HomeMy WebLinkAbout2015-01001 - new structure 'r.
, CITY OF ORONO * z 0 1 5 - 0 1 0 0 1 *
2750 KELLEY PARKWAY DATE ISSUED: 09/09/2015
ORONO,MN 55356-
952 249-4600 FAX: 952 249-4616
ADDRESS : 559 PARK LA
PIN : 06-117-23-41-0044
LEGAL DESC : MINNETONKA SUMMIT PARK
: LOT 000 BLOCK 006
PERMIT TYPE : NEW STRUCTURE
PROPERTY TYPE : RESIDENTIAL
COI�ISTRUCTION TYPE : SINGLE FAMILY
ACTIVITY : 101-SINGLE FAMILY HOUSES,DETACHED
VALUATION : $ 544,081.00
NOTE: SEPARATE PERMITS REQUIRED:PLUMBING,MECHANICAL,ELECTRICAL(STATE). (BASEMENT WILL NOT BE FINISHED,A
SEPARATE PERMIT WILL HAVE TO BE APPLIED FOR)SAC PD#4228 10/2U1975
NOTE: PRIOR TO THE START OF FRAMING AN AS-BUILT OUND RVEY MUST BE SUBMITTED AND APPROVED BY THE
CITY OR A STOP WORK ORDER WILL BE ISSUED: INITIAL.
NOTE: PRIOR TO ISSUANCE OF A CE TE OF OCCUP Y AN AS-BUILT SURVEY IS REQUIRED TO BE SUBMITTED AND
APPROVED BY STAFF. INITI •
NOTE: IN THE EVENT OF WINTE ONDITIONS OR OTHER UNFAVORABLE A DITIONS(WHICH PREVENT THE
COMPLETION OF THE EXTERIOR IMPROVEMENTS AND/OR AN AS-BUILT RVE ORARY CERTIFICATE OF OCCUPANCY
(TCO)MAY BE NECESSARY. A TCO REQUIRES A$1Q000 ESCROW. INITI :
NOTE:NO UNDERGROUND PLUMBING/SEWER WITHIN 10'OF THE WELL. INI
APPLICANT PERMIT FEE SCHEDULE 3,865.84
PLAN REVIEW 767.82
ATLAS HOMES INC STATE SURCHARGE(VALUATION) 272.04
7082 EAST FISH LAKE RD
MAPLE GROVE,MN 55311- TOTAL 4,905.70
(763)425-3333 Payment(s)
Minnesota State License#: BUIL-BC20269686 CHECK 1762 4,905.70
OWNER
O'DONNELL,TIMOTHY&JOAN
559 PARK LA
LONG LAKE,MN 55356-
AGREEMENT AND SWORN STATEMENT
The work for which this permit is issued shall be performed according to
the approved plans and specifications,applicable City approvals,and the
State Building Code. This permit is for only the work described and does
not grant permission for additional or related work which requires separate
permits. All provisions of laws and ordinances goveming this type of work
shall be compied with whether or not specified herein.This permit will
expire and become null and void if construction authorized is not
commenced within 180 days of the date of issu ce,or if construction is
suspend d for a period o 80 days at any tim er work has commenced.
Th pplic t is res ns l for assurin t r uired inspections are
r uested i co w� the S u' ing Code.This permit may be
evoked at fo ca e.
1 �,
9� 9 �� 2 �.�-� � q � l
�� , ,
an P ee ignature Date Issued By Signature Date
,
City of Orono
Buiiding Permit Application
for New Structures or Additions
Mailing Address: Permit number: /S" � �(��
�'�Q� PO Box 66
Q Crystal Bay, MN 55323-0066 Date received: S—�
IStreet Address:' Received by: /�.�'�
y ,�/ 2750 Kelley Parkway � Plan review fee: / 7
�" �� Orono, MN 55356 '
`qkE5H0�� Main: 952-249-4600 C�( -d(OOC)
Fax: 952-249-4616 www.ci.orono.mn.us �' �5��`��5�/$
This application form must be completed in full and all required information must be submitted. �x� t-
Incomplete applications will be returned. (P/ease print) Si�
GENERAL INFORMATION: �� Gj� K,�I U r��y'
Job Site Address: 559 Park Lane, Long Lake, MN 55356 � J
Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes � No
If yes,a specra!event permit is requrred with Police Department and Ciry Counci!approval 60 days prior to the event. Shutlle 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: Atlas Homes Inc
State License# BC269686 Expiration Date: � J
Phone: _(cell)763.691.4099 (office) 763 425 3333
Mailing Address: 7082 East Fish Lake Rd c�t :Ma le Grove z�P: MN
Contact Person: Mark Way Applicant is: Contractor / Homeowner (ClrcleOne)
Emaii andior Fax: mark(c�atlashomesmn.com
PROPERTY OWNER INFORMATION:
tvame: Timoth� & Joan O'Donnell
Phone(day): Joan- 309.361.9302 Tim 309.361.6695
Address: PO Box 632 City: Osseo ZfP: 55356
Email and/or Fax odonnell.t.m(a�qmail.com
ARCHITECT/ENGINEER INFORMATION:
Name:
Phone (day):
Address: City: ZIP:
Email and/or Fax:
Ff�A ICf`T IwICtS�f1AATInRf• f'`acrrinfinn nf nrniort•
� 4. Sewage Disposal&
� �i /� �v• �i ►���� �� // �y�. �' Gara e Water SuPP�Y
� g
j � Public Sewer
� �,f 5 ) � • �(�% ,I
; � NeW �}ar �v� �`� f ❑ Private Sewer
f� '
�
❑ Public Water
����
r _ -�-�,,,
n . �� � Private Well
1 p�ecl �� ��tr�► �v. '
� D'� ��.��
F
� � �.� � �.� —
E . �s 8 - �
TT ��
^ o � fj�� r �c� � "
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�
�
.�--___ _
_....,�._.._ .... _........._...
� 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: ❑ Masonry
Areas in sauare feet Attached= 3 ❑ Metal
c. Basement= 2113 Detached= ❑ Pole Bldg.
d. �51 story = 2133 ❑ ICF
e. 2"d Story= ��,�1� ❑On-site Prefab
❑Off-site Prefab
f. Yz Story = "'
❑Other(please specify):
g.Total Area=
REQUIRED SUBMITfALS:
All of the information must be submitted in order for our application to be processed:
Not
Enclosed A licable
� ❑ Buildin Permit Escrow A reement and Fees
9 5a ❑ Plan Review Fee
� � Com leted A lication Form
� O Pro osed Buildin Plans—2 full size sets,to scale and 1 reduced 11 x 17 or 8'/z x 11 set
SJ ❑ Minnesota State Ener Code Calculations and Mechanical Code Re uirements
6J ❑ Surve —2 full size,to scale meetin ALL surve re uirements
� ❑ Hardcover Calculations
� �1 Se tic S stem Certification
❑ ❑ Minnehaha Creek Watershed District(MCWD)Permit or �pP�;�d.
Documentation from MCWD statin no ermit is re uired
❑ � Landsca e Walls and/or Retainin Wall Plans
❑ � Stormwater Pollution Prevention Plan SWPPP
� ❑ Access Permit
' � ❑ Data Privac Adviso Form
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 S500;
• Certifies that the information supplied is true and correci 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 ihe 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
j Certificate of Occupancy is requested, a temporvry Certificate of Occupancy may be issued upon receipt of a S10,000
iescrow to ensure completion of the as-built survey and all site improvements.
� I I � IV I i
ApplicanYs Signature: �`'� �/t Date: �� ` � � �
, c�--'
Owner's Signature: ._ �G Date: 7•10.15
Par.ket!ast 1/ndafed .lanuarv 901.5
� PLAN �EVIEW CHECKLIST FOR NEW STRUCTURES / ADDITIONS
: � - ;- �� �-
4, "l l { �i,� ,� �'� � � ')�- � r.
Address: � ) _% ��I �" ��p I�- �--�-1�� ��--'' Permit No.: G..���`� — C..-;� 1.,� �
I F, �' �� t � � � c' �
Description of work: ��, ,,�;,, ?�i �;1\.!� ��{111� �'�/ �'� ��'r �� Date Rec d: � :� - �J
<' . , p r,� —
Septic review by: ��r_''„�v'�.,V "�� �V �;�:'� Date Approved:
Zoning review by: L,/�Vd�� Date Approved: "1 ' g�(�
Building review by: � r ��,( I yV Date Approved: Q •g'��
Grading review by: /�� Date Approved: `1�u��5
Zoning District: �--1`` - i�j Zoning File#: Reso#: Reso Date:
Zoning: Lot Area: �q Z-!�? !SF�'AC Width: Lot Coverage: ��r' I�?,��,,' SF `l C,`i ;� ;' %
Survey Submitted: Yes O No Date of Survey: � � �.� � ��,� Revised date(?):
Proposed Setbacks:
Fr t(Lake) ar(Street)h�' � �; S E W�) ( N �S E W�) Other Buildings Wetland
Side ��Side
i � ' % j i
, � -y
Defined Height: Peak Height: FFE: I.�'� � �� FFE minus 6 feet= A�j� t� (Existing Contour)
� � ,y �,.;. � ;� i, t %t
Perimeter(linear feet) = 1- 1- � i % . 50% _ � � E . • ( � � " L.F. below grade #of Stories
FOR A BUILDING WITH A BASEMENT OR CRAWL SPACE: FOR A BUILDING ON A SLAB FOUNDATION:
The distance between the lowest proposed The distance between the top of
�(_ � START WITH floor(of the basement or crawl space)and START WITH slab and the highest point of the
�(�L=-" the highest point of the roof. roof.
If you have a... If you have a...
• GABLE OR HIPPED ROCF
• GABLE OR HIPPED ROOF(no (no windows): Subtract hal!
�) windows): Subtract half the distance the distance between the
� , � between the highest point of the roof highest point of the roof to
to the low point of the corresponding the low point of the
SUBTRACTION gable or hipped roof corresponding gable or
�r (BASED ON . GABLE OR HIPPED ROOF(with SUBTRACTION hipped roof
' ROOF TYPE) windows): Subtract half the distance (BASED ON • GABLE OR HIPPED ROOF I
between the top of the highest ROOF TYPE) (with windows): Subtract
window and the highest point of the half the distance between
roof the top of the highest
• ALL OTHER ROOF TYPES(flat, window and the highest
point of the roof
mansard,etc):No subtraction. . ALL OTHER ROOF TYPES
SUBTRACTION Subtract the distance between the (flat,mansard,etc):No
�� � (BASED ON basemenUcrawl space floor and the subtraction.
EXISTING highest existing grade adjacent to the ADDITION Add the distance between the top
�!� � GRADES) foundation OR 10 feet(whichever is less). (BASED ON of slab and the highest existing
A EQUALS Defined building height ,. EXISTING grade adjacent to the foundation.
�f �( '7 � GRADES
[�- U G� �_ �, EQUALS Defined building height
r� �
��'i E"�� "1
Shoreland District MCWD Permit ✓� A erage Lakeshore Setback Bluff
Met?
Permit Number: �5 . Yes � No 0 N/A 0 Yes No
�Yes O No
• O N/A-see attached Setback:
Stormwater Quality Existing Hardcover Proposed
Overlay District o Hardcover Variance Required CUP Required
Tier circle one (/o and sf) %and sf
� ",-�=�'�:� � Yes �l0 0 Yes No
1 2 3 4 5 n'�� Type(s): Type(s):
Updated: January 2015 � , /„[r7O
z:\forms\plan review checklist 2015.docx �''�l� L�.,
/^ J �
�w�
REMARKS (in-house): • ,
Fees to be Char ed YES NO
Permit l/-`
�
Plan Review
State Surcharge (�
Investigation Fee ✓
� �'��.L � SAC— Number of SAC Units
�� ��►� 1 '
Other(specify) I�—
Square Foota e $ er Square Foota e
� �9asement Z� � � X = $
1S`FloorC.�Z � - X �D(�, �(Q = $
^ 9
��:� �.,� � 3� X . s" _ $ � � � � a
; Garage � X `Z�j , _ $ Z � �
Estimated Construction Value: � � �
�
Orono Inspections Required Work Requiring Separate Permits Required State Permits
� Site Plumbing 0 Grading/ Filling 0 Well
Silt Fence/ Erosion Control �Mechanical � Fire Electrical
� Hardcover Removal � Septic � Water Connection �
Footing ❑ Fireplace � Sewer Connection
Poured Wall � Masonry 0 Lawn Irrigation
Foundation Survey 0 Mfg. � Landscaping �
� Foundation Waterproofing 0 Other(specify) �
Radon Rock Bed '
Framing '
�
Insulation
As-Built Survey
Final
0 Other(specify)
REMARKS (in-house):
vther Review: Reviewed by: Date Approved:
Access: Existing: � YES 0 NO New: � YES � NO
OFFICIAL REMARKS -TO BE NOTED ON PERMIT AND INITIALLED
� No b � ;��n 0'
� (I/��', i � .��,
Updated: January 2015
z:\forms\plan review checklist 2015.docx
. �
��C�C O►f ��OI'Y��101'1
ouct sealing P�rfonr�ed For:
200
O►DONNELL, tim TRAJ NI NG
55A parlc in
anno, NN 5535G
��
4
�
O�e�rall Sealing I�ts N
�
m
Wl��en we arriv�ed, -� ��
m
J
YOUR DUG"T'S F-I��D: �
U
168.1 CFM af Leakage, ec�ivalerrt to a
50
31.8 Square Inch Hole
TI•rsa�e,c�s>A2sn�iig�a�sli//aFa%�/asse�yharr.
�el'V1�fll'IIS�'1�, 0
YOI�DUCTS HAVE: 0 2 4 s s �o i2 i4 is
Sealing Tirr+e in Minutes
18.4 CFM af L,eal��ge, equivalerrt to a
3.5 Square Irx�'1 Hole /aeroeea�Tect�r�ician ron
This oorr-esporxis to a 89.1%Fi�educ�ion in ,a�r�c�se io �zto
� �' o��s� �rzo�s
NoG� Duct l.eelc�ge r�esults are cala.�abed in Q,bic
Feeit per IVinube(CFIN1�rr�ees�red at a star�dar�d ��Desc.iiptian RETl�I
OPERAIIPIG P�of 2.5 Pa S�I Description ret�n
F�n�ere Horr�eSeel
AER05FAL�
�uct Sealing From The Inside
. ., _���,
RECEIVED
City of Orono SEP`— 2 2015
o No Hardcover Calculation Workshe
�jT1(OF ORONO
,, � Property Address: s-S-9 p�R K ��t A�E� �Ti�/N f�7t�'Aet/ O 'Dan��vE�c�
y�'�Kf5NO0.E` Prepared by: Date: �_,c_,_�••_
�'rRdni��'�'�' � A1'foc%r r�'l,s�r•�c. 9-I--/5
Stormwater Quality Overlay District Tier: (Circle one) ier Tier 2 Tier 3 Tier 4 Tier 5
Step 2. . R�P O S D RAH pC�Q B�
In the following table, identify all items of proposed hardcover on the property, keyed by letter to
Certificate of Survey (survey must accompany this form). Include all existing hardcover items thaY are
intended to remair�, as well as all proposed hardcover items that will be added. Use as many lines as
necessary to accurately depict proposed hardcover status of the property. For Tier 1 properties, identify
any features oy letter which are split at the 75' setback line and calculate hardcover square footage
se aratel for each ortion.
Key to Hardcover Item (Describe) Length x Width Total
Surve Square Feet
Exam le Ga�a e : 24'x 30' 720 S,F .
q O S.F.
B i y s s.F.
� fa : s.F.
o co �eF aaP s.F.
E o i.v S.F.
F CO S.F.
G � S.F.
H i, S.F.
I i le Ii /i I2 S.F.
� S.F.
K �- S.F.
� S.F.
M _ S.F.
N S.F.
p S.F.
p S.F.
Q S.F.
R - S.F.
g S.F.
T S.F.
� S.F.
�/ S.F.
W S.F.
x S.F.
Y S.F.
Z S.F.
1 Total Pro osed Hardcover S.F.
Excludable,'Nacdcover See<Cl .Code Sea78=1684:.
�C � rt,/ S.F.
S.F.
S.F.
' S.r.
S.F.
2 Total Excludable Hardcover ff S.F.
3 Net Pro osed Hardcover Subtract line 2 from line 1 6 S.F.
4 Total LotArea /�,� S.F.
Proposed Hardcover Percentage [(3)�(4)] Z�7: Zts%
,yv�,r� t covERF,�rron��. r,v�d =282o,c 2sf36� z�9.r .� ��,2,�Q =/y 997 %'o �"r,ckrr�rrr,r�,
This is an Information packet regarding Nardcover. Every effort has been made to insure the accuracy of the informatlon contained
herein;however,if any information is not consistenf with provisions of the Ciry Code,the Code provisions will prevail.
Page 9 of 9
City of �rono
.;: �oNo., Hardcover Calculation Worksheet
,
_ � ,,� Property Address: �-$ 9 pA n � �:.�•�1c
I,��' �c , -,-•, 'Dd.vrrtl EL L�
r �T!/Y; t .�v�/tt C
`"<<��K"� prepared by: _ ,, ,, , Date: �
�/� r�,����.�? � r; � � � .�,, lA*'�'S, ��c. `� — � /-!,S
Stor�mwater Quality Overlay District Tier: {Circle one) �Tler 1 lier 2 Ti�er 3 Tier 4 Tier 5
Step 1: ISTING HARDCaVE
In the following ta le i en i a items af exis6ng hardcwer on the praperty,keyed by letter to Certificate
of Suivey{survey must accompany this form). Use as many lines as necessary to accurately depict
existing hardcover status of the propeity. For Tier 1 properties, identify any features by letter which are
split at the 75' setback line and calculate hardcover square footage separately for each portion.
Key to ; Hardcover Item {Describe} Length x Width � Total
S�n�ve S uare Feet
Exam le Gara e `. 24'x 3'0.' 720 S.F.
A , ,�,/���.�� 8' o S.F.
6 �+ rc P O�t�v� -�.� Y '�� S.F.
C �.. `,�.� _ � . .. S.F.
D c�vG>t-c� ^�� - �5 S.F.
E � p .�c �T�- � �' S.F.
F � r,�%c�r--,' .:?F'r� " 2 3 0 S.F.
G ,�h%�t� 3 6 S.F.
H �'ic�' ,�?�;.� �.���•-.�` �.e.�:�t�.� IS S.F.
� 6rGet- r�s� �'�'-r�:,c, *.�- �' n.e�,F:'�� s � S.F.
J od r,� ,. / S.F.
K T-t p S.F.
� ��t_�'3'S !;e.�=v t, /G S.F.
M Bo,..+t x,U� �`�' ' ,_ :J .t� �. S.F.
N N t.c-).!t, � o S.F.
O S.F.
P S.F.
Q S.F.
R � S.F.�
S S.F.
T ' S.F.
U S.F.
V S.F.
W S.F.
X S.F.
Y S.F.
Z S.F.
(1) Total Exis6ng Hardcover � S.F.
Excludable Ftardco•vet S'ee�' �'i�c�e,Se:c��'�;��;. �
G�Ltts� � R' ?� cv,��,� �' �' i.0�' �-75" S6 S.F.
�r �. �. •� Be a/ s S.F.
.�Z�---
�i ie ,> >a .. �i _� g �.�.
S.F.
----�--S.F J
2 Total Excludable Hardcover �S.F.
(3 Net Existin Hardcover Subtract line 2 from line 1 S S.F.
4 Total Lot Area l 2i S.!=.
Existing Hardcover Percentage [(3)+(4y] 2 y, yy �/,�
(Propose next page}
SEP 2 3 2016 5� ��
January 8,2U1.� �l'���
; C11Y OF ORONO �- �j�,-f'
�
� a
C�tificate ofi Crorr�ple�tion
o�x s�����a Fo�-
soo
OrDONI�L.L, tim TRAINING
55�J perk I n
orono, MV 55356
a �
Ou�rall Sealing F�sults N
�
m
�
�
V1k�en we�-riv�ed, m
J
YOIJR DUG"TS I-i�� �
U 2(b
526.0 CFM af Leakage, equivalerrt to a
99.4 Square Inch Hde
77rs a�r.r�s 3f5e sir�frig�atas�il/aia���ass evay/xxr:
l�@I'M11G fif11Sf'1�, 0
Y����� 0 5 10 15 2a 25 30 35
Seaiing Time ir►Minutes
12.1 CFM af Leakage, equiv�errt to a
2.3 Sc�ane Irtch Hole Aer�Ted,niaan ron
This oorresporxls to a 97.7%Red�ion in ��io ��o
�'� �' Date aF Sed 3l7/2016
Not� Duc#Leekage r+esWts are cala.�ated in Cubic ��p�P�� �Pp�Y
Feet per Nirx,�e(CFWn meas�red at a starxfard
Oi�FiAT1WG P�JRE af 25 Pa. Seal Descripdon si,QplY
F�ird�n�r�e HorneSeel
AER05EAL� �������:
�uct Sealing From Tt�e Inside TreatedAirQompany
� " �iil��"� 99�4166th aourt
Bedcer, NN,��6308
Phone:
BUILDING LEAKAGE TEST
;�= ���: ,�,,,���'E w
a.,: ir�, �" t'
Date of Test: 1/31/2016 Test File:559 Park Lane
Customer. Technician:
Project Number.
Buiiding Address: 559 Park Lane
Test Results
1. Airflow at 50 Pascals: 1178 CFM50
(50 Pa=0.2 w.C.) 1.19 ACH50
2. Leakage Area: 64.8 in2 LBL ELA�4 Pa
3. Building Leakage Cunre: Flow Coefficient(C)= 92.6
Exponent(n)=0.650(Assumed)
4. Test Settings: Test Standard: RESNET One-Point Test
Test Mode: Depressurization
5. Accuracy Level StandaM Level of Accuracy Test
Infiltration Estimates
1. Estimated Average Annual Infiftration Rate:
2. Estimated Design Infiltration Rate:
Coat Estimates
1. Estimated Cost of Air Leakage for Heating:
2. Estimated Cost of Air Leakage for Cooling:
BUILDING LEAKAGE TEST Page 2 of 4
Date of Test: 1/31/2016 Test File: 559 Park Lane
Bullding Information Location Climate Information
Volume 59627 Ventilation Weather Factor
Surface Area Energy Climate Factor
FloorArea Heating Degree Days
Height Cooling Degree Days
#of Bedrooms Design Winter Wind Speed
#of Occupants Design Summer Wind Speed
Year of Construction Design Winter Temp Diff
Wind Shield M Design Summer Temp Diff
Heating and Cooling Co�t and Efticiency Information
Heating Fuel Gas
Heafing Fuel Cost
Heating Efficiency%
Cooling Fuel Cost
Cooling SEER
Equipment Information
Type Manufacturer Model Serial Number Custom Calibration Date
Fan Energy Conservatory Mc�del 3(110� -
Micromanometer Energy Conservatory DG700
BUILDING LEAKAGE TEST Page 3 of 4
Date of Test: 1/31/2016 Test File: 559 Park Lane
Depressurization Test:
Environmental Data
Indoor Temperature(°F) Outdoor Temperature(°F) Altitude(ft)
70.0 37.0 750.0
Baseline Pressure Data
Baseline 1 (Pa) 1.3
Baseline 2 1.8
Baseline 3 2.2
Baseline 4 2.2
Baseline 5 2.1
Average Basellne(Pa) 1.9
Baseline Range(Pa) 0.9
Data Points-Data Entered Manually
Nominal Baseline Adjusted Fan Nominal Adjusted
Building Preasure Building Pressure Preasure Flow Flow Fan
(Pa) (Pa) (Pa) (cfm) (cfm) Configuration
-49.4 -51.3 48.4 1261 1198 Ring A
Time Averaging Period: 10
Deviations from Standard RE3NET One-Point Test-Test Parameters
None
BUILDING LEAKAGE TEST Page 4 of 4
Date of Test: 1/31/2016 Test File: 559 Park Lane
Comments
None
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DATE TIME
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�� DATE TIME
CITY OF ORONO - ��� CALLED IN � /� �
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❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in adva 52) 249-4600
OwnerlContractor on site:
Inspector: '
White Copyllnspector's File Gnary CopylSfts Notice
� /� \../�/•
�� a DATE TIME �
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� ❑ INSULATION ❑WOOD BURNER/FIREPLACE ❑COMPLAINT
Q ❑ FINAL ❑WATER HOOK-UP ❑ FOLLOW-UP
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Inspector:
Whit�Cop�rAnsp�Ctor's FN� C�nary CopylSib No1bs
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INSPECTION N TICE _ � SCHEDULED /�-� ��
PERMIT NO. �-s �l � c MPLETED
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Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION
Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ PROGRESS
� ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT
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V BEFOREC0IIERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ pHOTO TAKEN
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❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hou in adv�ape��! �� � 249-46��
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OwnerlContractor on site:
Inspector.
/ �
White Copyllnspector's File L Cenary CopylSite Notice
♦ �
� • � • � •
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emo �
To: Finance Department
From: Christine Mattson, Planning Assistant ��V \
CC: Street File
Date: November 9, 2016
G/L: 101-22205
Re: Escrow Refund
Building Permit#2015-01001 pertaining to 559 Park Lane is complete. Please refund$10,000
to the property owners,Timothy&Joan O'Donnell.
The following is attached:
• Original signed escrow agreement
• Copy of cash register receipt showing escrow amount received
Mail to: Timothy&Joan O'Donnell
559 Park Lane
Long Lake, MN 55356
w:�street files�paric lane�559\escrow refund form 2015-01001.docac
TEMPORARY CERTIFICATE OF OCCUPANCY
ESCROW AGREEMENT
Orono Building Permit#2015-01001
� q
AGREEMENT made this�day of , 20�, by and between the CITY OF
ORONO, a Minnesota municipal corporation ("City") nd Timothy&Joan O'Donnell ("Owners").
Recitals
1. Construction of the new residence located at 558 Park Lane the ("Subject Property"),
legally described as Lots 9 8 10, Minnetonka Summit Park, Hennepin County Minnesota,
is the subject of building permit application number 2015-01001 has been completed.
2. Winter conditions currently prohibit 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 a10,000 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 comptetion 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 consuttant review) associated with building permit#2015-
01001 if compliance with the approved building permit is not accomplished.
3. MONTHLY BILLING. As the City receives consultant bills for incuRed 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 retumed 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.
155441
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.
7. ACCESS TO SUBJECT PROPERTY. The Owners hereby grant to the City, its agents,
employees, officers and contractors, the right to enter upon the subject property for the specific purpose of
inspecting and completing any exterior improvements, final grading, establishment of vegetation and the
restoration of the subject property should the Owners not complete the work by the specified dates.
CITY: CITY OF ORONO O ERS:
By: �/I! 4 V�`�� ��;'�' � -
�ts: n� l �'
�,� �� � . �`�� _ ��� � ���; -:�� r�� � A ,�� .� �.��
: �
155441
tIMOTHY M ODONNELL os�os ���" 17 3 7
JOAN M ODONNELL
1208 WINTERBERRY AVE
GERMANTOWN HILLS,IL 61548 narE �' �
� �
� PAY TO TE�
EROF � ����
� � � v.,.
OLLARS � �
. � �
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P.O.Box 1715,Peoria,IL 61656�1715
�trtt�.t�V��/I�.�-��W � ;
.� _ �.� �S�U� 1 �ii. i 7 3 7 , i
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City of Orono
2750 Kelley Parkway
Orono MN 55356 952-249-4600
Receipt No: 3.015406 Apr Z0, 2016
Joan 0'Donnell
Previous Balance: .00
Permits �
2016-00395 559 Park Lane 7,500.00
101-22205
Deferred Rev-Developer Deposit .
---------------
Total: 7.500.00
---------------
---------------
Check
Check No: 1737 7,500.00
Payor:
,lodri U'Gr�i n�e 1 i
Total Applied: 7,500.00
---------------
Change Tendered: .00
---------------
---------------
04/20/2016 10:05AM
, CITY OF ORONO * 2 0 1 6 — PJ 0 3 9 5 *
2750 KELLEY PARKWAY DATE ISSUED: 04/20/2016
ORONO,MN 55356-
952 249-4600 FAX: 952 249-4616
ADDRESS : 559 PARK LA
PIN : 06-117-23-41-0044
LEGAL DESC : NIINNETONKA SUNIMIT PARK
: LOT 000 BLOCK 006
PERMIT TYPE : ESCROW FEE-TIED TO BUILDING PERMIT
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ESCROW FEE-TIED TO BUILDING PERMIT
NOTE: THIS$7500 ESCROW IS TIED TO BUILDING PERMIT 2015-01001 FOR A TEMPORARY CERTIFICATE OF OCCUPANCY
APPLICANT ESCROW FEE-BUILDING 7,500.00
O'DONNELL,TIMOTHY&JOAN TOTAL 7,500.00
559 PARK LA Payment(s)
LONG LAKE,MN 55356- CHECK 1737 7,500.00
OWNER
O'DONNELL,TIMOTHY&JOAN
559 PARK LA
LONG LAKE,MN 55356-
AGREEMENT AND SWORN STATEMENT
The work for which this permit is issued shall be performed according to
the approved plans and spec�cations,applicable City approvals,and the
State Building Code. This permit is for only the work described and dces
not grant pertnission for additional or related work which requires separate
permits. All provisions of Iaws 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 for a period of 180 days at any time after work has commenced.
1'he applicant is responsible for assuring all required inspections are
requested in conformance with the State Building Code.T'his permit may be
revoked at any time for due cause.
/ /
Applicant Pertnitee Signature Date Issued By Signature Date
� � � � ✓
� Orono Building Permit#_���;�_��'
AGREEMENT made this day of , 20 by and between the CITY OF ORONO, a
Minnesota municipal corporation("City'� and T�mothy � Joan O'�onneil ("Owners").
Recitais
1. A building permit application has been filed for 1 �� �cated at
559 Park Lane the ("Subj t Pr�perty'), egally described as
Lots 9 & 10, Block 6, Minn�tonka Summit P�rk, HPnne in o m MinnPs�ta
2. Owners request the City to review this application which requires City approval and may require
consu�tant legal andlor engineering review.
3. The City will commence its review of the application and incur costs associated with said review only ii
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 wi�l 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 i c used by the work(including planning,engineering, or legal consultant review)associated with
building permit# � b 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 respansible 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 �equirements of the project have been successfully completed and
whether it is appropriate to retum 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 bal nce
to the subject property pursuant to Minn. Stat. §§415.01 and 36fi.01
CITY: CITY OF ORONO NER:
By: �.Y 1 ��V rR�l.
�ts: IS 1
�. � �- � �_., �� -.� ,�, s r .w, ,� - y ::. �; ,�,,. �:
,� .,: ,�.�q���...,���.���ef�+�l�` ���.��"J���� � i�
Par.kPt 1»s1 IlndatPd• Janu»rv�15
� • DEMOLITION PERMIT ��S—��(pD
ESCROW AGREEMENT
AGREEMENT made this I �1 day of ���t-� .�, 20 /S, by and between the CITY OF ORONO, a
Minnesota municipai corporation ("City") and O� �D N�n�l ('s ("pwners°),
Recitals
1. An application for a demolition permit has been flled for located at
559 Park Lane. Lon k N 55356("Subject Property�) legally described as
_Lots 9 & 10. Blor_ 6. Minn _tonka �mmit Park
2. In conjunction with the demolition, erosion control measures are required as shown on attached
Exhibit"B".
NOW, THEREOFRE, THE PARTIES AGREE AS FOLLOWS:
1. DEPOSIT OF ESCROW FUNDS. Contemporaneously with the execution of this Escrow Agreement,
the Owners shall deposit $2,500 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 (including planning, engineering, or legal consultant review) the Ciry has incurred to assure that
the erosion control measures are installed and maintained so the property complies with the provisions of Orono City
Code Chapter 79. The financial security may also be used by the City to eliminate any hazardous conditions
associated with the work and to repair any damage to public property or infrastructure that is caused by the work. If
compliance with the approved Land Disturbance Permit is not accomplished within the allowable time period,the City
may bring the project into compliance by use of the security.
3. RIGHT OF ENTRY. The Owners hereby grant the City, its agents, employees, officers and
contractors the right to enter the property to perform all work and inspections deemed appropriate by the City in
conjunction with the required erosion control measures, including but not limited to constructing or completing any and
all of the agreed upon improvements should the Owners' contractor not complete those improvements by the date
specified herein.
3. MONTHLY BILLING. As the City receives consultant bills for incurred costs, the City will in tum
send a bill to the Owners. Owners shall be responsible for payment to the City within 30 days of the Owners' receipt
of bill.
4. DISBURSEMENT FROM ESCROW ACCOUNT. In the event that the Owners do not make payment
to the City within the timeframe outlined in#3 above, shall issue a Stop Work Order until the Owners pay all expenses
invoiced pursuant to #3. The City may draw from the escrow account without further approval of the Owners to
reimburse the City for eligible expenses the City has incurred.
5. CLOSING ESCROW. Any remaining amount of the financial security deposited with the City for
faithful pertormance of the plans and specifications and any related remedial work will be released after the
completion and inspection of all such measures and the establishment of final stabilization for the Subject Property.
City Staff shall review the terms of this escrow agreement two times per year to determine whether the requirements
of the project have been successfully completed and whether it is appropriate to return the funds. Owner may also
request the release of the funds, and such funds shall be released upon City Staff receiving the appropriate
verification that all requirements of the project have been successfully completed.
6. CERTIFY UNPAID CHARGES. If the project is abandoned by Owners, or if the eligible expenses
incurred by the City exceed the amount in escrow, the City shall have the right to certify the unpaid balance to the
subject property pursuant to Minn. Stat. §§415.01 and 366.012.
CITY: CITY OF ORONO p /
By:�'�►,Kl�►n� Wl0 .� ��o.,�
�ts: h��/�
Form Last Updated: January 2015
' � � .� ' ' ' CITY OF ORONO * 2 0 1 5 - 0 0 8 9 5�
2 7 5 0 K E L L E Y P A R K W A Y DATE ISSUED: 07/17/2015
ORONO,MN 55356-
952 249-4600 FAX: 952 249-4616
ADDRESS : 559 PARK LA
PIN : 06-117-23-41-0044
LEGAL DESC : MINNETONKA SUMMIT PARK
: LOT 000 BLOCK 006
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 DEMOLITION PERMIT 2015-00860
APPLICANT ESCROW FEE-BUILDING 2,500.00
TOTAL 2 500.00
O'DONNEL,TIMOTHY&JOAN Payment(s) �
559 PARK LA CHECK 1619 2,500.00
LONG LAKE,MN 55356- ,
OWNER
O'DONNEL,TIMOTHY&JOAN
559 PARK LA
LONG LAKE,MN 55356-
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. 1'his pertnit is for only the work described and does
not grant permission for additional or related work which requires sepazate
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 suthorized is not
commenced within 1 SO 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
TIMOTHY M ODONNELL o�oe 70'��"� 1�19
JOAN M ODONNELL
1208 WINTERBERRY AVE
GERMANTOWN HILLS,IL 61548 nn'rE
�
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- City of Orono '
2750 Kelley Parkway �
Orono MN 55356 952-249-4600 ;
Receipt No: 3.013810 Jul 17, 2015
Joan 0'Donnell I
Previous Balance: .00
Permits
559 Park Lane Demoliiton 2,500.00
Escrow
101-22205
Deferred Rev-Developer Deposit
---------------
Total: 2,500.00 ,
---------------
Check
Check No: 1619 2,500.00
Payor:
Joan 0'Donnell
Total Applied: 2,500.00 �
--------------- �
Change Tendered: .00
---------------
O7/17/2015 11:16AM