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HomeMy WebLinkAbout2015-00323- addn/remodel/repair . CITY OF ORONO ill III 11111111III IIII IIIIIIIIIII 1111 * 2 0 1 5 - 0 0 3 2 3 * 2750 KELLEY PARKWAY DATE ISSUED: 04/10/2015 ORONO,MN 55356- (952) 249-4600 FAX: (952) 249-4616 ADDRESS : 60 ORONO ORCHARD RD S PIN : 02-117-23-21-0037 LEGAL DESC : N/A : LOT 000 BLOCK 000 PERMIT TYPE : ADDITION/REMODEL/REPAIR PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR ACTIVITY : 434-RESIDENTIAL VALUATION : $ 12,500.00 NOTE: DECK PRIOR TO RELEASE OF ESCROW MONEY AN AS-BUILT SURVEY MUST BE SUBMITTED AND APPROVED. INITIAL: APPLICANT PERMIT FEE SCHEDULE 247.83 STATE SURCHARGE(VALUATION) 6.25 DECKS UNLIMITED TOTAL 254.08 570 3RD STREET E Payment(s) COKATO,MN 55321- CHECK 8211 254.08 Minnesota State License#:BUIL-BC629155 uiiy or uroho OWNER 2750 Kelley Parkway Orono MN 55356 952-249-4600 WHITELEY,DOUGLAS&CLAUDIA Receipt No: 3.013137 Apr 10, 2015 60 ORONO ORCHARD RD S WAYZATA,MN 55391- Decks Unlimited Previous Balance: .00 Permits 2015-00323 60 Orono 247.83 AGREEMENT AND SWORN STATEMENT Orchard Rd S The work for which this permit is issued shall be performed according to 101-3i 510 Building Permits the approved plans and specifications,applicable City approvals,and the Permits State Building Code. This permit is for only the work described and does 2015-00323 60 Orono 6.25 not grant permission for additional or related work which requires separate Orchard Rd S permits. All provisions of laws and ordinances governing this type of work 101-20802 shall be compied with whether or not specified herein.This permit will Due to govts-State expire and become null and void if construction authorized is not Total: 254.08 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. Check The applicant is responsible for assuring all required inspections are Check No: 8211 9RA no requested in conformance with the State Building Code.This permit may be - rev. 4 at any time for due cause. ' Ad - Li / 0 - IS- 1-----k c� tit 1o1 i5-" Applican 'ermitee Signature Date Issued By Sign tu'a re Date CITY OF ORONO �� BUILDING PERMIT APPLICATION 5`� FOR NEW STRUCTURES OR ADDITIONS . o A' Mailing Address: c/s-00 3 <V PO Box 66 Permit number: -J 0 Crystal Bay, MN 55323-0066 / Date received: �-j Street Address:' \ �� Received by: 43.. riA. . ti� G� 2750 Kelley Parkway V�\� Plan review fee: /'/. ° t Orono, MN 55356 4KFsH°V.� 02015 —e,-0,3?- —. Total Fee: 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. ectvidl ettivoU Incomplete applications will be returned. (Please print) GENERAL INFORMATION: Job Site Address: 60 0 co n o p,,-ckq,,-e.,l g S Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes ❑ 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: 1:)«K5 kn1rr,r-1-.ecA State License# t3c b a,iSr Expiration Date: 3— 3/- /7 Phone: (cell) (D I o1- ?v., -680a. (office) Mailing Address: 5-7o 3e-o4 sir' - City: okga—d ZIP: '"'`-i S-5-'3a 1 Contact Person: Rq„q y fvto-L. Applicant is: ontrac or / Homeowner (circle One) Email and/or Fax: 1Moe rgnot y 0 y=hoo . c u.v.. PROPERTY OWNER INFORMATION: Name: Doo W h ;+c 1-e.,%-/ Phone(day): °t 5?- a I o - -7333 Address: City: ZIP: Email and/or Fax ARCHITECT/ENGINEER INFORMATION: Name: Phone(day): Address: City: ZIP: Email and/or Fax: PROJECT INFORMATION: Description of project: 1.Type of Project 2. Proposed Use 3.Structure Type 4.Sewage Disposal& Water Supply New Constructionngle Family with ❑ Residence Addition attached garage ❑Garage/Accessory Bldg. 0 Public Sewer ❑Accessory Building 0 Single Family with ,g Deck ❑ Relocation detached garage 0 Office/Commercial 0 Private Sewer ❑ Other: (specify) 0 Multiple Family/Condo 0 Warehouse 0 Public ❑ Storage ❑ Public Water **Any earth movement may also require 0 Commercial 0 Other(specify) MCWD review&permits. 0 Industrial 0 Private Well Minnehaha Creek Watershed District(MCWD) 0 Other: (specify) 18202 Minnetonka Blvd Deephaven,MN 55391 Phone: 952-471-0590 Fax: 952-471-0682 www.minnehahacreek.orq $ / )' r S Estimated Construction Valuation (excluding land) � STRUCTURE INFORMATION: 1.Structure Dimensions 1.Structure Dimensions(continued) 2.Type of Construction a. Length (ft.)= Number of bedrooms= Wood/Frame b. Width (ft.)= Number of garage stalls: 0 Masonry Areas in square feet Attached= 0 Metal 0 Pole Bldg. c. Basement= Detached= 0 ICF d. 1St Story = 0 On-site Prefab e. 2nd Story= 0 Off-site Prefab f. %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 ❑ 0 Permit Application ❑ ❑ 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 ❑ 0 Engineered Plans for Retaining Walls 4 feet or above ❑ 0 Minnehaha Creek Watershed District Permit(s) ❑ ❑ Plan Review Fee ❑ ❑ Application Escrow&Agreement ❑ 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: / / Date: 3 - / - / 5 Owner's Signature: Date: • PLAN REVIEW CHECKLIST FOR NEW TRUCTURES I ADDMONS AQ rOVIID f Permit 15.: Description of work: Date Rec'd: 5 t q. 15 Septic review by: a.'► Date Approved:. - Zoning review by: - :'f l ►.5'.. )► 11' Date Approved: - + ", } Building review by: Date Approved: 41.. 9-• 2.101 5 Grading review by: • Date Approved: Zoning District: " Zoning File#: Reso#: - Reso Date:. Zoning:Lot Area:5113`1L- SF/AC134 Width: Lot Coverage: SF % Survey Submitted.: D Yes 0,240 Date of Survey: Revised date(?): proposed Setbacks: Front Rear Street 4 ( R S '.� W N S E Y ( ? ) ( ) Other Buiid.ings Wetland Side de Definedi Height: ••-----. - Peak height: FE,. FFE-minus.6 feet= F --: -, 4Sxisting-C,,dntou Perirnetei (linear feet)= ` 50%= L.F.below grade #.of Stories FOR ABUILDING WITH A BASEMENT OR CRAWL SPACE: FORA BUILDING ON A SLAB FOUNDATION The distance between the lowest pro osed The distance between the tori•of ,, START tNITH ` .., floor(pf the basement or crawl apace:)and START WITH stab andd-thee igl\ ,p Inlzof -� he highest point of he roof { if you have a If you have GABLE OR kIPPEp 4109_,P,1' rw', G4,i LE.OR HlPP-Ep RODE windows): Subfracth )edistance - thedistance ,Stteenthhalf the d(s;gnce*Ili ii the ' between the hig eet4pofnt f the roof theii'estp nt 0-t.roof to<: torfheiow oftheacor spoflthng the so`i�poft d `e SUBTRACTION gable or h roof _r .• (BASED ON GALE OR HIPPED ROOF(wiitit totitRACT'TQN : ii gabNe of RQOFTVPE) • x s �(vmdgw - treat heskihe drstance DON fit, H P �0 betwee the top f &hlgl ,_'" T'PE) r F ''�Ubtract tl.i. 'win dowaild$1tighest of tib =ha hoe e ` w, roof `ttelopr?iaflhe rest j • ALL OTHER PROOF TYPES(s)at, P914'iMr fhe hist fnansard Qts).tom subtraotton a• • polbttif die nim# s TRACTION '.Sub act the distance tween#lie itsat ):014 ES' ON basementicAii spec t)oor ant!the u _ Asp TING -highestexisting grade adaa'eerit to the ` D`ITIt 0 , Add.t B dsia e a die ,< G S)' foundation'OR 10 feet(whichever Is less) 0•ON •,.•of stab and te;ttlgh' , misting ;, - EQUALS defined buHdingelght ISTING, grade adjaeentlotkie-loundahon:.- a� $� Defihed bUitg;h tltrieight .4 Shoreland District MCWD Perm$t Average Lakes "'e Setback luif � Yas o' . Permit Number. - D Yes fl No 1GIA Yee "N© fl NMA-see attached ' - �, Setback Stormwater Duality _ Proposed Overta District Existing Hardcover y (%and sf) Hardcover Variance Required CUP Required Tier(circle•one) (%and:sfl f D Yes 113 No D Yes Cl No 1 2 3 4 5 -;r 1 -`i Type(s): Type(s): •Updated: January 2015 • z:\forms\plan review checklist 2015.docx REMARKS (in-house): Fees to be Charged YES NO r Permit110"- • Plan Review r/' State Surcharge 3_, " 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 = fy Estimated Construction Value: $ t2)...5-00 ' 2)...5-00 Orono inspections Required Work Requiring Separate Permits . Required State Permits , D Site • 0 Plumbing 0 Grading i Filling CI Weil O Silt Fencel"ErosionControl 0 Mechanical 0 Fire © Electrical O Hardcover Removal Cl Septic Cl Water Connection Footing 0 Fireplace 0 Sewer Connection D.•Pour'ed il'all Cl Masonry 0"Lawn irrigation' I Foundation Surti.:ey. Ci Mfg. 13 Landscaping Cl Foundation Waterproofing 0 Other(specify) C" Radon Rock Sed ., p framing" 3lnsulation ;' .Built Survey; 0 Other{specify) i' A - REMARKS(m house): Other'Review: Retrlewed by: Date Approved: Access: Ea ting: D YES ONO blew: 'D YES 1:3 NO OFFICIAL REIiilA1OKS-TO BE NOD ON PERMIT AND INITIALLED -Frio( \+C,.. C ' 4 . at _ - c I rF .a_tictit da • ) 116\t • Updated: January 2015 z:\fomis\plan review checklist 2015.docx • Christine Mattson From: Christine Mattson Sent: Thursday, March 26, 2015 9:06 AM To: 'moerandy@yahoo.com' Cc: Melanie Curtis; Lyle Oman Subject: 60 Orono Orchard Road S/#2015-00323 Attachments: escrow agreement.pdf; letter.pdf Randy, Attached is a copy of the letter and attachments being mailed today. If you have any questions, please don't hesitate to contact me. Christine Mattson Planning Assistant City of Orono 2750 Kelley Parkway I Orono I MN 155356(physical address) PO Box 66 I Crystal Bay I MN 155323-0066(mailing address) 'g 952.249.4620 18 952.249.4616 ® cmattson@ci.orono.mn.us I www.ci.orono.mn.us Office Hours: Monday- Friday 8 am to 4:30 pm OUR OFFICE WILL BE CLOSED: Monday, May 25, 2015 1 CITY OF ORONO Street Address: Mailing Address: Telephone(952)249-4600 2750 Kelley Parkway P.O.Box 66 Fax (952)249-4616 ,9 Orono,MN 55356 Crystal Bay,MN 55323 www.ci.orono.mn.us kESHO� March 26,2015 Randy Moe Decks Unlimited 590 3rd Street E Cokato, MN 55321 Re: Building Permit Application#2015-00323 60 Orono Orchard Road S On March 19, 2015 the City received a building permit application for a deck. Staff conducted a preliminary review based on the information provided and determined the application materials to be complete. Additionally, 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 $700. The escrow agreement is enclosed. The property owner must sign the escrow agreement and submit a check for$700. Also, as we discussed on the phone,we do not require an updated survey for construction of this deck; however, we will require an as-built survey of the entire property showing all existing site improvements once the project is complete and before we will refund the escrow money. The City's survey requirements are enclosed. Prior to the commencement of any exterior/landscaping improvements not included on the proposed plans, i.e. patios,grading,sidewalks, retaining walls,etc., a Zoning Permit will be required. 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 NA& wittsfx..._ ristine Mattson Planning Assistant c Doug Whiteley;60 Orono Orchard Road 5;Wayzata, MN 55391 Lyle Oman, Building Official enclosures Hennepin County GIS - Printable Map Page 1 of 1 Henneon Interactive Property Maps M a p t tt11'' _'y'- t Set I ' _ , 1 ' ,'....; .. * - 1 ' .,; „iitir . I r 1 ,,. it*R'• I.'. / T h• yr p } . r, J k l� . Mf . - i, '0'.{,' 'i IN i t tC ; , .41AMS } • {., �\ • iia ; Parcel 02-117-23-21-0037 A-T-B: Abstract Map Scale: 1"= 100 ft. N ID: Print Date: 3/25/2015 • Owner Market D E&C M Whiteley $479,000 Name: Total: Parcel 60 Orono Orchard Rd S Tax $5,641.90 Address: Orono, MN 55391 Total: (Payable:2015) Property Sale Residential 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 Homestead I implied,including fitness of any particular stead: Date: purpose,merchantability,or the accuracy and completeness of the information shown. Parcel 1.32 acres Sale Area: 57,372 sq ft Code: 'COPYRIGHT©HENNEPIN COUNTY 2015 A Think Green! http://gis.hennepin.us/Property/print/default.aspx?C=45 5973.0759480951,49805 80.83 7207... 3/25/2015 S) Q LP ., ',?` i 1-, >- 1 da0 o � - w . . -4- (v) \ , o Cb ni n r \ I U Z 5 a N c'4.. c d f --1, 4.'8' cz (;) 0 Q, r u ( ' w I.— H I a, (n I T w �' ON - 2 Z _ Cw J V E D o o � w � o .c Ai j vi kr , oN N tot o 3 C (13 c or to I ‘ � � s iDATE TIME V CITY OF ORONO CALLED IN INSPECTION NOTICE SCHEDULED --- ---7/64.-1 91-4-F w PERMIT NO. Zp/E5--00?1.7COMPLETED ADDRESS L9 0 C)rO/r1f OrCI? /21 5 OWNER TELEPHONE NO.7(03 ZqZ £3/�f CONTRACTOR b eC k S tui Aj vn j fed • • DESCRIPTION F--/V I Dee lL W ❑ FOOTING 0 DEMO-FINAL 0 SEPTIC FINAL 11. ❑ POURED WALL ❑ PLUMBING RI 0 EXCAV/GRADING/FILLING Q0 FOUNDATION WATERPROOF IDPLUMBING FINAL 0 TREE REMOVAL ❑ RADON SLAB 0 MECHANICAL RI 0 SITE INSPECTION Q 0 FRAMING 0 MECHANICAL FINAL 0 PROGRESS I., ❑ INSULATION 0 WOOD BURNER/FIREPLACE 0 COMPLAINT Q ❑ FINAL ElWATER HOOK-UP ElFOLLOW-UP W 0 AS BUILT-SURVEY 0 EWER HOOK-UP 0 HARD COVER REMOVAL J ❑ DEMO-SITE 0 PTIC INSTALL ElFOUNDATION/REMOVAL ' OWNERICONTRACTOR TO MEET YO • YES_NO SUR: O COMMENTS: cc s6/b 23 /, ' 4. CC cc ke0 Yrn` mss' if&s 7 CZ "/4 4. im ccQ Z AIVI'C d W ❑WORK SATISFACTORY:PROCEED PROJECT COMPLETE CCW ❑CORRECT WORK&PROCEED ❑ SUE CERTIFICATE OF OCCUPANCY O LICORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORE COVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑PHOTO TAKEN INSPECTOR WILL RETURN CISTOP ORDER POSTED.CALL INSPECTOR ❑CITATION ISSUED ❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 Ai urs in advance. 9 , 9-4600 Owner/Contractor on site: '1'� /� Inspector. 7. `P41 �1 White Copyllnspector's File Canary CopylSite Notice \\, rt Ila' •• - 2 \ oRONopy • � o � R_ ,� , _se , \ \\51(441,4, \\NN.. \[a cP`. '/jA _ r " 'Q v .. �a yr r tl . - 4. n t , ila • I , I-'1'‘ . \,`_ CI. -- -,.zi, `,;\ .A.: r-,< -f ' - - ' '- 'J y e 1 y _ n' J b• j4 �t 1 4 _ ,,, . : , ,,... :.— .. \ \ \s _ ,..),._ . ee - • � ,. . 4 _ A _ „t ............_11.Moe _A rr `..,_ .rfitarillita .y : .. i .]\\ \ a �� C _��a /, '\s,_9p _ \ s \ \ � ' 4() - \ . _:* 3':5' , , 1 le f , • \ j ?.2 '' � outt � ' _:-..i.�, `'���I�l;. 35 . 00' o. thefso't c _ .. � _ to t'�, • \:' .. yS . /� \ asp 1• ; ___� _��, • i.` +3-� /r J 1 Copo 011°1111p � �:� 19�� s ��> ' e� oar '"4 F6S 2015 cr 3L3 (dQc,K-) Planning & Zoning Department Memo To: Finance Department From: Christine Mattson, Planning Assistant (4, F\ CC: Street File Date: June 22, 2016 G/L: 101-22205 Re: Escrow Refund Building Permit #2015-00323 pertaining to 60 Orono Orchard Road S is complete. Please refund$700 to the property owners, Doug &Claudia Whiteley. The following is attached: • Original signed escrow agreement • Copy of cash register receipt showing escrow amount received Mail to: Doug &Claudia Whiteley 60 Orono Orchard Road S Wayzata, MN 55391 wA.street files Orono orchard rd s60kesc row refund 2015-00323.doac BUILDING PERMIT ESCROW AGREEMENT i✓� Orono Building Permit#2015-00323 AGREEMENT made this / day of Hp Ir.� , 20,-S, by and between the CITY OF ORONO, a Minnesota municipal corporation ("City") Doug Whiteley("Owners"). Recitals 1. A building permit application has been filed a new decic located at 60 Orono Orchard Road South the ("Subject Property"), legally described as See 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 $700 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 #2015-00323 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. CI : CITY OF ORON OWNER: By. a CURL tit. Its: (1MIflI2V Rimit Escrow # 2c5_ 05323 Li3aL tri, Lo/s .59, 6Q 13, y6.~7/hv/,00,-/a,d,r' 4.45y J'G'ri//HBe?5 rG's/y vV- : 7 ,a'+1o5'W•e/ i 5 e/" ' 1�se//7mr'/6rn, r/y ofefolie s �/. ,fv*AVe,Orreetf. Q,PWo oAr/,, 'os. ;/ftp , d�^1coiri ' Co/ 5'9 relic!///es r or//yn4fsfc /yP o lipe pr+e/ if,h0 ono' /Y7 , / #/ ms/, 4 ,0e..7. rhstey // e #ie eo.� .4tSo .4e . br/ c,+rp4,r,37.5:410 1.40(a/'soil Coe 75, as metotransie,r `a/44,44fieftr // ° sacra/4e4,srL,-4,/•i/e e r.saie eat.' 7.0' r 9A''.e•:3CAMr, fie) 17-1-910 13325 idriaber DOUGLAS E. OR CLAUDIA A. WHITELEY (952)473-8109 60 ORONO ORCHARD ROAD SOUTH WAYZATA,MN 55391 _ !1 PAY TO THE • `0 ORDER OF DOLLARS 8 ..� WELLS FARGO BANK, N.A. MINNESOTA WELLSFARGO.COMC 11,--- FOR II 13325 • City of Orono 2750 Kelley Parkway Orono MN 55356 952-249-4600 Receipt No: 3.013080 Apr 1. 2015 Douglas Whiteley Previous Balance: .00 Permits 2015-00374 60 orono 700.00 orchard rd s 101-22205 Deferred Rev-Developer Deposit Total: 700.00 Check Check No: 13325 700.00 Payor: Douglas Whiteley Total Applied: 700.00 Change Tendered: .00 04/01/2015 01:45PM • CITY OF ORONO II 2750 KELLEY PARKWAY * 2 0 1 5 - 0037 4 *I DATE ISSUED: 04/01/2015 ORONO,MN 55356- (952) 249-4600 FAX: (952)249-4616 ADDRESS : 60 ORONO ORCHARD RD S PIN : 02-117-23-21-0037 LEGAL DESC : N/A : 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$700 ESCROW IS TIED TO BUILDING PERMIT#2015-00323 APPLICANT ESCROW FEE-BUILDING 700.00 ESCROW FEE-EROSION CONTROL 0.00 WHITELEY,DOUGLAS&CLAUDIA ESCROW FEE-GRADING 0.00 60 ORONO ORCHARD RD S WAYZATA,MN 55391- TOTAL 700.00 Payment(s) CHECK 13325 700.00 OWNER WHITELEY,DOUGLAS&CLAUDIA 60 ORONO ORCHARD 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