HomeMy WebLinkAboutRe: returned fee i 4�
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To: Finance Department
From: Christine Mattson, Planning Assistant C�/\
CC: Street �� (�
Date: September 9, 2015
G/L: 101-22205
Re: Escrow Refund
An Advance Plan Review fee was collected in error pertaining to a proposed project at 880
Partenwood Road. Please refund $531.88 to the applicant, Yardscapes, Inc.
The following is attached:
• Copy of cash register receipt showing escrow amount received
Mail to: Yardscapes, Inc.
8609 Harriet Avenue South
Bloomington, MN 55420
w:�street files�partenwood rd�880�adv plan reivew refund 2015-01008.docx
- ` CITY OF ORONO * 2 0 1 5 - 0 1 0 0 8 *
2750 KELLEY PARKWAY DATE ISSUED: 08✓10/2015
ORONO,MN 55356-
952 249-4600 FAX: 952 249-4616
ADDRESS : 880 PARTENWOOD RD
PIN : OS-117-23-43-0001
LEGAL DESC : PARTENWOOD
: LOT 006 BLOCK 001
PERMIT TYPE : ADVANCED PLAN REVIEW
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ADVANCED PLAN REVIEW
VALUATION : $ 63,000.00
NOTE: PLEASE FILL IN TI�FOLLOWING:
VALUATION OF PERMIT:$63,000
TYPE OF PERMIT THIS PAYMENT IS FOR: DRIVEWAY REPLACEMENT
PERMIT#THIS PR�PAYMENT IS TIED T0201�01010
APPLICANT ADVANCED PLAN REVIEW 531.88
TOTAL 531.88
YARDSCAPES,INC. Payment(s)
8609 HARRIET AVE SO. CREDIT CARD 5238 531.88
BLOOMINGTON,MN 55420-
(612)363-5789.
OWNER
GRAY,JERRY&CYNTHIA
880 PARTENWOOD RD
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 dces
not grant permission for edditional or related work which requires separate
permits. All provisions of laws and ordinances goveming this type of work
shall be wmpied with whether or not specified herein.This permit will
expire and become null and void if wnstruction suthorized is not
commenced within 180 days of the dau 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 confom►ance with the State Building Code.This permit may be
revoked at any time for due cause.
/ /
Applicant Permitee Signature Date Issued By Signature Date
CITY OF ORONO
BUILDING PERMIT APPLICATION
FOR NEW STRUCTURES OR ADDITIONS ��
A, MeNfilg Ad�ess: �
� O Pemdt rwmber.
� �Y PO Box 86 p� �
Cryatal BaY�MN 6532&0088 Date reoelved: O lD'-
y �' �50 �� Reoeived bY.
�. G.
�►P�y �,re�►�: ��'"3/ 88'
��kESHO��' ���MN 55358
Total Fee: ���5
Main: 952-249-4600 Fa�c 952-249-4816 www.a.orono.�.us
This application fonn must be completed in fulf and alt required informa�on musf be submitted. ,
Inwmplete aPPlications wfll be retumed. (P/ease pdnt)
GENERAL INFORMATION:
Job 31te Address: o
V1rll this be a Parade of Homes, Remodelers Shov�case Home or other Display Home? Yes No
!/1^es,e speck/e►renf pemr�!s�equ�red w�h PaNroe Deputr�nt�d C�y Couv�l approva!�days pAw to tM s�rent Shuldb bus ss�v�ce w�bs
requ�ed uMess app�ca�demonsbabes sullPds�on-sl�s parl�►q!s av�s. Nan-pemwlted ev�Ma w�not bs aNbwed.
CONTRACTOR/APPLICANT INFORMATION:
N8�1'1@: ��A2fl<<sPE(
State Ucense# Expiration Date:
Phone: (cel�) 6 �2� 3 6 3- �'T 6 (office) 9 rz 8��-z�s y
MailingAddress: : 'K��,,.�� ZIP: s- 420
Contact Person: �.,��,, S�t u�, ApplfcaM is: or Homeowner �cxa.o�o�
Email and/or Fax: 1„�,� �, �r A��s n e r,-,,,,� �c�...,
PROPERTY OWNER INFORMATION: i ,
Name: � C.�,�
Phone (daY): 6�z- n t
Address: _$�o ,C n r'T G•N l� �� �<� Clty b r��a ZI P• S.�` 9 I
Email and/or Fax C, .d,_ � .... <.�p.� ctn r�r ,c�...,
u __
ARCHITECT/ENGINEER INFORMATION:
Name: �v /A
Phone (day):
Address: City' ZIP�
Emaii artd/or Fax:
PROJECT INFORMATION: Desa�l tlon of ct:
1.Type ot ProjecE 2 Proposed Use 3.3tructure TYPe 4.8a�wage Disposal b
❑�� �� �a��ached��e �R��denoe , Water Suppiy
9�8 ❑�ra9e/Accessory BId9• t�J Pt�lic Sevver
❑AccessorY B�ding ❑ Sin91e FamNy wnh ❑Dedc
❑R�ocation 'Dr1 J`w� .�.��, detact�ed e ❑Offloe/Commerdal ❑Private Sew�er
❑Other.(spedN) a O M�Fa�y/Condo ❑Warehouse
a�� ���W�
�a,y.a�c n mo�eme M�,,,��s o�u�re ❑�o�►�aai �o��8�,,
MCWD rovlow 8 ❑Privvatte VV'ell
Mku�ehahs Creek Wa ersF�ed DisMct(MCWD) 0 p�gr(gpgq{y� e
18202 Mirr�etordca 81vd
Deephaven,MN 55391
Phone: 952-471-0590
Fax: 952-471-0682
vwvw. ' creek.
Estimated Construc�on Valuation(exduding land) ; � 3, c�o `—
STRUCTURE INFORMATION:
1.3tructure Dimensions 1.3tructure Dimensfons(continued) 2 Typa of Construction
a.Length(ft.)= Ntxttber of bedroans=
❑Wood/Frame
b.Width(ft.)= Number of garage atalts: ❑Masonry
Areas in aauare feet q�q�: ❑Metel
❑Pole Bidg.
c.Basemerrt= petaq�d:
d. 1 p St�y = ❑ICF
e.2nd Story= ❑On-site Prefab
❑Off-slte P�efab
f. i4 Story =
�Other(please sPe�Y)�
g.Totat Areas
REQUIRED SUBMITTALS:
All of the information must be submitted In order for our a lication to be rocessed:
Not
Enclosad Icabie
O � P�nit icatlon .�,
O O gt�Nd p�en.q
� 0 MN State Code CalCulatbns and Mec�enicai Code R �dremeMs Form
O � mee� aM uirements
a a Stomlwater Po1luBon Prev�endon Plan
O 0 Hard�Calc�latlo a
� 0 c em SRe Evaluation Re
0 0 Acoess PertMt
O O Wetiand Bu(fer I rovement Plan
O � ineered Plans for RetaiN Wa�s 4 feet or above
O O Mirx�ehaha Creek Watershed DisMc:t Pertr�t s
� � Plan Review Fee
O O Appik�tion Escxotiv 8�/�reement
0 O Other:
APPLICANT/OWNER ACKNOWLEDGEMENT:
• Aprees to provlde all infom�ation required or requested by the Buildin9 Depar�'nerrt:
• Agroes to pay the Criy ot Orono for enginoering consulbnt revia�r costs In excess oi�;
• Certifies that the infortnatlon s�lied is fi�e and corred to tl�e best of his/her kno�Medge. The applicaM recbgnizes tl�at they
are solely responsit�e for aubmitting a oomplete appiication being aware that upon feilure to do so, the staff has no altemative
but to r+ejec�R�ti1 it is ocmpiete;
• Adcnowledgea the Escro�n►�reement is oompleted and signed;
• Understands aome or aq of the infortnatlon that you are asked to provide on this appHcadon is dassified by State law as either
pfirate or c�onfideMiai. Pr(vate data��fom�atia�which generally cannot�gh�n to tl�e pubiic but can be given to the subJJecc:t
of tlie data. CoMiderrtiel data is GrfortnaHon which generafy cannot be given to eitl�the pubBc o�the subjed of tlie data. Our
purpose and irrtended use of this infortnatlon is to aru�ualy update oiu reoords and reoords of ofher govemmental aget�cies
requ�ed by law. If�u refuse to supply tl�e inforrnatfon,the appllc�tion may not be�sued.
• Agrees that In the eveM that weather or other condttions prevent the completton of an as-buik sunrey at the time the
Certiflcate ot Occupancy is requasted�a t�mporery Certifica�of Occupancy may be issued upon receipt of a;10�000
escrowto ensure compl n of the as-built survey and all site Improvements.
Applicarrt's Signature: Date: �- �� ?�
OHmers Signature: Date: