HomeMy WebLinkAbout2021-09-22 As Built Certificate of Survey -- Surety Agreement r C;
•0iit-uv
r City of Oak Park Heights
www.cityofoakparkheights.com
AS BUILT CERTIFICATE OF SURVEY/TURFF ESTABLISHEMENT
AND PUBLIC INFRASTRUCTURE SURETY
Building Inspection—Planning&Code Enforcement
The undersigned, hereby submits a surety deposit to the City of Oak Park Heights in the amount of
$1,750 to ensure that the rough-grade of the individual lot, after construction, is consistent with the
approved subdivision grading plan for that lot, that turf is established, and that any public
infrastructure that is damaged has been repaired to City of Oak Park Heights standards.
Upon receipt of the As Built Certificate of Survey, it will be reviewed for compliance. The site will be
inspected to verify turf establishment and that any damaged infrastructure has been satisfactorily
repaired.
Said surety deposit shall be returned to the undersigned, upon successful compliance verification of
the submitted as built certificate of survey, turf establishment and infrastructure condition.
Lot/Permit Identification: s3 3 ID-136`d
jO 1 00190
Permit Number: (,.j
Lot#: r� Block#: )3 Addition: i'l-Ps 40/0,4a /" A
Owner/Contractor(Please Print) /1"?/Z7 -
Address /(7.r1' j s�, ��. hen./ J-12,7J
Email Address yer-/.-0 432,,—At ,„4--/, Phone#: fir/P1- ?1771
A62��Jam`
Applicant Printed Name Date
Applicant Signature
14168 Oak Park Blvd.N. Phone:651.439.4439
Oak Park Heights,MN 55082 Fax: 651.439.0574
leroeq uo,Meta° co sampe j A reg
It
u
44
wI
i
G
•
s
V ru
Z O
I W
g Q.
411
3 'W o O .�
- 0 I zul -----"I Si. t 11_. Cr
a
o2Q Cr
UCI;,Z i 0
1
T(n
'Si mor
1 W
W N
Q 4CE.
0 '.
AC
II ;ii
0