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Home My WebLink About2012-00527 - demo t , CITY OF ORONO * z 0 1 z - 0 0 5 z 7 * 2750 KELLEY PARKWAY DATE ISSUED: 06/20/2012 ORONO, MN 55356- (952) 249-4600 FAX: (952) 249-4616 ADDRESS : 495 OXFORD RD PIN : OS-117-23-41-0011 LEGAL DESC : STIELOWS ADDN : LOT 003 BLOCK 001 PERMIT TYPE : DEMOLITION PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : DEMO-PRINCIPAL STRUCTURE ACTIVITY : 645-SINGLE FAMILY HOUSES(ATT& DET NOTE: 1. FOUNDATIONS/ALL DEMO DEBRIS TO BE REMOVED FROM GROUND&DISPOSED OF OFF SITE,PER PCA REGULATIONS. 2. WELLS MUST BE ABANDONED. 3. INSPECTIONS DONE BEFORE BACKFILLING. NOTE: A 24-48 HOUR NOTICE IS REQUIRED FOR ALL INSPECTIONS. CALL(952)249-4600. SEWER MUST BE DISCONTINUED AT THE CITY SERVICE BY QUALIFIED CONTRACTOR BEFORE DEMO PERMIT IS ISSUED. CHECK TO MAKE SURE THIS PERMIT HAS BEEN PULLED BEFORE ISSUING THIS PERMIT. APPLICANT DEMOL[TION-PRINCIPAL STRUCTURE 75.00 MARK BEND[CKSON, INC. STATE SURCHARGE DEMO 5.00 1501 HUNTER DR WAYZATA, MN 55391- MISC FEE 0.00 (612)695-8072 TOTAL 80.00 OWNER SAMPLE, MIKE&ANNE 1449 BAY RIDGE RD WAYZATA, MN 55391- AGREEMENT AND SWORN STATEMENT The work for which this permit is issued shall be performed according[o 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 goveming 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 r a period of 180 days at any time after work has commenced. The applic ht is responsible suring all required inspections are request d conformance w th t e State Building Code.This permit may be revoke a any time fqr due c u e. i �G � �/ �Z C) / �?C,1�Z_ / / pplican Vermitee Signatu Date Issue By ' nature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED A VE. ► • 040�0 City of Orono FOR CTTY USE ONLY P.O.Box 66 Date Received:4-i t`�l�'<'. Permit# i`,'�;' �; ��- -) y;,;�,� 2750 Kelley Parkway a� ��"-:��n.. � Crystal Bay,MN 55323 Amount: $ SAC Credit: t��,��c`� (952)249-4600 �'�O$ Homeowner(s)Signed: ❑Yes Resolutions(if any)Signed:❑Yes ❑None Required Zonin Disclosure Si ned: ❑Yes ❑None Required CITY OF ORONO - DEMOLITION PERMIT (All permits must be approved by the Building Official and/or Zoning Department) � , ,.� �ua�aer:Information: �� '- � Type: �Residential ❑ Commercial i Site Address: � �/ ` ��/ C./ Q�� , �� Owner: / `"/�� i�e �AM,D��' Mailing Address: ��Q( ��F��c�c� � v city: 0��`J/�U zip: �'�� M�f ��'��( Home Phone: �l-� ��ll� ��'U� Alternate Phone: �i�� 5� ;,pplicant Information: m�' sa� `��a��•�� : . �._��.-: Conira��Sp�..• �FNDlCKSON, II�',, Contact Persan: ��f +��C�� 1501 HUN ��: — Address: OIVAYZRTA, MN 55391 State License #: City: Zip: Expiration Date: Phone: � ��`�C`��'��" Alternate Phone: tcr�o�-2�1BI @rv�n•C.�w� .,3�� ;��NDI�IONS &HOLD HARMLESS'��G�E21%I�E'1�dT ; � `"� .; .� �3.;-.'�..M�n . General Instructions: 1. You may be required to obtain other permits, i.e.: well abandonment, sewer, etc. 2. Work must not begin unless the permit card is available on the job site. 3. A 24-48 hour notice is required for all inspections. Call (952) 249-4600. 4. Sewer must be discontinued at the City service by qualified contractor before demo permit is issued. Demolition by means of: ❑ Manual Disassembly,.�f Heavy Equipment ❑ Other Permit(s) Issued: ❑ Sewer Disconnection ❑ Well Abandonment# � In return for issuance of said Demolition Permit, the undersigned owner hereby agrees to: 1. Submit a survey, aerial photo or sketch showing all structures on the property. Note which structures are to be demolished. 2. Submit a survey, aerial photo or sketch showing proposed erosion control measures in accordance with Chapter 79, Construction Site Runoff Control. 3. Submit a $2,000 escrow and an escrow agreement signed by the property owner. 4. Keep all structure(s) enclosed and/or secured until such time as demolition is complete. ' ! � 5. Keep all demolition debris off adjoining properly and/or the public rights-of way unless specific prior approval is obtained in writing for temporary use thereof. 6. Completely remove foundation(s) from the ground. 7. Completely dispose of all demolition debris off site in accordance with all applicable PCA requirements. 8. Abandon water wells in accordance with State Health Department regulations. 9. Call for an inspection when all debris has been removed, before backfilling. 10. Within 5 working da.ys of superstructure removal, a fmal inspection shall be requested. The site shall be left clean and clear of all debris, with any excavation filled with earth level with the adjacent ground elevation (except when such excavation is to be used as part of a new building and such new building is actually under construction). 11. Abandon septic systems per Minnesota Rules Chapter 7080. All septic tanks must be pumped, crushed and filled with native soils. An inspection is required after the tanks are pumped and before the tanks are crushed and filled. 12. The undersigned owner shall and hereby does indemnify and hold harmless the City of Orono, its agents, employees and assigns from and against all claims, damages, losses or expenses, including attorney fees, against the City, its agents, employees and assigns arising out of or resulting from the demolition described herein as performed by the property owner, his employees, agents, subcontractors or assigns. PERMIT TYPE AND FEE CALCULATION $75.00—Principal Structure � $ �� J�� ❑ $50.0�—Accessory Structure x (how many) l. Subtotal of above permit requested $ 2. State Surcharge 5.00 3. TOTAL PERMIT FEE (add lines 1-2 above) $ Iy✓'�� The undersigned herby applies to the City of Orono for issuance of a Demolition Permit, agrees to do all the work in a strict accordance with the ordinances of the City and the regulations of the State of Minnesota, and certifies that all sta.tements made on this application are complete,true and correct. Applicant's Signature: � Date: `� j/ r Owner's Signature: Date: Approved By: Date: (D �?�d ' 1 Z. ( ilding Official) * Zoning Disclosure Required? YES ❑ NO *This must be filled out by Zoning Dep ent—For either answer,a Zoning Official must sign all applications. * Approved By: Date: �p • �"t ' �� (Zoning Official) o�`'��o Principal Dweiling Demol[tion Permit �� ZONING DISCLOSURE & DECLARATION To the property owner: Demolition of the principal dwelling structure on a property may automatically terminate certain rights which rnay have accrued to the property by virtue of the continued existence of that building. • Rebuilding on a substandard lot of record (i.e. a lot that does not meet the zoning district required lot area or width standards) will, with few exceptions, require variance approval by the City Council, and such approval is neither automatic nor guaranteed but requires that a hardship be demonstrated. • Additionally, all current zoning standards will have to be met by the new principal dwelling including setbacks, lot coverage by structures, hardcover(impervious surtace), height limits, etc. • Where municipal sewer is not available, provision of two(2}sites for a conforming on-site sewage treatment system is mandatory. • Unless speci�ically approved by the City, all accessory structures must be removed at the time of principai dwelling demolition. This also applies to seasonal and permanent docks, which may not be re-installed until a new principal dwelling has reached the framing stage. 7he following information is presented for the purposes of advising the property owner of ths implications of removal of the rinci al dwellin on the ro e : 1. Property Address: 498 Oxford Road #�� 05-117-23�1-0011 Required Lot 2 acres Required Lot Width: 200' 2. Zoning DisVict: LR-1A Area: Actual Lot Area: 2.25 acres` Actual Lot Width: 214' ' rcling to Hennepin County Lot area variance is Is not quired. Lot width variance Is not quired. 3. Required Setbacks Front/Lake 75' Rear SO' Side 30' Side 3S, Lakeshore Lot: Street Average l.akeshore Setba : must be met s not Ilcable. 4. Lot Coverage by Structures: limited to 15°�6 of lot area oes not a 1 lot area>2 acres 5. Harcicover limitation are applicable are not anallcable. 0-75'zone= 0%allowed 75-250'zone=25%allowed 250-500'zone= 30%allowed 500-1000'zone=35%allowed 6, Municipal sewer is available. 7. No Wetl d{s resent. The und igned pr e owner hereby acknowledges receipt of the above information, Staff Initials v� i��a I �-� �--- Prope Owner's Sign u Date (Origin I: Street File; Copy: Property Owner) w:lstreet files\oxford rd44951zoning disclosure 8�property information fOT1ri.dOCX Created: January 28,2008 DATE TIME V CITY OF ORONO CALLED IN INSPECTION NOTICE SCHEDULED PERMIT NO. °�O/d-Do SZ� coM�TEp \�T - ADDRESS � � f-��, OWNER TELEPHONE NO. CONTRACTOR � DESCRIPTION J-.�Q(/lO�(.�A J � �-�-E.�� ❑ FOOTING ❑ PLUMBING FINAL p EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICALRI ❑ LAKESHORENVETLANDS y ❑ 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�D�MO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP _ ❑ DEMO-FINAL � SEPTIC INSTALL ❑ HARD COVER REMOVAL J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL 2 OWNERICONTRACTOR TO MEET YOU:_YES_NO c�., COMMENTS: � W a � � O a � O � W � Q � 2 W � W � � d �t,'''_ W� �sLJpwRKSATISFACTORY:PROCEED ❑ PROJECTCOMPLEfE W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY 0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFOREC�/ERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN INSPECTOR WFLL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED ❑ INSPECTIONREQUIRED.CALLTOARRANGEACCESS. Call for the next inspection 24 hours in advance. (952) 249-46�� Owner►Contractor on site: Inspector. White Copyllnspector's Flle Canary CopylSite Notice DATE TIME CITY OF ORONO CALLED IN I�/^� INSPECTION NOT CE j SCHEDULED PERMIT NO.��—t�bJL� COMPLETED ADDRESS _ � � FH OWNER TELEPHONE NO. CONTRACTOR � DESCRIPTION �-�� ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORENVETLANDS y ❑ FRAMING ❑ MECHANICAL FINAL O ❑ TREE REMOVAL Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS � ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT � ❑ DEMO-SITE 0 SEPTIC MAINT. ❑ FOLLOW-UP _ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL � OWNER/CONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W C � t L,SQ ; s � o � � � '� -� � ��r- �c � � t � ° �'�..1 P t/}c � w � Q � z W � W � � GW ❑WORKSATISFACTORY:PROCEED L7`PRpJECTCOMPLETE � ❑CORRECT WORK&PROCEED G ISSUE CERTIFICATE OF OCCUPANCY W 0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY � BEFORECOVERING PERMANENT ❑ CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CAIL INSPECTOR '� CITATION ISSUED ❑ INSPECTION REQUIRED.CALI TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. �95Z� Z49-4600 OwnerlContractor on site: Inspector. �� White Copyllnspector's File Canary Copy/Site Notice . • . . • . 1 • emo To: Finance Department From: Christine Mattson, Planning Assistant / , CC: Street File ��V '" v Date: 1/29/2013 G/L: 101-22205 Re: Demolition Permit Escrow Refund Demolition Permit #2012-00527 pertaining to 495 Oxford Road is complete. The applicant submitted a new escrow and signed escrow agreement in conjunction with the construction of a new home (2013-00007), therefore the demolition permit escrow can be refunded. Please refund $2,000 to Michael &Anne Sample. The following is attached: • Original signed escrow agreement • Copy of cash register receipt showing escrow amount received Mail to: Michael &Anne Sample 1449 Bay Ridge Road Wayzata, MN 55391 w:\street files\oxford rei�495\escrow refund memo 2012-00527.doc DEMOLITION PERMIT#2812-00527 ESCROW AGREEMENT /;� � � AGREEMENT made this /7 day of �UNr , 20 �� by and between the CITY OF ORONO, a Minnesota municipal corporation ("City")and Michael &Anne Sampls("Owners"). Recitals 9. An app(ication for a demolition permit has been filed for an accessory structure located at 495 Oxford Road ("Subject Property"}legally described on attached Exhlbit"A". 2. In con}unction with the demolition erosion control measures are required as shown on attached Exhibit"B°. NOW,THEREOFRE�THE PARTIES AGREE AS FOLL�WS: 1. DEPOSt7'OF E3CRt3W FIfNDS. Contemporaneously with the execution of this Escraw P`qresment, the Owners shali deposit$2,000 with the City. All accrued interest, if any, shall be paid to the City to reimburse the C1ty for its cost in administerfng the escrow accounf. 2. PURPOSE OF ESCROW. The purpose of the escrow is to guarantee reimbursement to the City for all out-of-pocket costs (including planning,eng9neering, or legal consultant review)the Ciry has incurred to assure that the erosion control measures are instailed and mair�tained so the property complies with the provisions of Orono City Code Chapter 79. The financial securlty may also be used by the City to eliminate any hazardous conditlons associated with the work and to repair any damage to public property or infrastructure that is caused by the work. if compliancs with the approved Land Dlsturbance Permlt is not accomplished within the allowable time period, the Clty may bring the project into compliance by use of the securiry. 3. RIGIfT OF ENTRY. The Owners hereby grant the City, its ageMs, empioyees, officers and contractors the right to enter the property to perform all work and inspections deemed appropriate by the Clty in conjunction with the required erosion control measures, including but not limited to constructing or completing any and all of the agraed upan improvements should the Owners' contractor not complete those improvements by the date specified herein. 3. MONTHLY BILLING. As the City receives consultant bills for incurred costs, the City wifl in tum send a biil to the Owners. Owners shall be responsible for payment to the City within 30 days of the Owners'receipt of bill. 4. DISBURSEMENT FRC?M ESCROW ACCOUNT. In the event that the Owners do nof make payment to the City within the timeframe outlined in#3 above, shall issue a Stop Work Order until the Owners pay all expenses invoiced pursuant to #3. The City may draw from the escrow account without further approval of the Owners to reimburse the City for eligible expenses the City has incurred. 5. CLOSING ESCROW. Any remaining amount of the �nancial security deposited with the City for faithful performance af the plans and speciflcations and any related remedial work will be released af#er the completion and inspectivn of all such measures and the establishment of finai stabilization for the Subject Property. 6. CER'FIFY UNPAID CHARGES. If the projsct 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 . TY O ORONO O S: � � � By: Its: � v� � 150784 , � r-' - _ , l... , . . . . -... .. r �' ,�� '4vriu �l#"G��'G:.'o �' �.�a;�b�lray' '�]k�w� r?�r�a�;�� ,�4.,;� ''.ti{��-, 3��k9��t;t3 � �� i �%!i1 ��fi �,��A:� �dGt�r�ty fi��r;z�r'r,c� ��.�r��;�}�� '��'jc'wr+,�6a '�; 1 �w� �...,, �� t°r:� � t , 7 �f •��"��r , 1 . �. i.N�o�v.I"af� .. ' ( l�-'f�!"t'E+G!' �.F3;�-_jck��j<,f,�f. � �Ca�;� � �p�3�: i t� M1�^T '' �� 'Z+�'y.ilF ' � . �.(1t�t '. s� - . �. . ^�+. °'! �'1��i t� 6:: ~n��,�, -y�~ ��rE�3.t nAF,I i:.a�� ir�>�,�` P�.�}��7��` ��•�?��[7,�j�'p . . � . .�� ✓.��'! �+.. � ��4.�r� � . . . _ +��j.' d i°�'J�yR'j „ . `3 DEMOLITION PERMIT#2012-00527 ESCROW AGREEMENT EXHIBIT "A"- LEGAL DESCRIPTIQN ' L �� v�S � lc�I I , ► � � �� G�� i Cl��; � � �� 150784 Hennepin County GIS -Printable Map Page 1 of 1 � - � Interac �ie Property ; _. Maps M a p ��. :z� .�.: i r si 1 d �� x ,�s �ry`.., iK:.:: t, I I II �JI 1 � Il�f�il � II ��... Y:;�, . %. �... �;a. .:�- .� :r Parcel 05-117-23�1-0011 A-T-B: ToRens Map Scale: 1"�100 ft. N ��' Print Date:6/19/2012 �} N�e� Michael Sample&Anne Sample M o��t $2,580,000 w Parcei 495 Oxford Rd Tax $33,172.74 Address: Orono, MN 55356 Total: (Payable:2012) Property Residential Lake Shore $e�e $1,650,000 Type: Price: This map is a compilation of data from various Home- Homestead Sale 02/2012 sources and is fumisned°a,s iS��witn no stead: Date: representation or warranty expressed or implied,induding fitness of any particular Other—See Certificate purpose'merchantability,or the accuracy and ParCel 2.25 ac�es Sale completeness of the information shown. Area: 97,865 sq ft COd@: �j al Estate Value COPYRIGHT�HENNEPIN COUNTY 2012 � Think Greent http://gis.co.hennepin.mn.us/Property/print/default.aspx?C=452009.6690914275,4979724.... 6/19/2012 Christine Mattson From: Christine Mattson Sent: Tuesday, June 19, 2012 4:41 PM To: 'm91 sample@yahoo.com'; 'bendickson2181 @msn.com' Subject: 495 Oxford Road/Demolition Permit#2012-00527 Attachments: LETTER Permit Info needed for demo.pdf; Escrow Agreement-Demolition.pdf; Zoning Disclosure.pdf Hello, Attached is a letter detailing the remaining items needs to process the demolition permit at 495 Oxford Road. If you have any questions, please don't hesitate to contact me. Christine Mattson Planning Assistant City of Orono 2750 Kelly Parkway � Orono ; MN ; 55356(physical addressJ PO Box 66 s Crystal Bay ; MN ; 55323-0066(mailing addressJ 'ji' 952.249.4620 E 8 952.249.4616 � cmattson@ci.orono.mn.us ; � www.ci.orono.mn.us Summer Office Hours began Monday,May 21,2012 Monday-Thursday: 7:30 am to 5 pm Friday:7:30 am to 11:30 am OUR OFFICE WILL BE CLOSED: Wednesday,Ju/y 4,2012 i • CITY OF ORONO * 2 0 1 2 — 0 0 5 6 6 * 2750 KELLEY PARKWAY DATE ISSUED: 06/20/2012 ORONO,MN 55356— (952) 249-4600 FAX: (952)249-4616 ADDRESS : 495 OXFORD RD PIN : OS-117-23-41-0011 LEGAL DESC : STIELOWS ADDN : LOT 003 BLOCK 001 PERMIT TYPE : ESCROW FEE-TIED TO BUILDING PERMIT PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ESCROW FEE-TIED TO BUILDING PERMIT NOTE: ESCROW FOR DEMO PERMIT 2012-00527 APPLICANT ESCROW FEE-BUILDING 2,000.00 SAMPLE,MIKE&ANNE TOTAL 2,000.00 1449 BAY RIDGE RD WAYZATA,MN 55391- (952)847-3159 OWNER SAMPLE,MIKE&ANNE 1449 BAY RIDGE 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 goveming this type of work shall be compied with whether or not specified herein.This permit will expire and become null and void if conswction authorized is not commenced wi in 180 days of the date of issuance,or if construction is suspended for period of 180 t any time after work has commenced. The applicant responsible or ass ring all required inspections are requested i nformance wi the tate ilding Code.This permit may be revoked a� time for e c se. � � / ZU / �c�t / / pplicant P rmitee Signature Date Issued By Si re Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABO E. � o� O O CITY of ORONO Municipal Offices r'� .;; � Street Address: Mailing Address: '�+�� ,�,�' 2750 Kelley Parkway P.O.Box 66 ,�G Orono,MN 55356 Crystal Bay,MN 55323-0066 ��k'EsHog' June 19, 2012 Mike 8�Anne Sample 495 Oxford Road Long Lake, MN 55356 Re: 495 Oxford Road Demolition Permit Application #2012-00527 The City is in receipt of your.demolition permit application which was received by this office on June 13, 2012. The following items must be submitted in order for your application to be considered complete and for the review to continue: 1. Zoning Disclosure 8 Declaration. Attached is a Zoning Disclosure and Declaration form. This form must be signed by the property owners and retumed. 2. Demolition Permit. Please submit required items 1 and 2 as listed on the demolition permit application. • Submit a survey, aerial photo or sketch showing all structures on the property. Note which structures are to be demolished. • Submit a survey, aerial photo or sketch showing proposed erosion control measures in accordance with Chapter 79, Constructron Site Runoff Control. 3. Demolition Escrow 8� Escrow Agreement Demolition permits require submittal of an escrow and an escrow agreement. The purpose of the escrow is to guarantee conformance with City Code Chapter 79 relating to erosion control and stormwater. The required escrow amount for this project is $2,000. The escrow agreement is enclosed. The property owner must sign the escrow agreement and submit a check for$2,000. The above information is required in order for the review to continue. Please feel free to contact me at 952.249.4620 or by email at cmattsonCa�ci.orono.mn.us if you have any questions. Sincerely, CITY OF ORONO � stine Mattson Planning Assistant c Mark S. Bendickson, Inc.; 1501 Hunter Drive; Wayzata, MN 55391 via email at bendickson2181�Dmsn.com Mike Sample via email at m91samqleCa�vahoo.com Lyle Oman, Building Official enclosures Telephone (952)249-4600•Fa�c(952)249-4616 www.ci.orono.mn.us i I � i � �. � � � � ; �o io� � — ; :� � � a� � � �, f : � � L � o - � � ; . � � ; ■ •� �'; ,� � � � •-' ri � � ` � � � ..3 � V j � � L� !� v d � � f�': t:.• �r _ � I I } i i i I i �+� �� v I � � " � � a g� � � � � a� � i — _ �'� �} � - � � � ; i � � a' ; �o i � .� N! � �� i a �; ; �,� - � �� , i � � �',. ; � � ` ; � � � .�, � ❑ — d' �I � ��; � W �i ; �� T � : � � .� � ; � �. � � � c � C b - � 1ii � � I � a.1O+ b 2 N '* � '� � C; � Q, �j L '� �� C �� —� � ; �' _ � � � N, _ � � i ci � � � I w '� 1� 1ffi � �' d �� I � � � � . �f � '� � �i � ` , � CITY OF ORONO * 2 0 1 3 - 0 0 0 4 9 * 2750 KELLEY PARKWAY DATE ISSUED: OU18/2013 ORONO,MN 55356- (952) 249-4600 FAX: (952) 249-4616 ADDRESS : 495 OXFORD RD PIN : OS-117-23-41-0011 LEGAL DESC : STIELOWS ADDN : LOT 003 BLOCK 001 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 BULDING PERMIT#2013-00007-PD CHECK#5980-BY MICHAEL SAMPLE / APPLICANT ESCROW FEE-BUILDING 2,500.00 SAMPLE,MIKE&ANNE ESCROW FEE-EROSION CONTROL 0.00 1449 BAY RIDGE RD WAYZATA,MN 55391- ESCROW FEE-GRADING 0.00 (952)847-3159 TOTAL 2,500.00 OWNER SAMPLE,MIKE&ANNE 1449 BAY RIDGE 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 dces 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 aze 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. � , . BUILDING PERMIT ESCROW AGREEMENT Orono Building Permit#2013-00007 � AGREEMENT made this 1� day of�P*��t+-�1 , 20 i 3, by and between the CITY OF ORONO, a Minnesota municipal corporation ("City")and Michael &Anne Sample ("Owners"). Recitals 1. A building permit application has been filed for a new sinale family residence and detached ar4 aQe located at 495 Oxford Road the ("Subject Property"), legally described as Lot 3. Block 1. Stielows Addition. 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 bullding permit #2013-00007 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: CITY OF ORONO OW R: gy: ��lI (�1t�1'�"� � �ts: �-� Internaf Use Only: ' �Origfraal:ta,Pl�nning ��Cop.y'to:l�raper�y O+�vner ��opy`tc�Street Flle CITY OF ORONC� * Z 0 1 3 - 0 0 0 0 6 * 2750 KELLEY PARKWAY DATE ISSUED: O1/04/2013 ORONO, MN 55356- (952) 249-4600 FAX: (952) 249-4616 REPRIN"rED ON 1/4/2013 ADDRESS : 495 OXFORD RD PIN : OS-I17-23-41-0011 LEGAL DESC : STIELOWS ADDN : LOT 003 BLOCK 001 PERMIT TYPE : ADVANCED PLAN REVIEW PROPERTY TYPE : RESIDENT[AL CONSTRUCTION TYPE : ADVANCED PLAN REVIEW VALUATION : $ 1,150,000.00 NOTE: PLEASG FILL IN THE FOLLOWING: VALUATION OF PERMIT: $ 1,150,00Q00 TYPE OF PERMIT THIS PAYMENT IS FOR: NEW I IOME YERMI"I'#TH[S PRGPnYMGNT IS�l'IED"I�(>:2013-00007 PLAN REVIEW PD ORIGINALLY ON PERMIT 2012-00639$5153.69. NEW PLAN REVIEW FEE IS$4261.89. DIFFERENCE OF 891.80 TO BE CREDITED TO BUILDING PERMIT FEF,. APPLICANT ADVANCED PLAN REVIEW 4,261.89 STONEWOOD, LLC TOTAL 4,261.89 7407 WAYZATA BLVD MINNEAPOLIS, MN 55426- 4,261.89 (952)697-5590 �Q�� Minnesota State License#: 20594315 a�D/a-OD(o'.�� OWNER SAMPLE, MIKE&ANNE 1449 BAY RIDGE RD WAYZATA, MN 55391- AGREEMENT AND SWORN STATEMENT The work for which this permit is issucd 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 widiin 180 days of the date of issuance,or if construction is suspended for a period of 180 days at any time atter 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 13y Signature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.