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Home My WebLink About2017-00632 - demo � CITY OF ORONO * Z 0 1 7 - 0 0 6 3 Z * 2750 KELLEY PARKWAY DATE ISSUED: 07/17/2017 ORONO, MN 55356- (952) 249-4600 FAX: (952) 249-4616 ADDRESS : 1150 PINE VIEW DR PIN : 28-118-23-42-0009 LEGAL DESC : PINE VIEW : LOT 3 BLOCK 1 PERMIT TYPE : DEMOLITION PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : DEMO-PRINCIPAL STRUCTURE ACTIVITY : 645-SINGLE FAMILY HOUSES(ATT&DET NOTE: I. FOUNDATIONS/ALL DEMO DEBRIS TO BE REMOVED FROM GROUND&D[SPOSED OF OFF SITE,PER PCA REGULATIONS. 2. WELLS MUST BE ABANDONED. 3. INSPECT[ONS DONE BEFORE BACKFILLING. NOTE: A 24-48 HOUR NOTICE IS REQU[RED FOR ALL INSPECTIONS. CALL(952)249-4600. SEWER MUST BE DISCONTINUED AT THE C(TY 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 STONEWOOD, LLC STATE SURCHARGE DEMO 1.00 153 E LAKE STREET TOTAL 76.00 WAYZATA, MN 55391- Payment(s) (612)462-4000 CHECK 14880 76.00 Minnesota State License#: BUIL-BC594315 OWNER WOHLWEND,DAVID 4526 BLUEBELL TRAIL S MEDINA, MN 55340- AGREEMENT AND SWORN STATEMENT The work for which this permit is issued shall be performed according to the approved plans and speci6cations,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 for a period of 180 days at any time afrer work has commenced. The applicant is responsible for assuring all required inspections are requested in conform nce with the State Building Code.This permit may be revoked at any hm r due caus . � o / "T"/ YU �l � �l �/ A i nt Permite g�u�; Date ssued By gnature Date � �--```Y-`�'� City of Orono RECEIVED /�� F K TY USE ONLY z ��y P.O. Box 66 Date Received�� Permit# �� `� ✓� �fr �-.� 2750 Kelley Parkway I'�t � �ry�� ,) Crystal Bay, MN 55323�UI`1 � � Amount: $ r�" SAC Credit: i (952)249-4600 i � � �,,�" � Homeowner(s)Signed: ❑Yes �'ti�� ! � CITY OF ORONO t,.. � Resolutions(if any}Signed:�Yes ❑None Required �ti��`��11�-� `Lonin Disclosure Si ned: ❑Yes ❑None Re uired �.��'u�'• CITY OF ORONO - DEMOLITION PERMIT (All permits must be approved by the Building Official and/or Zoning Department) Job Site / Qwner Information: Type: [�d] Residential ❑ Commercial Site Address: I�SO 'Qr��cs-J Owner: _'��,,;L- ��,1w�.�.L Mailing Address: N526 �w�.N fir•.:l S City: M.c�►�� Zip: Ss3�Ic Phone: Email: '�1. �0�-��1-�1 M�). c�^^ Contra+ctcar 1 Applicant Informatian: Contractor/App.: S�I�e,.�,w.�1 � i►.� Contact Person: �S�M.cw�t . �� Address: i53 1,.,n,� 5-� � State License#: 'i�t 5q�t'315 City: �--iz-•t..� Zip: 553^� Expiration Date: 3�� Phone: L�2- ��'t-- ��o Email: Sv� (bl 5fio^cw��• ��-�- SPECIAL CCINDITIONS & HOLD HARMLESS AGREEMENT 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 � 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 copy of permit approval from the Minnehaha Creek Watershed District (MCWD). The City will not issue a demolition permit without a copy of the permit(s) from the MCWD or documentation stating permit(s) are not required. Form Last Updated: July 2015 I� " ui� 150784 � ' � . 4. Submit a $2,500 escrow and an escrow agreement signed by the property owner(copy attached). 5. Keep all structure(s) enclosed and/or secured until such time as demolition is complete. 6. Keep all demolition debris off adjoining property and/or the public rights-of way unless specific prior approval is obtained in writing for temporary use thereof. 7. Completely remove foundation(s) from the ground. 8. Completely dispose of all demolition debris off site in accordance with all applicable PCA requirements. 9. Abandon water wells in accordance with State Health Department regulations. 10. Call for an inspection when all debris has been removed, before backfilling. 11. Within 5 working days of superstructure removal, a final 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). 12. 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. 13. 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 $ —7� - ❑ $50.00 —Accessory Structure x (how many) � 1. Subtotal of above permit requested $ �1 5 2. State Surcharge 1.00 3. TOTAL PERMIT FEE (add lines 1-2 above) $ �G � The undersigned herby applies to the i of Orono for issuance of a Demolition Permit, agrees to do all the work in a strict accordance ith e ordinances of the City and the regulations of the State of Minnesota, and certifies that all s em nts made on this application are complete, true and correct. Applicant's Signature: Date: �,,�� Owner's Signature: Date: S. 1 b. ►'J ,�J ; Approved By: ( r� ;'� �'�' Date: A � ( uilding icial) *Zoning Disclosure Required? ❑ YES NO �'��, � (�4�Z, *This must be filled out by Zoning Department— For ei er answer, a Zoning Official must sign all applications. * Approved By: � Date: (Zoning Official) Form Last Updated: July 2015 150784