HomeMy WebLinkAbout2017-00748 - demo � ' CITY OF ORONO
* * 2 PJ 1 7 - 0 0 7 4 8 *
2750 KELLEY PARKWAY DATE ISSUED: 08/04/2017
ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 2420 OLD BEACH RD
PIN : 21-117-23-22-0002
LEGAL DESC : SHORE HILLS
: LOT 001 BLOCK 000
PERMIT TYPE : DEMOLITION
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : DEMO-PRINCIPAL STRUCTURE
ACTNITY : 645-SINGLE FAMILY HOUSES(ATT&DET
NOTE:
1. FOUNDATIONS/ALL DEMO DEBRIS TO BE REMOVED FROM GROUND&DISPOSED OF OFF SITE,PER PCA REGULATIONS.
2. WELLS MUST BE ABANDONED.
3. INSPECTIONS DONE BEFORE BACKFILLING.
NOTE: A 24-48 HOUR NOTICE IS REQUIRED FOR ALL INSPECTIONS. CALL(952)249-4600.
SEWER MUST BE DISCONTINUED AT THE CITY SERVICE BY QUALIFIED CONTRACTOR BEFORE DEMO PERMIT IS ISSUED. CHECK
TO MAKE SURE THIS PERMIT HAS BEEN PULLED BEFORE ISSUING THIS PERMIT.
APPLICANT DEMOLITION-PRINCIPAL STRUCTURE 75.00
GORDON JAMES CONSTRUCTION STATE SURCHARGE DEMO 1.00
5159 MAIN STREET E TOTAL 76.00
P.O. BOX 306 Payment(s)
MAPLE PLAIN, MN 55359- CHECK 13810 76.00
(763)479-3117
Minnesota State License#: BUIL-20531961
OWNER
SANGUINETTI,JOSEPH
2420 OLD BEACH RD
WAYZATA,MN 55391-
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 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 are
requested in conformance yvith the State Building Code.This permit may be
revok at any tim for d �e cause� ,
� �
. /� �-
� ,�� `'��-- ��� ��- �„i � ��D �"-�L�-�Z �' i 7 i ��
A lica ermitee Signature Date Issued B ignature Date
�OA lO City of Orono R ITY USE ONLY �7
�y P.O.Box 66 Date Received� Pcrmit# �� " /
2750 Kelley Parkway
Crystal Bay,MN 55323 Amount: $ ��� SAC Credit:
(952)249-4600
a
�' Homeowner(s)Signed: ❑Yes
�E' �,� Resolutions(if any)Signed:❑Yes ❑None Required
17KES H��� Zoning Disclosure Signed: ❑Yes ❑None Re uired
CITY OF ORONO - DEMOLITION PERMIT
(All permits must be approved by the Building Official and/or Zoning Department)
Job Site / Owner Information:
Type: �Residential ❑ Commercial
Site Address: _ 2y�0 C�I d Q eac►� ►�o0.a
Jos�Ph s�,..'µ;,,���-;
Owner: A�� Abouelc„��„ Mailing Address: Zy20 dld �jca�� �oaa
City: �✓�o�o Zip: SS-39�
Phone:_ (n12 - 8yS- 3889 EmaiL ar�N. Abo�ci�.�c��@4c��rlis.cow,
�
Contractor/ pplicant Information:
Contractor/App.: Cro�doh ��a�+�s Contact Persorr. Jcf��•Y '�tio��Oso�
Address: S�lS9 �''1a;., 5+�. Su:f� �L00 State License#: �C S3I `i(vI
City: A �a,,, Zip: 5535 9 Expiration Date:
Phone: qSL - 215� Z�(o3 Email: ic�crty @ 9o✓-do� - ;ar�cJ. c��
�
SPECIAL CONDITIONS & 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) Issu d: ❑ Sewer Disconnectio ❑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 �`, '3'�
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 pertormed by the property owner, his employees, agents, subcontractors or assigns.
PERMIT TYPE AND FEE CALCULATION
�$75.00 — Principal Structure $ , 5�bv
�`� � ❑ $50.00 —Accessory Structure x (how many)
1. Subtotal of above permit requested $
2. State Surcharge 1.00
3. TOTAL PERMIT FEE (add lines 1-2 above) $ �� . �
The undersigned herby applies to the City of Orono for issuance of a Demolition Permit, agrees to do
all the work in a strict accordance with the ordinances of the City and the regulations of the State of
Minnesota, and certifies that all statements made on this application are complete, true and correct.
Applicant's Signature: Date: �� '�/�?.c�l �
Owner's Signature: Date:
Approved By: v Date: � �C `
(B ilding O icial)
*Zoning Disclosure Required? ❑ YES NO
"This must be filled out by Zoning Department—For e er answer, a Zoning Official must sign all applications.
*Approved By: ����'1 Date: � ' �`�'��
(Zoning Official)
Form Last Updated: July 2015
150784
, . . , �.: � � :
� . , �
` �.�Id1►�..� � �
. � _
�` ' '� Daily Soil Observation Notes
Project No: . Date: Report No:
, i
Project Name: � f`` % �'( ' , Project Location:
Client: Temp/Weather:
Project Manager: ' r � '� r :��%�'� Time Arrived: Departed:
� � � � .
�N Areas Observed: ❑ Building Pad ❑House Pad ❑Roadway ;� ❑Parking/Walks ❑ Footing
❑Proof Roll QOther (describe): ' � � ' ~�''r-'�" ' ` r
Soil report available? ❑ Yes [�No Report reviewed? ❑Yes ❑No Report prepared by:
Finish floor evaluation: __ Bottom of footing elevation: __ Bottom of excavation elevation: ___
Approved plans available? [,�Yes ❑No Specified compaction: � Fill source:
�*
Oversizing appears adequate? Q NA ❑Yes ❑ No Soils observed agree with Soils report? ❑Yes ❑No
Soils appear adequate for design loads? ❑Yes ❑No Proposed project bearing capacity(psf):
Contractor notified of results? ❑Yes ❑No Name of person notified: � t ' � �
i ,
r F� ,�Y INiil� / (fJ'.�.�GC�'�,;+�
Was a copy of this report left on site? ❑Yes ❑ No If so,whom was it submitted to? ���C� v 1,��
r�1
�
��- i1 !2 � � D U
N - .
;
�� ,
,
�
���� ��
a
�� � . �� ��
i
�
i � '��!,J;J
Notes/Comments: ' n;�t��,'v� ��.!�(.f ;�r! �:� ' i /�_ �' ,,, ,. � ����lrc � . ,.,/t
t ; t
�' ' �' �(,'�!l� / ;<fi� ��!�Q�.�,;�- I� �`r.�d a,/�{ G � ,�r �-y�/ /t-,n c•l
, ' /�
(�/�`. ! %G/1 "1'��S +' (�t,� ;�i� �� �C��� . '/ � �''� <v � 'f-
/1 �., �•u,� � ��G%'C'�Y(� f ��� 1'�S .
, � � i , <•� � (l,� �;(' � �;,n,- �� ''? �< <:>
J '
^ 1
Performed By: Reviewed By: Date: � - ,'�
� ,
This is a preliminary report and is provided solely as evidence that field observations and/or testing was performed.Observations and/or conclusions and/or
recommendation conveyed in the final report may vary from,and shall take precedence over,those indicated in a preliminary report.
, 1 �
/ /,� � �
" --��— TIME
CITY OF ORONO CALLED IN �� �
INSPECTION TICE ���HEDULED c��- 7 / I . L `-'
PERMR NO. - � OMPI e
ADDRESS � �� ��� ° ��—�
OWNER TELEPHONE NO�S a-� S-��(��
CONTRACTOR �� �
`' DESCRIPTION �� r-�- �-��- U
� ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL
� ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING
❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL
Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION
Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ RATED WALLS
� ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT
J��IAI�` ❑ WATER HOOK-UP ❑ FOLLOW-UP
_ ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL
J ❑ DEMO-SITE ❑ SEPTIC INSTALL
? OWNERICONTRACTOR TO MEET 11�U:_YES_NO
� COMMENT'S:
4 rJ e � -
j �// �,c ,`j��s e r�.�W e� �ra�..� ��e v.e-�ia� '
OO
� .
° �� �e.,�v✓� r�.�rG.,���� a-�' s�G� ��.6.•s
Q •� S�li ��os �r�� s�t� -
� ,
z
wCa(< sG c� Kt«tu�
�
�
0
W� ❑WORK SATISFACTORY:PROCEED O PROJECT COMPLETE
W (�CpRRECT WORK 6 PROCEED ❑ISSUE CERTIFlCATE OF OCCUPANCY
O O CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE COMERINCa PERMANENT
❑CORRECT UNSAFE CONDITION WRHIN HOURS. p pHOTO TAKEN
INSPECTOR WFLL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
❑INSPECTION REWIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (952) 249-4600
OMn�erlContractor on site:
Inspector: � /h-� �-
,� WMts CopyAnspector's Fik Gnary CopYlSlfe Notks
:�