HomeMy WebLinkAbout2013-00100 - new structure ' • •• CITY OF ORONO I 4 I� I 1 I 11 '�i 1� '1 11 * 20 1 3 - 00 1 00 *
2750 KELLEY PARKWAY DATE ISSUED: 02/26/2013
ORONO,MN 55356-
(952) 249-4600 FAX: (952)249-4616
ADDRESS : 665 ORCHARD PARK RD
PIN : 31-118-23-11-0005
LEGAL DESC : UNPLATTED 31 118 23
: LOT 000 BLOCK 000
PERMIT TYPE : NEW STRUCTURE
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : SINGLE FAMILY
ACTIVITY : 101-SINGLE FAMILY HOUSES,DETACHED
VALUATION : $ 450,000.00
NOTE: SEPERATE PERMITS REQUIRED:PLUMBING, MECHANICAL, FIREPLACE,
LAWN IRRIGATION, WELL(STATE),ELECTRICAL(STATE)
ADV.PLAN REVIEW OF$2,051.89 PD CHECK#2718,BY SYSTEMS BUILT,INC.
NOTE: A FOUNDATION SURVEY REQUIRED PRIOR TO FRAMING INSPECTION. INITIAL:
NOTE: CI ` • ROVAL OF AN AS BUILT SURVEY REQUIRED PRIOR TO CERTIFICATE OF CUPANCY ISSUANCE.
INITIAL: /��
*WETLAND t FFER MUST MEET CITY CODE STANDARDS PRIOR TO ISSUANCE OF A C.O.-ADDITIONAL PLANTINGS AND/OR
INVASIVE SPECIES REMOVAL MAY BE REQUIRED(SEE CITY ENGINEER COMMENTS).
NOTE: BE AWARE,IN THE EVENT 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 PERMIT FEE SCHEDULE 3,156.75
SYSTEMS BUILT,INC. STATE SURCHARGE(VALUATION) 225.00
5159 MAIN STREET TOTAL 3,381.75
MAPLE PLAIN,MN 55359-
(763)479-5555
Minnesota State License#: BC636167
OWNER
REYNOLDS, WILLIAM&MOLLIE
3630 LIVINGSTON AVE
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
re. ested in co ormance with the State Building Code.This permit may be
risked at` e or due cause.
,A _ / Z / 26 / l3 / /
•pp i an •ermite Signature Date Issued y Si ture ate
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED AB E.
City of Orono
Building Permit Application
for New Structures or Additions
Mailing Address. 3_od/OQ
o,, PO Box 66
Permit number: /
0 Q Crystal Bay, MN 55323-0066 Date received: 47—/p2"13
A ' e A. Street Address:'
Received by: �7
��� ��A):t � �t' 2750 Kelley Parkway Plan review fee: ci d 6/ $9
\kestio'� Orono, MN 55356 ak) 3 _'OO�9
Total Fee: v,
Main: 952-249-4600 Fax: 952-249-4616 www.ci.orono.mn.us
This application form must be completed in full and all required information must be submitted.
Incomplete applications will be returned. (Please print)
GENERAL INFORMATION:
Job Site Address: “,S O,rrive-,L&,-k I jtct-
Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes Z 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: S J /I- i . cLia Sync,- ci (3u; (4cr-.r
State License# Expiration Date: 3/3///3
Phone: 7G,3 ^ q79- S5-5-5- (office) (,l 2- 2,09- Sq/6 (cell)
Mailing Address: 5')5/ Ma'n Sf; t eox 3/PZ Cit :/Y(„pp((a;,, ZIP: SS3.,7
Contact Person: (,,r,,�/ ,'rn kin son Applicant is: ontrabtor / Homeowner (circle One)
Email and/or Fax: Jo tin 5,,,,it� wausatyhame,s _cy n.1
PROPERTY OWNER INFORMATION:
Name: 8i1( °f' Mollie- IQ 1, rtvaS
Phone(day): (,1 2 - 9 y0- 57 `/7
Address: 3(,30 L;vIreys++on Ave, City:way?-a,--rt ZIP: .S5-3? I
Email and/or Fax Mollie-wr 8- i ma;(. cowl
ARCHITECT/ENGINEER INFORMATION:
Name: Wcu.s,iA l-fowl&S " Suyt.crrc Qu; (1.4„(1--
Phone(day): 703- 4 7f- SETS"
Address: 6-icol ,fgarn 0_ t3ok 38z. City:frL /Z 04ik ZIP: .SSS357
Email and/or Fax: ;t,y,,SanJ ®, l../a.SRul7orHes.car►,
PROJECT INFORMATION:
1.Type of Project 2.Proposed Use 3.Structure Type 4.Sewage Disposal&
Water Supply
ErNew Construction ®Single Family with in Residence
❑Addition attached garage ❑Garage/Accessory Bldg. 0 Public Sewer
❑Accessory Building ❑ Single Family with ❑ Deck
❑ Relocation detached garage ❑Office/Commercial 0 Private Sewer
• ❑Other: (specify) ❑Multiple Family/Condo ❑Warehouse
0 Public 0 Storage ❑ Public Water
**Any earth movement may require 0 Commercial ❑Other(specify)
MCWD review&permits. 0 Industrial [Sr 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) $ 1/S Z 000
Packet Last Updated: 03-06-2012
,o1
•
STRUCTURE INFORMATION:
1.Structure Dimensions 1.Structure Dimensions(continued) 2.Type of Construction
//�//
a. Length(ft.)= 7� '
Number of bedrooms= 3
tgi Wood/Frame
b.Width(ft.)= g Number of garage stalls: ❑Masonry
Areas in square feet Attached= 2 I=1 Metal
0 Pole Bldg.
c. Basement= Detached=
d. 151 Story = zoos. ❑ ICF
0 On-site Prefab
e.2nd Story=
0 Off-site Prefab
f. 1/2 Story = —
-
❑Other(please specify):
g.Total Area=
REQUIRED SUBMITTALS:
All of the information must be submitted in order for your application to be processed:
Not
Enclosed Applicable
fll ❑ Permit Application
❑ Proposed Building Plans
❑ 0 MN State Energy Code Calculations and Mechanical Code Requirements Form
ist 0 Survey(meeting all requirements)
®' 0 Stormwater Pollution Prevention Plan
O Si Hardcover Calculation(s)
❑ 0 Septic System Site Evaluation Report
O ® Access Permit
O 0 Wetland Buffer Improvement Plan
❑ til Engineered Plans for Retaining Walls 4 feet or above
NI 0 Plan Review Fee
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 Signature: - 0111;41-----
Date: 2/l(/f 3
Owner's Signature: r/j/ / e i� • Date: Z-//(7/3
Packet Last Updated: 03-06-2012 / I
-22 -
Lid[ L EVrartf CHEC(LM7 FOR NEW .LIciU a I ADC6T *
Address/Permit Number: ✓ P6-6/vie.-
Description of w orfs: ijat/ I%,
• SeSeptic review by: t2 . /
p Date Approved: - 13 1
Zoning review by: _:1.. �l Date Approved: erfi JS
i3uifctirtg review by: Date Approved: t�
Grading review by: h .,/ Date Approved:
Zoning District: /{ Zoning File#: --0 Reso#: -' Reso Date: —Di
Zoning: Lot Area: ,, SF I AC Width: Lot Coverage: SF %
Survey Submitted: I Yes in: No Date of Survey: V I ef 115 Revised date(?):
Proposed Setbacks: tfotitAV
•
Front(Lake) Rear(Street) ( N S E W ) ( (`' S E N ) Other Buildings Wetland
Side Side
170
I it • r �� 6
Defined Height: #s, Peak height: ,, FFE: taO°fP FFE rtf e _= o t/(E,istfrtg Contour
Perimeter(linear feet)_ Voq,CP 50%_iO #of StoresZ O ' I YES
FOR A BUILDING WITH A BASEMENT OR CRAWL SPACE:
The distance between the lowest FOR A BUILDING ON A SLAB FOUNDATION:
/jam START WITH proposed floor(of the basement or crawl
o 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.
GABLEOR HIPPED ROOF(no if you have a...
6 Subtract half Othe • GABLE OR HIPPED ROOF(no
windows).distancebetween the highest point windows): Subtract half the distanc
of the roof to the low point of the between the highest point of the roc
to the low point of the corresponding
I 77 SUBTRACTION corresponding gable or hipped roof
• GABLE OR HIPPED ROOF(with SUBTRACTION gable or hipped roof
.
(BASED ON ROOF (BASED ON GABLE OR HIPPED ROOF(with
TYPE) windows): Subtract half the ROOF TYPE) windows): Subtract half the distanc
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 roof
J
e ALL OTHER ROOF TYPES(flat, a ALL OTHER ROOF TYPES(flat,
�,, mansard,etc)-No subtraction mansard,etc).No subtraction.
ADDITION Add the distance between the top of slab
Subtract the distance between the
yUBTRACTION (BASED ON and the highest existing grade adjacent tc
' F I ,(BASED ON EXISTING basement/crawl space floor and the EXISTING the foundation.
�' ��� GRADES) highest existing grade adjacent to the GRADES)
ay foundation OR 10 feet(whichever is less). EQUALS Defined building height
1,*//j EQUALS Defined building height
Shoreland District kriClr_"D Permit Received Average Lakeshore SKRet? flub.lli ;'
UYes 'o ! Yes nNo ® N/A c` ED Yes _f ' O
U Yes U No \ /A •
Permit Number: -
Setback:
StormwEter Quality Existing Proposed
Overlay District Tier Hardcover l Hardcover Variance RequiredCUP Required
i-
U Yes AlO l Yes ,-No
Type(s): Type(s):
Updated* January 2013
v:\forms\plan review checklist 2013.docx
REQ £RKS (in-house):
Fees to he Clued Y . NO
Plan Review
state Surcharge
Investigation Fee
SAC-idumeber of SAC Units
Other(specify)
Square Footage S per Square Footage
•
Basement X - $
1°t Floor X = $
2nd Floor X = $
Garage X = $
Estimated Construction Value: i____
Orono Inspections Required Work Requiring Separate Permits Required State Permits
Cl Site rS.Plumbing 13 Grading/Filling D Well
® Hardcover Removal Mechanical ® FireElectrical
ooting O Septic 13 Water Connection
.1.-.Poured Wall Z Fireplace CI Sewer Connection
Foundation Survey 12 Masonry Lawn Irrigation
adon Rock Bed 12 Mfg.
_Framing 13 Other(specify)
Insulation
y_As-Built Survey
AFinal
Wetland Buffer
Cal Other(specify)
REMARKS (in-house):
Other Review: Reviewed by: Date Approved:
Access: Existing: EY YES i s NO New: I5 YES D NO
OFFICIAL REMARKS -TO BE F CTED ON PERMIT AND INITIALLED
r _ t
4Y i 'r r, ` j.e"1.0.,- s C/;s y r J ", ;u 4Y, fl .ri �N?:31 wt�l �1✓
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exi " d !�^l( V4,-44
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Updated January 2013
•
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Exhibit M: New Construction Energy Code Compliance Certificate
Per N1101.8 Building Certificate.A building certificate shall be posted in a permanently visible location Date 1 2/5/20131
inside the building. The certificate shall be completed by the builder and shall list information and values
of components listed in Table N1101.8.
Mailing Address of the Dwelling or Dwelling Unit City S
665 Orchard Park Rd. Orono .,�..„,,.,. . . .,.
Name of Residmfiel Cmtractor MN Lionise Number
Systems Built, Inc., d.b.a. Suncrest Builders BC636167
THERMAL ENVELOPE RADON SYSTEM
Type:Check All That Apply X Passive(No Fan)
Total R- Active(With fan and monometer
Value of or other system monitoring device)
all Types
Insulation Location of
Insulation NA Fib Fibt Foan Foat Mir Rigi Rigic Other Please Describe Here
Below Entire Slab X
Foundation Wall X Exterior
Perimeter of Slab on Grade X
Rim Joist(Foundation) X interior
Rim Joist(1st Floor'-) X
Wall X
ceiling,fiat X
Ceiling,vaulted X
Bay Windows or cantilevered areas X
Bonus mom over garage X
Describe other insulated areas
Windows&Doors Heating or Cooling Ducts Outside Conditioned Spaces
Average U-Factor(excludes skylights and one door)U: 0.32 Not applicable,all ducts located in conditioned space
Solar Heat Gain Coefficient(SHGC): 0.28 R-value
MECHANICAL SYSTEMS Make-up Alr Select a Type
Appliances Heating System Domestic Water Heater Cooling System Not required per mech.code
Fuel Type Geothermal Nat. Gas Geothermal X Passive
Manufacturer Water Furnace A.O. Smith Water Furnace Powered
Interlocked with exhaust device.
Model TBD TBD TBD Describe:
Input in Capacity Output in Other,describe:
BTUS: in Gallons: Tons:
Rating or Size
Heat Loss: 54300 Heat Gain: 31600 Location of duct or system:
Structure's Calculated
AFUE or SEER: 21
HSPF%
4.1 Calculated
cooling load: 31600
Efficiency Cfm's
"round duct OR
Mechanical Ventilation System "metal duct
Describe any additional or combined heating or cooling systems if installed:(e.g.two furnaces or air Combustion Air Select a Type
source heat pump with gas back-up furnace): Not required per mech.code
Select Type X Passive
X Heat Recover Ventilator(HRV) Capacity in cfms: Low: 67 High: 137 Other,describe:
Energy Recover Ventilator(ERV)Capacity in cfms: Low: High: Location of duct or system
Continuous exhausting fan(s)rated capacity in cfms:
Location of fan(s),describe: Cfm's
Capacity continuous ventilation rate in cfms: "round duct OR
"metal duct
Total ventilation(intermittent+continuous)rate in cfms:
.z
. 66, .,,-- oRGH O P k 110
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SeC. DATE TIME
CITY OF ORONO CALLED IN '7-a 7
INSPECTION NOTICE SCHEDULED 1/43 - /-/3 I:3-4
PERMIT NOr.12O/3—d O/e7Z7 COMPLETED
ADDRESS S 49rC-442- �
OWNER TELEPHONE NO. '/Z 328 / 7 (68
CONTRACTOR Jin-& -
__II / `_ I
DESCRIPTION ��O T` ��
LU• 0 FOOTING 0 PLUMBING FINAL ❑ EXCAV/GRADING/FILLING
Q 0 POURED WALL 0 MECHANICAL RI ❑ LAKESHORENVETLANDS
C/ ❑ FRAMING 0 MECHANICAL FINAL
11 TREE REMOVAL
• 0 INSULATION 0 WOOD BURNER/FIREPLACE 0 SITE INSPECTION
Q ❑ RADON SLAB 0 WATER HOOK-UP 0 PROGRESS
❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT
• 0 DEMO-SITE 0 SEPTIC MAINT. ❑ FOLLOW-UP
• ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL
❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL
Z OWNER/CONTRACTOR TO MEET YOU:_YES_NO
o COMMENTS:
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WCC IWORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE
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OO ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
✓ 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 hours in advance. (952) 249-4600
Owner/Contractor on site: /
11r3 LIS
Inspector. �./ i/-'"��
White Copylinspector's File Canary CopylSite Notice
—ON DATE TIME
CITY OF ORONO CALLED IN
INSPECTION NOTICE /y/� SCHEDULED - 13 A:06
PERMIT NO.�/3 UdIV v COMPLETED
25 �/q/,
ADDRESS do`"
OWNER TELEPH N cb".°3 e--/7
CONTRACTOR CU---n-C.
DESCRIPTION 0-7/(/Le t C�
LijLL.
❑ FOOTING I=1 PLUMBING FINAL 0 EXCAV/GRADING/FILLING
Q 0 POURED WALL 0 MECHANICAL RI ❑ LAKESHORENVETLANDS
ti ❑ FRAMING 0 MECHANICAL FINAL
El TREE REMOVAL
0 INSULATION 0 WOOD BURNER/FIREPLACE 0 SITE INSPECTION
❑ RADON SLAB 0 WATER HOOK-UP 0 PROGRESS
❑ FINAL 0 SEWER HOOK-UP 0 COMPLAINT
v 0 DEMO-SITE 0 SEPTIC MAINT. 0 FOLLOW-UP
i ❑ DEMO-FINAL 0 SEPTIC INSTALL 0 HARD COVER REMOVAL
❑ PLUMBING RI ❑ SEPTIC FINAL 0 FOUNDATION/REMOVAL
Z OWNER/CONTRACTOR TO MEET YOU:_YES_NO
o COMMENTS:
CC
LU
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LuWORKSATISFACTORY:PROCEED ❑ PROJECT COMPLETE
W ElCORRECT WORK&PROCEED 0 ISSUE CERTIFICATE OF OCCUPANCY
9 0 CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
0 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 hours in advance. (952) 249-4600
Owner/Contractor on site:
Inspector. Lk,/ ,
White Copy/Inspector's File Canary Copy/Site Notice
DA.15
TIME
CITY OF ORONO DIN — v`
INSPECTION OTICE a�/ CHEDULEDMire- 9:
PERMITNO. /�- CO 'LETED /)
ADDRESS h5 / ' pet.uc_. (t',t.
OWNER TEL 1P • E NOla D._3 Zo O 6
CONTRACTOR 401.°.1A-4111, J_ /__4 %- i_A _2/ - _ 1
Air
j: DESCRIPTION
LU0 FOOTING 0 PLUMBING FINAL EXCAV/GRADING/FILLING
Q ❑ POURED WALL 0 MECHANICAL RI ❑ LAKESHORE/WETLANDS
y ❑ FRAMING ❑ MECHANICAL FINAL
Q ❑ TREE REMOVAL
• 0 INSULATION 0 WOOD BURNER/FIREPLACE 0 SITE INSPECTION
Q 0 RADON SLAB 0 WATER HOOK-UP 0 PROGRESS
0 FINAL ❑ SEWER HOOK-UP 0 COMPLAINT
v 0 DEMO-SITE 0 SEPTIC MAINT. 0 FOLLOW-UP
0 DEMO-FINAL 0 SEPTIC INSTALL 0 HARD COVER REMOVAL
v 0 PLUMBING RI 0 SEPTIC FINAL ❑ FOUNDATION/REMOVAL
<---- OWNER/CONTRACTOR TO MEET YOU:_YES_NO
o COMMENTS:
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W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
O ElCORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ 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: � /�
r“
Inspector. l/J��
White Copy/Inspector's File Canary Copy/Site Notice
1 •
DATE TIME Jr
CITY OF ORONO CALLED IN
INSPECTION NOTICE SCHEDULED 3-13-13
PERMIT NO. 1-013 -OOtCO COMPLETED 3-15
ADDRESS (P(I6 O I vl d Pct 124
OWNER TELEPHONE NO.
CONTRACTOR �" L
> y. DESCRIPTION 1 6UIv1 ' v- ii 1"I
❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING
Q 0 POURED WALL 0 MECHANICAL RI ❑ LAKESHORE/WETLANDS
❑ FRAMING ❑ MECHANICAL FINAL
El TREE REMOVAL
• 0 INSULATION 0 WOOD BURNER/FIREPLACE ❑ SITE INSPECTION
• ❑ RADON SLAB 0 WATER HOOK-UP ❑ PROGRESS
0 FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT
v 0 DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP
_ 0 DEMO-FINAL ❑ SEPTIC INSTALL 0 HARD COVER REMOVAL
0 PLUMBING RI ❑ SEPTIC FINAL 0 FOUNDATION/REMOVAL
Z OWNER/CONTRACTOR TO MEET YOU:_YES_NO
o COMMENTS:
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W• 0 WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE
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• 0 CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
C) 0 CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
c BEFORE COVERING
PERMANENT
0 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. 4 co mace M.
White Copy/Inspector's File Canary Copy/Site Notice
50- DATE TIME
V
CITY OF ORONO CALLED IN 22. /}
INSPECTION TI SCHEDULED `f-23-i_- / ,3L
PERMIT NO. XO�4t'/' c COMPLETED
ADDRESS (275 OCCka-tc/ 6:31P-C1 `L _
OWNER TELEP ONE NO. 763 7q SS1,5
CONTRACTOR S -- = T 5 3 -LA__c_
• DESCRIPTION Fra4m...6.44_52-r
j ❑ FOOTING 0 PLUMBING FINAL 0 EXCAV/GRADING/FILLING
ct 0 POURED WALL 0 MECHANICAL RI 0 LAKESHORE/WETLANDS
ti 0 FRAMING 0 MECHANICAL FINAL
❑ TREE REMOVAL
Z
0 INSULATION 0 WOOD BURNER/FIREPLACE 0 SITE INSPECTION
Q 0 RADON SLAB 0 WATER HOOK-UP 0 PROGRESS
0 FINAL 0 SEWER HOOK-UP 0 COMPLAINT
✓ 0 DEMO-SITE 0 SEPTIC MAINT. ❑ FOLLOW-UP
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0 DEMO-FINAL 0 SEPTIC INSTALL ❑ HARD COVER REMOVAL
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DATE TIME
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INSPECTION NOTICE SCHEDULED 7-2.5--13 g:30
PERMIT NO.O74/3^ UO lOD COMPLETED ,/
ADDRESS 6o( J5 Dec�a, Rd,
OWNER TELEPHONE NO. 2b3 41179 55S-S
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CERTIFICATE OF SURVEY FOR
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LEGAL DESCRIPTION OF PREMISES : j NQ O
The North 20.0 rods of the South 30.0 rods of the Southeast Quarter SOUTH 1/4 LINE OF NE
of the Northeast Quarter of the Northeast Quarter of Section 31, SE4 c4
4 1/4 \
•i bF NE 1/4 OF / v .<
Township 118 North, Range 23 West of the 5th Principal Meridian. SEC. 31-118-23 111,
o : denotes iron marker rr ll
__917.--: denotes existing contour line, per City of Orono maps *NOTE: SINCE NO WETLAND DELINEATION V
HAS BEEN DONE, THE 45 FOOT SETBACK 80 40 0 40 80 r4
Bearings shown are based upon an assumed datum. HAS BEEN SHOWN FROM THE 984 CONTOUR O r1
I
FOR ILLUSTRATION PURPOSES. THIS WOULD I I I--�—
This survey shows the boundaries of the above described property, the location of CHANGE BASED ON AN ACTUAL DELINEATION I — 1
five existing buildings, existing driveway, and existing topography from City of Orono I I it
maps. It does not purport to show any other improvements or encroachments. SCALE I N FEET
DESIGNED REVISION DATE DESCRIPTION I hereby certify that this survey was prepared by me, SCALE
G R 0 N B E R G & ASSOCIATESINC. or under my direct supervision, and that I am a duly 1".40.
1 2-11-10 SETBACKS,POSSIBLE SEPTIC AREAS,AND POSSIBLE HOME SITES ADDED ) • registered Civil Engineer and Land Surveyor under the
DRAWN CONSULTING ENGINEERS, LAND SURVEYORS, & SITE PLANNERS laws of the State of Minnesota. DAE
1-29-10
445 NORTH WILLOW DRIVE, LONG LAKE, MN. 55356
CHECKED - JOB NO.
952-4-73-4141 10-022
Mark S. Gronberg Minnesota License Number 12755
10-022
(940 ()dant
Planning & Zoning
Department
Memo 0/vio
To: Finance Department
From: Christine Mattson, Planning Assistant
CC: Street File
Date: 3/18/2013
G/L: 101-22205
Re: Escrow Refund
A requirement of Building Permit#2013-00100 was an Agreement for Removal or Retention
of Non-Conforming Accessory Structures pertaining to 665 Orchard Park Road. A foundation
as-built survey has been submitted and approved. The $2,500 escrow being held in
conjunction with the agreement can be refunded.
The following is attached:
• Original signed escrow agreement
• Copy of cash register receipt showing escrow amount received
Mail to: William & Mollie Reynolds
3630 Livingston Ave
Wayzata, MN 55391
w:\street files\orchard park rd\665\escrow refund memo for right of entry agreement 2013-00100.doc
Agreement for Removal or Retention
of Non-Conforming Accessory Structures
Right-of-Entry
THIS AGREEMENT,made and entered into this day of February 2013,
by William G. Reynolds and Mollie W. Reynolds, husband and wife, (hereinafter referred to
as "Owners") and the City of Orono, a Minnesota municipal corporation(hereinafter referred to
as the"City").
WITNESSETH:
WHEREAS, Owners have made application to the City for demolition of the
principal residence structure on the property located at 665 Orchard Park Rd within the City of
Orono, such property legally described as: The North 20.0 rods of the South 30.0 rods of the
_. Southeast Quarter of the'Northeast Quarter fo the Northeast Quarter of Section 31, Township
118 North, Range 23 West of the 56- Principal Meridian, Hennepin County, Minnesota
(hereinafter referred to as "Subject Property"); and
WHEREAS, the Subject Property contains a principal structure and one or more
nonconforming accessory structures shown on the survey or site plan attached hereto as Exhibit
A and described as follows: 18.7' x 25.8' shed and 30.3' x 33.4' shed(hereinafter"the Sheds");
and
WHEREAS, the Sheds are nonconforming with respect to side yard setback and
front yard setback requirements;and
WHEREAS, Owners are aware that according to Orono Municipal Zoning Code
Section 78-1432, at the time the principal structure is removed, all accessory structures shall also
be removed; and
WHEREAS, the ordinances of the City require removal of all accessory
structures at the time of removal of the principal structure;and
WHEREAS,at the Owners' request, the City intends to issue a demolition permit
to allow the principal structure to be removed and allow the nonconforming accessory
structure(s) to remain on the Subject Property without a principal structure subject to the
provisions of this Agreement;and
WHEREAS, the Owners intend to, upon demolition of the principal structure,
immediately replace the principal structure on the site with a new principal structure for which
Building Permit application#2013-00100 has been submitted;and
WHEREAS, the Owners agree that the Sheds will be removed if construction of
the new principal structure is not started within 120 days of the demolition permit issuance.
Page 1 of 4
NOW, THEREFORE, THE PARTIES TO THIS AGREEMENT AGREE TO THE
FOLLOWING:
1. Owners may retain the existing nonconforming accessory structure(s), the Sheds, subject
to the following conditions:
A) Owners agree to obtain a building permit for construction of the replacement
residence within 60 days of demolition; to begin construction on the new
residence within 120 days of demolition; and to complete all exterior work within
1 year of building permit issuance and receive a Certificate of Occupancy within
2 years of building permit issuance.
B) The Owners agree to submit an escrow in the amount of $2500.00 with the
demolition permit. The escrow shall be held until the as-built foundation survey
is submitted for the new residence.
C) In the event that any activity described in item A has not been accomplished
within the defined timeframe, the Owners shall remove the Sheds at the Owners'
expense.
D) If the Owners fail to perform their removal obligations per the above provisions,
The Owners hereby agree as follows:
1) The City may enter upon the property and remove the Sheds.
2) The City may assess any costs of removal to the subject property which exceeds
the escrow.
2. This Agreement shall be binding upon current and future owners of Subject Property, and
shall be filed within the chain of title of the Subject Property.
3. The Owners of the Subject Property consent to the execution of this Agreement and to its
terms,as shown by their signature(s)upon this document.
4. Owners shall indemnify and hold harmless the City, the City Council, and the agents and
employees of the City from and against all claims, damages,losses or expenses,including
attorney fees, which the City, City Council and agents and employees of the City may
suffer or for which it may be held liable, arising out of or resulting from the assertion against
them of any claims,debts or obligations in consequence of the performance of the terms of this
Agreement.
Page 2 of 4
CITY OF ORONO:
By: IsCIVI‘or
By: L" DoLcd' .
Its City Clerk
A
7ePof1
ACKNOWLEDGEMENT
STATE OF MINNESOTA )
) ss.
COUNTY OF HENNEPIN )
The foregoing instrument was acknowledged before me this day of
, 2013 by p ' 7 c.)14,i/jtv , the
'1/141, of the City of Orono on behalf of the municipal corporation.
Notary Public
ACKNOWLEDGEMENT
STATE OF MINNESOTA )
) ss.
COUNTY OF HENNEPIN )
The foregoing instrument was acknowledged before me this 5 day of
3fDna , 2013 by (Q . -pe &b_ , the
-�-��,, n ('J �_� i of the City of Orono on behalf of the municipal
corporation./
41
Notary Public
Page 3 of 4
Owner(s):
By: y' ))
ACKNOWLEDGEMENT(APPLICANTS)
STATE OF MINNESOTA )
) ss.
COUNTY OF HENNEPIN )
The foregoing instrument was acknowledged before me this 1g_ day of
, 2013 by and
(husband and wife) as their free act and deed.
MAUREEN E MURPHY
Notary yPuP bli���
f
1 '�' NOTARY PI.fBLIt,-MINNESOTA
MY COMMISSION ;P1;ES 1/31/17
Page 4 of 4
C'/'i v of Or�rir,
I:d F[1 Kelley Parkway,..
"F 'e p f N+e ,?l0106453
•
��/,{//'l(a�yn��ning ssorand(Zoning
Escrow - r;C5 iOrc:eara Park e Jl?r�r v'
101-22;4)5-
Deferred Rev-be Eloper Dep -,
ni
Chetk
Check No. 6184
tier i:.i
Total pplied:
Cttenye Tendered:
oo 1
CITY OF ORONO . 11�;(� �� ( 1��1 111111111
11
* 20 1 3 - 00 1 28 *
2750 KELLEY PARKWAY DATE ISSUED: 0212212013
ORONO, MN 55356-
(952) 249-4600 FAX: (152) 249-4616
ADDRESS 665 ORCHARD PARK RD •
PIN : 31-118-23-11-0005
LEGAL DESC : UNPLATTED 31 118 23
LOT 000 BLOCK 000
PERMIT TYPE : ESCROW FEE-OTHER
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ESCROW FEE-OTHER
NOTE: THIS$2500 ESCROW IS FOR THE ACCESSORY STRUCTURE FOR 665 ORCHARD PARK RD-PD CHECK#6184
BY WILLIAM&MOLLIE REYNOLDS
•
APPLICANT ESCROW FEE-OTHER 2,500.00
REYNOLDS, WILLIAM&MOLLIE TOTAL 2,500.00
3630 LIVINGSTON AVE
WAYZATA,MN 55391-
(612)940-5747
OWNER
REYNOLDS,WILLIAM&MOLLIE
3630 LIVINGSTON AVE
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
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
s ,
Planning & Zoning
Department
Memo
To: Finance Department
From: Christine Mattson, Planning Assistant4
CC: Street File
Date: August 11, 2014
G/L: 101-22205
Re: Escrow Refund
Building Permit Application #2013-00100 pertaining to 665 Orchard Park Road is complete.
Please refund the$10,000 to the applicant, William &Mollie Reynolds.
The following is attached:
• Documentation from Campbell-Knutson stating they have no unbilled WIP
• Documentation from Bolton & Menk stating they have unbilled WIP in the amount of
$104. There is no other WIP for this project, so it falls under the$500 credit.
• Original signed escrow agreement
• Copy of cash register receipt showing escrow amount received
Mail to: William&Mollie Reynolds
665 Orchard Park Road
Long Lake, MN 55356
w:\street files\orchard park rd\665\escrow refund request 2013-00100.docx
Christine Mattson
From: David Martini [davidma@bolton-menk.com]
Sent: Wednesday, August 06, 2014 3:30 PM
To: Christine Mattson
Subject: RE: Unbilled WIP
It looks like we have the following WIP:
6.104 for 2013-00100'
$52 for 2013-01306
$52 for 2014-00278
$124.50 for 2013-00431
David P. Martini, P.E.
Bolton & Menk, Inc.
P: (952) 448-8838 ext. 2458
M: (612) 756-4315
email: davidma( bolton-menk.com
From:Christine Mattson [mailto:CMattson@ci.orono.mn.us]
Sent:Tuesday,August 05,2014 4:53 PM
To:'Sherry Charboneau'; David Martini
Subject: Unbilled WIP
Hi.
Any unbilled WIP for the following? I would greatly appreciate a response before noon tomorrow,Wednesday,August
6th. Thank you.
Applicant Address Building Permit# Land Use#
Reynolds,William& Mollie 665 Orchard Park Rd 2013-00100
Ashfeld, Dan 1376 North Arm Dr 2013-01306
Prchal, Derek 4705 Watertown Rd 2014-00278 14-3649
Maenner, Bradley 3590 Northern Ave 2013-00431
Christine Mattson
Planning Assistant
City of Orono
2750 Kelley Parkway ! Orono '; MN 55356 (physical address)
PO Box 66 I Crystal Bay I MN 55323-0066(mailing address)
'i' 952.249.4620 { 8 952.249.4616
cmattson@ci.orono.mn.us www.ci.orono.mn.us
Summer Office Hours: (Monday, May 19 through Friday,August 29,2014)
1
Christine Mattson
From: Sherry Charboneau [SCharboneau@ck-law.com]
Sent: Tuesday, August 05, 2014 5:04 PM
To: Christine Mattson
Subject: RE: Unbilled WIP
Christine:
I still happen to be working tonight.
NO UNBILLED WIP for our firm on the apps listed below.
Sherry
Sherry L. Charboneau
Legal Assistant
CAMPBELL KNUTSON P.A.
1380 Corporate Center Curve•Suite 317•Eagan,MN 55121
V(651)234-6230•Fax:(651)452-5550
5charboneauna ck-law.com•www.ck-law.com
From: Christine Mattson [mailto:CMattsonOci.orono.mn.us]
Sent:Tuesday, August 05, 2014 4:53 PM
To: Sherry Charboneau; David P. Martini
Subject: Unbilled WIP
Hi.
Any unbilled WIP for the following? I would greatly appreciate a response before noon tomorrow,Wednesday,August
6th. Thank you.
Applicant Address Building Permit# Land Use#
Reynolds, William & Mollie 665 Orchard Park Rd 2013-00100
Ashfeld, Dan 1376 North Arm Dr 2013-01306
Prchal, Derek 4705 Watertown Rd 2014-00278 14-3649
Maenner, Bradley 3590 Northern Ave 2013-00431
Christine Mattson
Planning Assistant
City of Orono
2750 Kelley Parkway Orono ; MN 155356(physical address)
PO Box 66 § Crystal Bay 1 MN 1 55323-0066(mailing address)
V 952.249.4620 18 952.249.4616
®cmattson@ci.orono.mn.us ; " www.ci.orono.mn.us
Summer Office Hours: (Monday, May 19 through Friday,August 29,2014)
1
TEMPORARY CERTIFICATE OF OCCUPANCY
ESCROW AGREEMENT
Orono Building Permit
#2013-00100(&/Demolition Permit#2013-00101)
..
AGREEMENT made this ail day of fi..1L[ ' , 2013, b and be een the CITY OF
ORONO, a Minnesota municipal corporation ("City")and - ' 1t I I! ] p yY)Uld S ("Owners").
Recitals
1. Construction of the new residence located at 665 Orchard Park Road, the ("Subject
Property"), legally described as: The North 20.0 rods of the South 30.0 rods of the
Southeast Quarter of the Northeast Quarter of the Northeast Quarter of Section 31,
Township 118 North, Range 23 West of the 5th Principal Meridian, Hennepin County,
Minnesota, is the subject of Building Permit application number #2013-00100 has been
completed.
2. Rain and wet weather conditions currently prohibit full completion of exterior
improvements, final grading, and vegetation establishment. An as-built survey cannot be
accurately conducted at this time.
3. Owners request the City issue a temporary certificate of occupancy ("TCO") to the
Owners so that the Owners may occupy the new residence.
4. The City will issue a TCO only if the Owners establish an escrow to ensure completion of
exterior improvements, continuation of erosion control and submittal of an as-built survey
to the City.
NOW THEREFORE,THE PARTIES AGREE AS FOLLOWS:
1. DEPOSIT OF ESCROW FUNDS. Contemporaneously with the execution of this Escrow
Agreement, the Owners shall deposit $10,000 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 assure completion of any
exterior improvements, final grading, establishment of vegetation as well as 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#2013-00100 (& Demolition Permit #2013-00101) if compliance with
the approved building permit is not accomplished.
3. MONTHLY BILLING. As the City receives consultant bills for incurred costs, the City will
in turn send a bill to the Owners. Owners shall be responsible for payment to the City within 30 days of
the Owners' receipt of bill.
4. DISBURSEMENT FROM ESCROW ACCOUNT. In the event that the Owners do not make
payment to the City within the timeframe outlined in #3 above, shall issue a Stop Work Order until the Owners
pay all expenses invoiced pursuant to#3. The City may draw from the escrow account without further approval
of the Owners to reimburse the City for eligible expenses the City has incurred.
5. CLOSING ESCROW. The Balance on deposit in the escrow, if any, shall be returned to
the Owners when the review has been completed and written notification is received from the Owners
requesting the funds.
155441
2750 Kell
City of Grant
Oronoey Parkway WaY
Receipt
No .009228 952-249-4600
Mol 1ie Reyrt* `�1 24, 2r� �
Ids
PrevioPermits Dalalance:
0 r
Par8 665
De ktl?.� Creha;,, C •00
1)e feared J T� 00.00
0
201_0
Total. Rev DeveluCer Deposit
Check
Check
'agar;Na; 6240
Tota]4e Reynolds 7,S1)0.v�.__
pp-zed,
Change Tendered; __
07/24/2013 12:04f'N_- 00
CITY OF ORONO 111111 1 i Ili
* 20 1 3 - 007013
2750 KELLEY PARKWAY DATE ISSUED: 07/24/2013
ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 665 ORCHARD PARK RD
PIN : 31-118-23-11-0005
LEGAL DESC : UNPLATTED 31 118 23
: LOT 000 BLOCK 000
PERMIT TYPE : ESCROW FEE-APPLICANT
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ESCROW FEE-APPLICANT
NOTE: THIS$7500 ESCROW WILL BE COMBINED WITH THE$2500 WE HAVE ALREADY RECEIVED TO ISSUE THE
TEMPORARY CERTIFICATE OF OCCUPANCY.
APPLICANT ESCROW FEE-APPLICANT 7,500.00
REYNOLDS,WILLIAM&MOLLIE ESCROW FEE-DEVELOPER 0.00
3630 LIVINGSTON AVE
WAYZATA, MN 55391- TOTAL 7,500.00
(612)940-5747
OWNER
REYNOLDS,WILLIAM&MOLLIE
3630 LIVINGSTON AVE
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
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
DEMOLITION PERMIT,BUILDING PERMIT&
WETLAND BUFFER ESTABUSHMENT ESCROW AGREEMENT
Demolition Permit 1201340101
1110
����,, Building � �
Permit00
1 2013-0010
AGREEMENT made this -L / day of _ 1l z,0rl by ands etween the CITY OF ORONO,
a Minnesota municipal corporation (`City")and L( t(2 Owners").
Recitals .t^ �,�,�w- -
1. A building permit application has been filed for ail(, lIo � i+ oYYew 'w'mV
located at 665 Orchard Park Road, the ('Subject Property), legally desc ri as The North 20.0 rods of the
South 30.0 rods of the Southeast Quarter of the Northeast Quarter of the Northeast Quarter of Section 31,
Township 118 North, Range 23 West of the 5th Principal Meridian, 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 the establishment and
development of the required native wetland buffer and reimbursement to the City for ail 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 wok 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 Demolition Permit 02013-00101 & Building Permit 1 2013-00100 if compliance with the
approved building permit is not accomplished.
3. MONTHLY BILUNG. 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 wain 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, the buffer is established and written notification is received
from the Owners requesting the funds.
6. CERTIFY UNPAID CHARGES. If the project is abandoned by Owners, or if the eligible expenses
incurred by the City exceed the amount in escrow,the City shall have the right to certify the unpaid balance to the
subj pursuant to Minn. Stat. §§415.01 and 366.012.
CITY'. C •, 1! ' •' 0 OWNER: ,- . c)
By: _ ��!� ��IL ki LLL.1f�Lci I L 1
Its: ifr� � B .i.„.•;"744.- , 'c 4
lnanwi Use Only: 0 Original to Planning 0 Copy to Property Owner 0 Copy to Street FIN
DEMOLITION PERMIT&BUILDING PERMIT ESCROW AGREEMENT
Demolition Permit#2013-00101
Building Permit#2013-00100
AGREEMENT made this day of 1 ,20 14 ky and between the CITY OF ORONO,
a Minnesota municipal corporation ("City")and /AJItl[arvt_p I oll Fy�f0/cl5 ("Owners").
Recitals �/
1. A building permit application has been filed for an
located at 665 Orchard Park Road,the("Subject Property"), legally described as The North 20.0 rods of the South
30.0 rods of the Southeast Quarter of the Northeast Quarter fo the Northeast Quarter of Section 31, Township
118 North, Range 23 West of the 5th Principal Meridian, 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 Demolition Permit #2013-00101Building Permit #
2013-00100 if compliance with the approved building permit is not accomplished.
3. MONTHLY BILLING. As the City receives consultant bills for incurred costs, the City will in turn
send a bill to the Owners. Owners shall be responsible for payment to the City within 30 days of the Owners'
receipt of bill.
4. DISBURSEMENT FROM ESCROW ACCOUNT. In the event that the Owners do not make payment
to the City within the timeframe outlined in#3 above, shall issue a Stop Work Order until the Owners pay all expenses
invoiced pursuant to #3. The City may draw from the escrow account without further approval of the Owners to
reimburse the City for eligible expenses the City has incurred.
5. CLOSING ESCROW. The Balance on deposit in the escrow, if any, shall be returned to the
Owners when the review has been completed and written notification is received from the Owners requesting the
funds.
6. CERTIFY UNPAID CHARGES. If the project is abandoned by Owners,or if the eligible expenses
incurred by the City exceed the amount in escrow, the City shall have the right to certify the unpaid balance to the
subject property pursuant to Minn.Stat.§§415.01 and 366.012.
CITY: • OF O N OWN -:
By: � ��.� __./
Its: gicktot.. \ 1L `k
inteitrOat'UseOOP final., 0**Oa `1Copy#+ir$raiperrO e►'„ ''I t4RYr r`'Sireef"0
•
City of lircrio
275k, •
J. u i�ply
i
Fev6iDt Or.r. 1006494 .Fab 22, :00i7
I t c f Wt Iia Fr~ph i i
Plaollnq oning
'665 U'r c.iard! i)a#'N Road ad ,
•
Uteck
cIp:i idf, • 500
02/22/2 03 03717120V,
. . CITY OF ORONO ( I [IF �' !� rill ':I
* 20 1 3 - 0 0 1 27 *
2750 KELLEY PARKWAY DATE ISSUED: 02/22/2013
ORONO,MN 55356-
(952) 249-4600 FAX: (952)249-4616
ADDRESS : 665 ORCHARD PARK RD
PIN : 31-118-23-11-0005
LEGAL DESC : UNPLATTED 31 118 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 DEMO PERMIT#2013-00101 AND BUILDING PERMIT#2013-00100 PD CHECK#6186
BY WILLIAM&MOLLIE REYNOLDS.
APPLICANT ESCROW FEE-BUILDING 2,500.00
REYNOLDS,WILLIAM&MOLLIE ESCROW FEE-EROSION CONTROL 0.00
3630 LIVINGSTON AVE
WAYZATA,MN 55391- ESCROW FEE-GRADING 0.00
(612)940-5747 TOTAL 2,500.00
OWNER
REYNOLDS,WILLIAM&MOLLIE
3630 LIVINGSTON AVE
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
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
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