to review this application. 3. The City will commence its review of the application and incur costs associated with said review only if the Owner establishes an escrow to ensure reimbursement to the City of its costs. NOW THEREFORE,THE PARTIES AGREE AS FOLLOWS: 1. DEPOSIT OF ESCROW FUNDS. Contemporaneously with the execution of this Escrow Agreement, the Owners shall deposit$2,500 with the City. All accrued interest, if any, shall be paid to the City to reimburse the City for its cost in administering the escrow account. 2. PURPOSE OF ESCROW. The purpose of the escrow is to guarantee reimbursement to the City for all out-of-pocket costs the City has incurred (including planning, engineering. in excess of $500, or legal consultant review) or will incur in reviewing the plan. Eligible expenses shall be consistent with expenses the Owners would be responsible for under a building permit application. The escrow will also guarantee reimbursement to the City for all out-of-pocket costs the City has incurred to assure that the work is completed in accordance with the Stormwater Pollution Prevention Plan and the provisions of Orono City Code Chapter 79. The financial security may also be used by the City to eliminate any hazardous conditions associated with the work and to repair any damage to public property or infrastructure that is caused by the work (including planning, engineering, or legal consultant review) associated with building permit #2014-01376 if compliance with the approved building permit is not accomplished. 3. MONTHLY BILLING. As the City receives consultant bills for incurred costs, the City will in turn send a bill to the Owners. Owners shall be responsible for payment to the City within 30 days of the Owners' receipt of bill. 4. DISBURSEMENT FROM ESCROW ACCOUNT. In the event that the Owners do not make payment to the City within the timeframe outlined in #3 above, shall issue a Stop Work Order until the Owners pay all expenses invoiced pursuant to #3. The City may draw from the escrow account without further approval of the Owners to reimburse the City for eligible expenses the City has incurred. 5. CLOSING ESCROW. The Balance on deposit in the escrow, if any, shall be returned to the Owners when all requirements related to the project are complete. City Staff shall review the terms of this escrow agreement two times per year to determine whether the requirements of the project have been successfully completed and whether it is appropriate to return the funds. Owner may also request the release of the funds, and such funds shall be released upon City Staff receiving the appropriate verification that all requirements of the project have been successfully completed. 6. CERTIFY UNPAID CHARGES. If the project is abandoned by Owners, or if the eligible expenses incurred by the City exceed the amount in escrow, the City shall have the right to certify the unpaid balance to the subject property pursuant to Minn. Stat. §§415.01 and 366.012. CITY: QTY OF RONO OWNER: By: 1l�U � Its: TI i I ii t �.1]6f1 1 , /4� lS®1, 44,„„,) 4:14:°°:-1 s ;y • CITY OF ORONO 11 I III * 2014 - 01449 *4 2750 KELLEY PARKWAY DATE ISSUED: 12/19/2014 ORONO,MN 55356- (952)249-4600 FAX: (952)249-4616 ADDRESS : 450 OLD LONG LAKE RD PIN : 36-118-23-34-0014 LEGAL DESC : SUMMIT STATION : LOT 007 BLOCK 001 PERMIT TYPE : ESCROW FEE-TIED TO BUILDING PERMIT PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ESCROW FEE-TIED TO BUILDING PERMIT NOTE: ESCROW FOR BUILDING PERMIT#2014-01376-PD CK#15649 BY SCHWARZ BUILDERS APPLICANT ESCROW FEE-BUILDING 2,500.00 SCHWARZ BUILDERS INC. TOTAL 2,500.00 Payment(s) 240 MINNETONKA AVE S, SUITE 2 CHECK 15649 2,500.00 WAYZATA,MN 55391 (952)476-6768 Minnesota State License#:BUIL-BC003922 OWNER POLICINSKI,CHRISTOPHER&ANNE 450 OLD LONG LAKE RD 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 as uri :all required inspections are requested in conform.. ce with t S :t,Buil g Code.This permit may be revoked at any ti f• • e catr, �. 9 yLie �� 79/ Applicant 'ermitee Sign. re Date Issued By Signature Date City of Orono 2750Kelley e ey5356waY OronoMN 952-249-4600 Receipt No: 3.012484 Dec 19. 2014 Schwarz Builders Inc. Planning and Zoning 2,500.00 2014-01449 450 Old Long Lake Rd 101-22205 Deferred Rev-Developer Deposit___-_-_-- Total: ______2_500 00_ Check 2,500.00 Check No: 15649 Payor: Schwarz Builders Inc. 2,500.00 Total Applied: _______________ .00 Change Tendered: _ _____________ 12/19/2014 11:36-AM