HomeMy WebLinkAbout2015-01447 - addition to home ' ' CITY OF ORONO
2750 KELLEY PARKWAY * � 0 1 5 - 0 1 4 4 7 *
DATE ISSUED: 12/04/2015
ORONO, MN 55356-
952 249-4600 FAX: (952)249-4616
ADDRESS : 2730 PHEASANT RD
PIN : 21-117-23-23-0057
LEGAL DESC : PHEASANT LAWN/2
: LOT MB BLOCK MB
PERMIT TYPE : ADDITION/REMODEL/REPAIR
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR
ACTIVITY : 434-RESIDENTIAL
VALUATION : $ 300,000.00
NOTE: SEPARATE PERMITS REQUIRED:PLUMBING,MECHANICAL,FIREPLACE,ELECTRICAL(STATE)
NOTE:PLEASE SEE AND INITIAL NEW BUILDER ACKNOWLEDGEMENT FORM
ADDITION TO HOME
APPLICANT PERMIT FEE SCHEDULE 2,369.92
XPAND,INC. STATE SURCHARGE(VALUATION) 150.00
13727 JOHNSON MEMORIAL DR TOTAL 2,S19.92
SHAKOPEE,MN 55379- Payment(s)
(952)292-6107 CREDIT CARD 0244 2,519.92
Minnesota State License#: BUIL-BC457158
OWNER
COTTER,JEFF&PEGGY
2730 PHEASANT RD.
EXCELSIOR,MN 55331-
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 sepazate
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. �
� �-�L � � � � tic-5
Applicant Permitee Signature Date Issued ignature Date
� PLAN REVIEW CHECKLIST FOR NEW STRUCTURES / ADDITIONS
Address: � f�U �M IL..LUQ�T I`.� Permit No.: L�.J� - � ��i'�
Description of work: �� �� �''� ► 1(�'`Q..,� Date Rec'd: � � " �2 ' ��
Septic review by: �i1` '4- (�� Date Approved:
Zoning review by: Date Approved: �Z� � �
Building review by: ��,L�7 , �ii��= Date Approved: �<— �- ���
�
Grading review by: Date Approved:
Zoning District: ' � Zoning File#: Reso#: Reso Date:
Zoning: Lot Area: 2- �b S AC Width: Lot Coverage _ � _ iSF I?- ��I _%
Survey Submitted: �es � No Date of Survey: a• �J ' I� Revised date(?): ��• 2��
Landscape plan submitted? 0 Yes �No Landscaper: .
Proposed Setbacks: �� �^"�`�"�'� VlWn � �"`�'� ' � '�•h�QOI�,
Fr t(Lake)� �(Street)3D ( S E W �) ( N �S E W') Other Buildings Wetl�and
� Side �Side
, � � Z► D
Defined Height: Peak Height: FFE: FFE minus 6 feet= (Existing Contour) `.
Perimeter(linear feet) = 50% = L.F. below grade
Basement? � Yes 0 No, Stories
FOR A BUILDING WITH A BASEMENT OR CRAWL SPACE: FOR A BUILDING ON A SLAB FOUNDATION:
The distance between the lowest proposed Slab at or above grade–
floor(of the basement or crawl space)and measure from hicthest existinq
START WITH the highest point of the roof. ra ade to the highest point of the
START W ITH roof even if fill was brought in to
elevate home.
If you have�—
SUBTRACTION • GABLE 6R HIPPED ROOF(no Slab below grade easure
(BASED ON windows): Subtract half the distance from highest e ' ing grade to the
ROOF TYPE) between the highest point of the roof hi hest o' of the roof.
to the low point of the corresponding If you e a...
gable or hipped roof SUBTRACTION ' ' GABLE OR HIPPED ROOF
�� (no windows): Subtract half
,y''" • GABLE OR HIPPED ROOF(with (BASED ON the distance between the
y„� windows): Subtract half the distance ROOF TYPE) , highest point of the roof to
,� between the top of the highest
window and the highest point of the the low point of the
roof corresponding gable or
hipped roof
j`/ • ALL OTHER ROOF TYPES(flat, • GABLE OR HIPPED ROOF
mansard,etc):No subtraction. (with windows): Subtract
!SUBTRACTION Subtract the distance between the half the distance between
�i (BASED ON basemenUcrawl space floor and the the top of the highest
EXISTING highest existing grade adjacent to the window and the highest
GRADES) foundation OR 10 feet(whichever is less). point of the roof
• ALL OTHER ROOF TYPES
(flat,mansard,etc):No
EQUALS Defined building height subtraction.
Defined building height
/ EQUALS
Updated: October 2015
z:\forms\plan review checklist 10-2015.docx
Shoreland District MCWD Permit Average Lakeshore Setback g�uff
M et?
�Yes 0 No Permit Number: 15 _ Yes � No � N/A � Ye No
� N/A–see attached Setback:
Stormwater Quality Existing Proposed
Overlay District Tier Hardcover Hardcover Variance Required CUP Required
circle one % and sf % and sf
�,5�6 �(p.q�'p 0 Yes o � Yes � o
Q 2 3 4 5 �g,� �� �� �� Type(s): Type(s):
Fees to be Char ed YES NO
Permit �
Plan Review �
State Surcharge 't/—"
Investigation Fee �/'
SAC– Number of SAC Units
Other(specify)
Square Footage $ per Square Footage
Basement X = $
1 St Floor X = $
2nd Floo� X = $
Garage X = $
_ �,
.--,,{�/(`�� r1 ��c,
Estimated Construction Value: $ �7�%'V, ���/
Orono Inspections Required Work Requiring Separate Permits
�Footing ❑ Site Plumbing 0 Grading/ Filling
� Poured Wall Silt Fence/Erosion Control � Mechanical 0 Fire
� Foundation Survey � Hardcover Removal 0 Septic � Water Connection
.Foundation Waterproofing ❑ Other(specify) Fireplace � Sewer Connection
Framing 0 Masonry 0 Lawn Irrigation
�Insulation �Mfg. � Landscaping
0 As-Built Survey 0 Other(specify)
r Final
Lathe Required State Permits
� Other(specify)
� Well Electrical
REMARKS (in-house): 3��CJ Z7�0�
Ph �oUc.r.3�,� � �. ,: c �� _
�u ou�s�U►�. .y,b�;�rWprK .
OFFICIAL REMARKS -TO BE NOTED ON PERMIT AND INITIALLED:
�See Builder Acknowledgement Form
scrow an as- � approved.
Updated: October 2015
. ��\fnrmc\nlan rcvia�u rhar41ic4'I fl_9(11 F rinrv
'..
� � � CITY OF ORONO �q�
y`f' ,5! r'�. �o�
BUILDING PERMIT APPLICATION ��
FOR NEW STRUCTURES OR ADDITIONS
/�OA:.., Mailing Address: Permit number: aol �--�/L
�yO\ PO Box 66
%� \, Crystal Bay, MN 55323-0066 Date received: j %
� � ,� Street Address:� ived ✓�
ti�.` � 2750 Kelley Parkway p 15�" � t Plan review fee: 5 , � �
� Orono, MN 55356 J`��� ��
�kfSH��'� 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.
Incomplete applications will be returned. (Please print)
GENERAL INFORMATION: ,� ,,
Job Site Address: ����� ��������' � � �Y�v� �. � � �
Will this be a Parade of Homes, Remodelers Showcase Home or o her 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 su�cient on-site parking is availab/e. Non-permitted events wil/not be a/lowed.
CONTRACTOR/AP�LICAN INFORMATION:
Name: � �1�,C ,
State License# '-�1 r' � Expiration Date: � :
Phone: cell -�'1 - 3� office �. - qa-6►p
Mailing Address: �`�^') h�, l�i,,�� ca\ r�v@ Ci : ;�L�,cx 7= ZIP: 5��7
Contact Person: n Applicant is: Contractor / Homeowner (CirGe One)
Email and/or Fax: r;.r w. oc �.
PROPERTY OWNER INFORMA ION:
Name: �� � c�-
Phone da � - " '
� Y)� _ .���
Address (' `� � �r '� ;� Ci : �o�F j-•i ZIP: �'�,��i�
Email and/or Fax p,r r., c' •
ARCHITECT/ENGINEER INFORMATION: �IY�C•CQY�1
Name:
Phone (day):
Address: City: ZIP:
Email and/or Fax:
PROJECT INFORMATION: Descri tion of ro'ect:
1.Type of Project 2.Proposed Use 3.Structure Type 4.Sewage Disposal&
Water Supply
❑ New Construction �Single Family with Residence
�Addition attached garage Garage/Accessory Bldg. �Public Sewer
❑Accessory Building ❑ Single Family with ❑ Deck
❑ Relocation detached garage ❑Office/Commercial ❑Private Sewer
❑ Other: (specify) ❑ Multiple Family/Condo ❑Warehouse
❑ Public ❑ Storage ❑ Public Water
"*Any earth movement may also require ❑Commercial ❑Other(specify)
MCWD review 8�permits. ❑ Industrial ❑ Private Well
Minnehaha Creek Watershed District(MCWD) ❑ Other: (Specify)
18202 Minnetonka Blvd
Deephaven,MN 55391
Phone: 952-471-0590
Fax: 952-471-0682
www.minnehahacreek.or
Estimated Construction Valuation (excluding land) $
, .'�
STRl1CTURE INFORMATICIN:
1.Structure Dimensions 1.Structure Dimenslons(continued) 2.Type of Construction
a. Length(ft.)= �� Number of bedrooms=� �,�yood/Frame
b.Width(ft.)= 5�— Number of garage stalls: ❑Masanry
Areas in spuare feet Attached=� ��e��
c. Basement= �3�-� Detached= � Pole Bldg.
❑ ICF
d. 1$`Story = �a�3�
� ❑On-site Prefab
e.2"d Story=
❑Off-site Prefab
f. '/:Story = ❑Other(please specify):
g.Total Area=
REQUIRED SUBMITTALS:
All of the information must be submitted in order for our application to be rocessed:
Not
Enclosed licabls.
� ❑ Permit lication
'6� ❑ Pro sed Buildin Plans
'� ❑ MN State Ener Code Calculations and Meahanical Code Re uirements Form
❑ ❑ Surve meetin all uirements
❑ ❑ Stormwater Pollution Prevention Plan
❑ ❑ Hardcover Calculation s
❑ ❑ Se tic S tem Site Evaluation Re rt
O ❑ Access Permit
❑ ❑ Wetland Buffer Im rovement Plan
❑ O En ineered Plans for Retainin Walls 4 feet or above
❑ ❑ Minnehaha Creek Watershed District Permit s
❑ ❑ Plan Review Fee
❑ ❑ Application Escrow&Agreement
❑ ❑ Other:
APPLICANT/OWNER ACKNOWLEDGEMENT:
• Agrees to provide all information required or requested by the Buifding Department;
• Agrees to pay the City of Orono for engineering�onsultant review costs in exceas of s500;
• 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 nntil it is complete;
• Acknowledg�s 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 informa6on which generally cannot be given to the public but can be given to the subject
of the data. Confidential data is informa6on 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 govemmental agencies
required by law. If you refuse to supply the information,the application rYray not be issued.
• Agrees that in the evelrj�that weather or other conditions prevent tl��ornpletiw'�of an as-built survey at tfie time the
Certiftcats af Occupan is requarsted,a t�emporary Certific�te of Occupancy may be issued upon receipt of a S90,OQ0
escrow to ensure comp�tion of the as-built suwey and all site improvemerrts.
' l
/
Applicant s Signature: v Date: I �C.
Owner's Signature: � Date:
�_.__,..:..:
Builder Acknowledgement Form
#2015-01447
Builder
Permit Conditions Initials
Schedule a minimum of one hour for the framing inspection.
Erosion control mechanisms must be installed and inspected by the City
proper to any land disturbing activities. The contractor must provide a
minimum of a 24 hour notice prior to inspection.
Erosion control shall be installed and maintained throughout the entire �'
project and must remain until vegetation has been established.
No underground sewer within 20 feet of well.
Prior to the finalization of and prior to closing out the permit an as-built
survey and hardcover calculations must be submitted and approved.
In the event of winter or other unfavorable weather conditions (which
prevent the completion of the exterior improvements and/or as-built
survey) a Temporary Certificate of Occupancy (TCO) may be necessary. A
TCO requires a $10,000 escrow. ���Q�P ��,�� X
� �. � b � �S )
Advisory Comments ��' yr �S
Any changes to the exterior/landscaping improvements, i.e. patios, grading,
sidewalks, retaining walls, etc. not currently shown on the approved survey
and landscaping plan will require a separate Zoning Permit application to be
submitted and approved prior to the work commencing.
Any retaining walls that are over 4-feet in height or tiered walls not
separated by twice of the height of the lower wall require engineered plans
and a building permit to be submitted and approved rp ior to construction.
w:\applications,license or permit applications\builder acknowledgement form.docx
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City of Orono RECEIVED
�No Hardcover Calculation Worksheet NOV 122015
s� G�
Property Address: J� �3� �����-� � r_��( OF ORONO
`'KFSHoa`� Prepared by: ��.�P�c��1�---����� Date: ��- �z -/S
Stormwater Quality Overlay District Tier: (Circle one) Tier 1 Tier 2 Tier 3 Tier 4 Tier 5
Step 1: EXISTING HARDCOVER
In the following table identify all items of existing hardcover on the property, keyed by letter to Certificate of
Survey(survey must accompany this form). Use as many lines as necessary to accurately depict existing
hardcover status of the property. 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
Surve Square Feet
;���camp�e {Garage) (24'x�0'.) ����J�;�.)
se 3 7 ,
A �. X ., , , w x 5_ . . S.F.
B S.F.
C pc S.F.
D �r a, ' 7•� S.F.
E S.F.
F r � � Wq I� S.F.
G v W mJ� � S.F.
H ,.r wo., w� � � `� � S.F.
I S.F.
J S.F.
K S.F.
L S.F.
M S.F.
N 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 Existin Hardcover S.F.
�cclud�le#lar<Icov�r " C� C�d�Se�v'�1, . . :: ..}, , ; ,, :.; . ,.
S.F.
S.F.
S.F.
S.F.
S.F.
2 Total Excludable Hardcover S.F.
3 Net Existin Hardcover Subtract line 2 from line 1 S.F.
4 Total Lot Area S.F.
Existing Hardcover Percentage [(3)_(4)] %
(Proposed Hardcover next page)
Packet Last Updated: January 2015 This is an information packet regarding Hardcover. Every effort has been made to
ensure the accuracy of the information contained herein;however,if any information is
not consistent with provisions of the City Code,the Code provisions will prevail.
Page 16
RECL►V',�� -
Minnesota State Energy Code Calculations and Mechanical Code Requirements Forrrl �OV � 2 2015
Additional copies can be found by going to: htta://www.dli.mn.pov/CCLD/PDF/sbc 1322 cert.pdf
CITY OF ORONO
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----- � � � - - � ------ This draw ng a nerther a legallY rewrded map nor a
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rvey and is not intended to he used as one.This
drawing is a compilation of records,information,and data
0 89 F2Et e b uate�d in various citV,<ounry,and state offices,and other
s affecting the area shawn,and is to be used for
refe ence purposes only.The City of Orono is not
OO Bolton&Menk,Inc-Web GIS 11/20/2015 8:00 AM r r c n n n c i h l r f n r a n v i n a r n n u i n s h r r P i n r n n f a i n r d
Christine Mattson
From: Adam Edwards
Sent: Tuesday, November 24, 2015 2:08 PM
To: Christine Mattson
Subject: RE: 2730 Pheasant Road/#2015-01447
Chris,
I've reviewed the subject site/grading plan.
There do not appear to be any grade changes. I've stamped the plan approved.
Adam
From:Christine Mattson
Sent:Tuesday, November 24,2015 1:19 PM
To:Adam Edwards<aedwards@ci.orono.mn.us>
Subject:2730 Pheasant Road/#2015-01447
Adam,
We received a building permit for additions to the existing house at 2730 Pheasant Road. Please review and provide
comments.
Thank you.
Christine Mattson
Planning Assistant
City of Orono
2750 Kelley Parkway I Orono I MN I 55356(physical address)
PO Box 66 � Crystal Bay I MN � 55323-0066(mailing address)
'� 952.249.4620 � 8 952.249.4616
�cmattson@ci.orono.mn.us � �b www.ci.orono.mn.us
Office Hours: Monday-Friday 8 am to 4:30 pm
OUR OFFICE WILL BE CLOSED: Thursday& Friday, November 26&27,2015
Thursday& Friday, December 24&25, 2015
Friday,January 1,2016
1
Christine Mattson
From: Andy Gansmoe <agansmoe@xpandinc.com>
Sent: Friday, November 20, 2015 10:33 AM
To: Christine Mattson
Subject: Re: FW: 2730 Pheasant Road/#2015-01447
Christine,
The answer to question one is all retaining walls are existing, we are not installing any new or additional walls.
To answer question four, we will not be installing any new landscaping under the proposed plan. We will be
installing a sidewalk from the porch to the driveway. There is already a sidewalk there which we are replacing.
The contractor performing all of the excavation and concrete work is ICI, innovative concrete incorporated. I
have contacted the surveyor and will have the rest of the information to you shortly. Thank you
Andy Gansmoe
Xpand Inc
Business Development Coordinator
agansmoe@xpandinc. com
952-270-8132
On Nov 20, 2015 8:16 AM, "Christine Mattson" <CMattson(a�ci.orono.mn.us>wrote:
' Andy,
'', I had your email address entered inconectly, my apologizes.
'' From: Christine Mattson
' Sent: Friday,November 20, 2015 8:15 AM
' To: 'agansmore(a),xpandinc.com' <a�ansmorenae,xnandinc.com>
Cc: 'cotterpm(a�vmail.com' <cotterpm(cr��,vmail.com>; Roger Peitso <rpeitso(a�ci.orono.mn.us>
Subject: 2730 Pheasant Road/#2015-01447
�dy,
", We have performed a cursory review of the survey for 2730 Pheasant Road and request the survey be updated
' based on the following comments:
i
'I 1. Retaining walls are shown. Are the retaining walls existing or proposed? Please have the surveyor
' correctly label.
'' 2. Have the surveyor show the average lakeshore setback line. Please note, any above grade additions or
' changes forwazd of the average lakeshore setback back line will require a variance request and council
' approval.
', 3. The survey is difficult to read, was it to be printed in color? The contours and spot elevations are almost
' invisible. Please submit two clear copies of the survey meeting all of the City's survey requirements. Copy
' attached.
4. Will there be any additional changes to the landscaping with the additions being proposed? If so,the City
' requires a landscape plan be submitted showing all the proposed exterior/landscaping improvements, i.e.
i patios, grading, sidewalks,retaining walls, etc. The plan should include the name of the individual performing
' the work.
'' The hardcover calculations are shown on the survey. For future projects,the hardcover calculations should be
' shown on the City's Hardcover Calculation Worksheets.
' Please note, our engineer has not reviewed this survey so there may be additional comments forthcoming.
', Escrow&Escrow Agreement. 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 guazantee conformance with City Code Chapter 79 relating to
erosion control and stormwater. The required escrow amount for this project is$2,500. The escrow agreement is attached. The
'° property owner must sign the escrow agreement and submit a check for$2,500.
' Minnehaha Creek Watershed District (MCWD). Your project may trigger the Minnehaha Creek Watershed DistricYs
', (MCWDs) permitting requirements; please contact the MCWD directly at 952-471-0590 regazding your project. Please note,
', the City of Orono will not issue a building permit without a copy of the MCWD permit or documentation stating the proposed
' project does not trigger any of their permitting requirements.
'' Please don't hesitate to contact me if you have any questions.
' Christine Mattson
', Planning Assistant
2
' City of Orono
' 2750 Kelley Parkway � Orono � MN � 55356 (physical address)
' PO Box 66 � Crystal Bay � MN ( 55323-0066 (mailing address)
� 952.249.4620 � g 952.249.4616
' � cmattson(a�ci.orono.mn.us j � www.ci.orono.mn.us
' Office Hours: Monday- Friday 8 am to 4:30 pm
' OUR OFFICE WILL BE CLOSED: Thursday&Friday, November 26& 27, 2015
'' Thursday &Friday, December 24 & 25, 2015
Friday, January 1, 2016
3
� � a a n�m o e@ � Q�d i �.c.c��
Christine Mattson � �
From: Christine Mattson
Sent: Friday, November 20, 2015 8:15 AM
To: 'agensmore@xpandinc.com'
Cc: 'cotterpm@ymail.com° Roger Peitso
Subject: 2730 Pheasant Road/#2015-01447
Attachments: escrow.pdf; Survey Requirements-August 2015.pdf
Andy,
We have performed a cursory review of the survey for 2730 Pheasant Road and request the survey be updated based on
the following comments:
1. Retaining walls are shown. Are the retaining walls existing or proposed? Please have the surveyor correctly
label.
2. Have the surveyor show the average lakeshore setback line. Please note, any above grade additions or changes
forward of the average lakeshore setback back line will require a variance request and council approval.
3. The survey is difficult to read,was it to be printed in color? The contours and spot elevations are almost
invisible. Please submit two clear copies of the survey meeting all of the City's survey requirements. Copy
attached.
4. Will there be any additional changes to the landscaping with the additions being proposed? If so,the City
requires a landscape plan be submitted showing all the proposed exterior/landscaping improvements, i.e.
patios,grading, sidewalks, retaining walls,etc. The plan should include the name of the individual performing
the work.
The hardcover calculations are shown on the survey. For future projects,the hardcover calculations should be shown on
the City's Hardcover Calculation Worksheets.
Please note,our engineer has not reviewed this survey so there may be additional comments forthcoming.
Escrow& Escrow Agreement. 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 $2,500. The escrow agreement is
attached. The property owner must sign the escrow agreement and submit a check for$2,500.
Minnehaha Creek Watershed Distrid(MCWD). Your project may trigger the Minnehaha Creek Watershed District's(MCWDs)
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 the MCWD permit or documentation stating the proposed project does
not trigger any of their permitting requirements.
Please don't hesitate to contact me if you have any questions.
Christine Mattson
Planning Assistant
City of Orono
2750 Kelley Parkway � Orono � MN � 55356(physical addressJ
PO Box 66 � Crystal Bay � MN � 55323-0066 (mailing addressJ
'� 952.249.4620 � 8 952.249.4616
�cmattson@ci.orono.mn.us � � www.ci.orono.mn.us
1
Office Hours: Monday- Friday 8 am to 4:30 pm
OUR OFFICE WILL BE CLOSED: Thursday& Friday, November 26&27,2015
Thursday& Friday, December 24&25,2015
Friday,January 1,2016
2
DATA PRIVACY ADVISORY
In accordance with Minnesota State Statute 13.04 Rights of Subjects of Data, Subd. 2, "Tennessen warning", we
would like to inform you that your request for a permit or license from the City of Orono or any of its departments
may require you to furnish certain private or confidential information.
You are notified that:
1. The information you furnish will be used to determine your qualification for the permit or license
requested.
2. You may refuse to supply data, but refusal may require that the City deny the permit or license.
3. The information may be shared with other local, state or federal agencies to the extent necessary
to process the permit or license.
4. If your requested permit or license requires Council action to approve, some information may
become public.
5. You have certain rights under Minnesota State Statute 13.04(see following page)to review private
data on yourself.
6. Your full name is required to process this application or permit.
� �� C���
Fir Mi d e Last
�►'�,30 ,,���.� ,�
Add ress
C�-��e-�'��� �� ���� /
City State Zip Phone
I understand my rights as stated above.
Signa re
Packet Last Updated.� August 2015
Page 7
� , '.
Permit Application: Self-Checklist for Completeness
Please note, the applicant must initial in the boxes below to acknowledge the minimum required
information is included with the submitkal. If not, the application will NOT be accepted. Call
952.249.4620 to schedule a meeting with staff if you have questions on application submittal
requirements.
r ` �Completed Application �
U
�V+ 1 ►'�����
� � Plan Review Fee Paid �d�
i ��� `� ' c Y�(,�-��L
� � � � �( V��`�'�` � �� e�
, � l� � _ _ (
Signed Escrow Agreement & Escrow Payment `� �`L-`'�����"
��� ;� S,�u �c ��
�
Building Plans (to scale) x2 (�(� , VE�.e.�-r�
Certificate of Survey (to scale) showing the proposed project &
meeting all requirements x2 � ��� U �
��`�
�' Hardcover Calculations (if applicable) bn S��r v��� � ���:�
��.e�+
' I am aware that 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 their permitting
requirements). I will contac�.�he MCWD at 952-471-0590
regarding this project.
Signed by:
Address: � �(�-� �3 �
Permit #: ��j / �--���f�
Melanie Curtis
From: Melanie Curtis
Sent: Tuesday, September 15, 2015 10:11 AM
To: Kathy Alexander
Subject: 2730 Pheasant
I looked in the past info in the file. It looks like we've used the line drawn befinreen the neighboring houses as the average
lakeshore setback in the past. We will use it for your application as well.
Melanie
Sent from my iPhone.
i
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ID: Print Date: 12/3/2015 �
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Owner C L Vojta& D D Vojta Market ��02,000
Name: Total:
Parcel 2730 Pheasant Rd Tax $8,230.26
Address: Orono, MN 55331 Total: (Payable:2015)
Property Residential Lake Shore Sale $900,000
Typ2: P�iC@: This map is a compilation of data from various
sources and is furnished"AS IS"with no
Home- Non-Homestead Sale 01/2010 representation orwarranty expressed or
St@8d: D8t@: implied,including fitness of any particular
purpose,merchantability,or the accuracy and
completeness of the information shown.
Parcel 0.6 8Cf@S Sale Warranty Deed COPYRIGHT OO HENNEPIN COUNTY 2015
Area: 26,139 sq ft Code:
�', ��-�:Green!
https://gis.hennepin.us/Property/print/default.aspx?C=452598.222690005 96,4975144.1900... 12/3/2015
Melanie Curtis
From: Christine Mattson
Sent: Wednesday, December 02, 2015 1:03 PM
To: 'Andy Gansmoe'
Cc: 'cotterpm@ymail.com'; Melanie Curtis
Subject: RE: 2730 Pheasant Road/#2015-01447
Andy,
The escrow must be paid with a check. The escrow money should also come from the property owner. Please note, if
you pay the escrow on behalf of your client,the City refunds the money to the property owner as they are ultimately
responsible for the project.
Christine^'
From:Andy Gansmoe [mailto:agansmoe@xpandinc.com]
Sent:Wednesday, December 02,201512:58 PM
To:Christine Mattson<CMattson@ci.orono.mn.us>
Subject: Re: 2730 Pheasant Road/#2015-01447
Hey Christine,
I will bring a check when I pick up the permit. Does it have to be a check or can pay with a card?
Andy Gansmoe
Xpand Inc
Business Development Coordinator
agansmoe@xpandinc. com
952-270-8132
On Dec 2, 2015 11:27 AM, "Christine Mattson" <CMattson(c�ci.orono.mn.us>wrote:
Hi Andy,
i
a I'm putting the final touches on the building permit application. Has the property owners signed the attached
escrow agreement and returned with a check for$2,500? Or are you planning on bringing it in with you when
� you pick up the permit?
E
i
i
j Christine Mattson
i
;
Planning Assistant
i
`; City of Orono
; 2750 Kelley Parkway � Orono � MN � 55356 (physical address)
� PO Box 66 � Crystal Bay � MN � 55323-0066 (mailing address)
I � 952.249.4620 � 8 952.249.4616
r
�
i
i � cmattson,,,ci.orono.mn.us � �] www.ci.orono.mn.us
': Office Hours: Monday - Friday 8 am to 4:30 pm
;
�
,
! OUR OFFICE WILL BE CLOSED: Thursday &Friday, December 24 & 25, 201 S
i
i
Friday, January 1, 2016
�
� Monday, January 18, 2016
i
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❑STOP ORDER POSTED.CALL INSPECTOR
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
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Inspector: `
White CopyllnspecMr's File Cenary CopylSite Notke
L� � C�.l�i�
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CITY OF ORONO CALLED IN /-2�/,(� n e
IN.��i� Q�j�DI��SCHEDULED ���
PERMR NO.�r'� ETED
AD�ESS v� �
a1NNER TELEPHONE NO. �S��7D� ��
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Q ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL
Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION
Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ RATED WALLS
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❑STOP ORDER POSTED.CALL INSPECTOR
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Inspector.
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White Copyllnspector' Cenary CopylSfte Notice
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DATE TIME
CITY OF ORONO CALLED IN � 3��
INSPECTION NOTIC c�(��c HEDULED �—�_(o
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Inspector.
White Copyflnspector's File nary CopylSite Notice
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�/ DATE TIME�
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❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
for the next in ection 24 hours in advance. (g52) 249-46�0
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White Copyllnspector's File Canary CopylSite Notice
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qTY OF ORONO CALLED IN
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❑STOP ORDER POSTED.CALL INSPECTOR
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C� DATE TIME
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INSPECTION NOTICE SCHEDULED 1� �
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White Copyllnspector's File Canary CopylSite Notice
� � � � ,
DAjE TIME
CITY OF ORONO CALLED IN �
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Q ❑ FRAMING ❑ MECHANICA�FINAL ❑ RATED WALLS
� ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT
Q ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP
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❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Ca11 for the next inspection 24 hours in advance. (g52) 249-4600
OwnerlContractor on site:
inspector. Sl i h- +��
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. � ' DATE TIME
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ADDRESS�1-�-� �'����.��i� 11 ��
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Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING
y ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL
Z ❑ RADON SLAB ❑ MECHANICA�RI ❑ SITE INSPECTION
Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ RATED WALLS
� ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT
Q ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP
_ ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL
v ❑ DEMO-SITE ❑ SEPTIC INSTALL
2 OWNERICONTRACTOR TO MEET YOU:_YES_NO
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� ❑CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
W
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOWERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. p pHOTO TAKEN
INSPECTOR WFLL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (952) 249-46��
OwnerfContra n site:
Inspector.
White Copyllnspector's Flle Cenary CopylSfte Notiee
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To: Finance Department
From: Christine Mattson, Planning Assistarit CA�
�Y' `
CC: Street File
Date: December 7, 2016
Ca/L: 101-22205
Re: Escrow Refund
Building Permit#2015-01447 pertaining to 2730 Pheasant Road is complete. Please refund
$2,500 to the property owner, Jeff&Peggy Cotter.
The following is attached:
• Original signed escrow agreement
• Copy of cash register receipt showing escrow amount received
Mail to: Jeff&Peggy Cotter
2730 Pheasant Road
Excelsior, MN 55331
w:l.street fli es�pheasant road�2730�escrow refund 2015-01447.docac
BUILDING PERMIT ESCRGW AGREEMENT
drono Buiiding Parrnit#�2015-01447
AGREEMENT made this�day o ,20�5, by and between the CITY OP ORONO,
a Mlnnesota municipaE carporation("Cit�and Jeff 8�Peggy Cotter("Owners').
_ -Recitals -----
1. A building permit appiication fias been filed fer additions located at 2T3fl Pheasant Road the
(°Subject Property"), Negaily described on Exhibit A,attached.
2. Owners request the City�review this appl�ation.
3. The City will commence its review of the applir�on and incur c�sffi associatied with said r+eview
only if the Owner astabiishes an escrow to ensur�e r�mbursement to the City of its costs.
NOW THEREFORE�THE PARTIES AGREE AS FOLLOWS:
1. DEPOSR OF ESCROW FUNDS. C�temporaneously witt� the execution of this Escrow
Agreement, the Ovmers shall deposit$2,500 with the City. AA acxrved interEst, if any, shall be paid bo the City to
r+eimburse the Ciiy for its c�st in adminisbering the escrow accaunt
2. PURPOSE OF E8CROW. The purpose o#the s�+ow �to guarantee reimbursement to the City
t�or el� out-of-pocket c�sts the City has inaumed (including planning, engineering, in e�ess of $508, or legal
consultarrt review} or will inc�r in reviewing the plan. Eligib� ex�nses sl�all be consisbent with expenses tt�
Chmers would be responsibie tor under a building permit applicatlort.The escrow will also guarantee reimbursement
to the Cit�r for aU out-0f-podcet oosts the City has incurned t�o assure that the work�c�mpteted in accor+dance with
the Stortnwatier Polluaon PrEvention Pian and the provisions of Oronc City Code Chapter 79.The finanaal securiiy
may alsfl be used by the City to eiiminate any hazarrdaus c�nditions associated with the work and bo repair any
damage to public property or infrastructure that is caused by the Wrork (induding plannir�, engineering, or legal
oar�suitant review)associabad with buiiding permlt�'1015-09447 if compliana with the approved buiiding permit
is not a�ccom�ist�ed.
3. MONTHLY BILLING. As the City receives consuttant bilis ior incuned c�sts, the City wEll in tum
send a biil to the Owners. Qwners shall be responsible for paymerrt b�the City within 30 days of the Owners'receipt
of bill.
4. �I8BURRENIENT pROM ESCROIN ACCOUNT. In the event that the Owners do n�make psyment to
tha City within the timeframe outli�d in#3 above, shall issue a St�Wark Order until the Owners pay ail ex�enses
invoiced pursuant to#3. The City may draw from the es�+aw acvouM without further approvai of�e Ormers to r�mburse
the City for eligtbfs exper�ses tt�e City has incumed.
5. C�OSINQ ESCROVY. The Balsnce on�posit in the esc�v,if any,shail be returned to the Qwners
when the review hes been�rnpletied and writ6en notification is received from the Owners r+equesting the funds.
6. CERTIFY UNPAID CHARGES. If the project is abandoned by Owners,or if the eligible expenses
incurred by the City exceed the amaunt in ascrow,the City shall have the right to c;erMy the unpaid balance to the
suhject property pursuant to Minn. 5tat§§415.a1 snd 388.012.
CiTY: CITY OF ORONO OWNE •
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-- --- _- - 6559
JEFFREY A.OR MARGARET M.COTTER
6120 SIERRA CIR. 17-t/97o 933
StiOREWOOD,MN 55331 .!� /A�`� ���
PH.952-401-0085 `�C� �
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PAY TO THE �p?SbQ�
ORDER�F
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06559
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City ofi Orono
2750 Kelley Parkway
Orono MN 55356 952-249-4600
Receipt No: 3.014743 Dec 4, 2015
Jeffrey Cotter
Previous Balance: .00
Permits
2015-01525 2730 Pheasant 2,500.00
Rd
101-22205
Ueferred Rev-Developer Deposit
---------------
Total: 2,500.00
Check
Check No: 6559 2,500.00
Payor:
Jeffrey Cotter
7ota1 Applied: 2,500.00
Change Tendered: .00
12/04/2015 11:50AM