HomeMy WebLinkAbout2000-P02985 - demo s �
CITY OF ORONO PERMIT
2750 Kelley Parkway - PO Box 66 Permit Number: Po29ss
Crystal Bay, Minnesota 55323 Permit Type: Demotic�on
(612) 249-4600 Date Issued: 9ilgi2oo
SITE ADDRESS: 1875 Shadywood Rd
WAYZATA,MN 55391
P ID: 17-117-23-24-0002
DESCRIPTION:
Proposed Use:
Permit Class: Building
Permit Type: Demolition Permit Sub-type(s): Demo-Principal Structure
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
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m.�st be abondoned. Inspection before backfilling.
F EE SU MMA RY: Permit Fee: $ 50.00
Valuation: $ 0.00
State Surcharge Fee: $ 0.50
TOTAL FEE: $ 50.50
APPLICANT: MARK KOSEK OWNER: MA�&GrrrA KosEx
1855 SHADYWOOD ROAD 1875 SHADYWOOD RD
WAYZATA,MN 55391 WAYZATA MN 55391
THE UNDERSIGNED I�REBY REQUESTS PERMISSION TOMAKE THE REAL IMPROVEMENTS SPECIFIED
AND AGREES TO DO ALL WORK IN STRICT COMPLIANCE WITH ALL CI'IY OF ORONO ORDINANCES AND
STATE OF MINNESOTA BUILDING CODE REQUIREMENTS.
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APPLI ANT PE [TEE I N TURE ISSUED BY SIGNATCTRE
Copies: City,Applicant,Assessor, Finance Page 1
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CITY OF ORONO APPLICATION FOR DEMOLITION PERMIT
P.O. Box 66 (2750 Kelley Parkway)
Crystal Bay, IvN 55323
SPECIAL CONDITIONS & HOLD HARMLESS AGREEMENT
General Instructions
1. You may be required to obtain other permits, i.e. well abandonmment, etc.
2. Work must not begin unless the permit cazd is available on the job site.
3. A 24 hour notice is required for all inspections. Call (612) 249-4600.
JOB SITE ADllRESS: � `=� ,-�����-cC-�,,�t,•-o�;-�l ���
Occupancy Type: Residential ommercial
OWNER'S NAME: Phone:
Mailing Address: City:
CONTRACTOR'S NAlI�IE•� t" ������ �x�� C�� I�'Iti°�i,��Bus.No.: �'l l - (c�� Z�y�/
MailingAddress: 3 7� j���.�,��►�-t� �P�� N City:_(�,���z��.�
Demolition if planned by means of: manual disassembly
� heavy equipment
Permits Issued:
# Well Abandonment
In return for issuance of said Demolition Permit, the undersigned owner hereby agrees as follows:
1. The structure(s) shall be kept enclosed and/or secured until such time as demolition is
complete.
2. Demolition debris will be kept off adjoining property and/or the public rights-of-way unless
specific prior approval is obtained in writing for temporary use thereof.
3. Foundations shall be completely removed from the ground.
4. All demolition debris shall be completely disposed of off site in accordance with all
applicable PCA requirements.
�. Water wells must be abandoned in accordance with State Health Department regulations.
6. Inspection required when all debris has been removed,before backfilling.
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7. 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«ith 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).
8. 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.
9. Septic systems must be abandoned per Minnesota Rules Chapter 7080. All septic tanks must
be pumped,crushed and filled with native soils. An inspection is required after the tanks aze
pumped and before the tanks are crushed and filled.
PERMIT TYPE AND FEE CALCULATION
� $50.00 -Principal Structure
$30.00 -Accessory Structure
1. Subtotal of above permit requested $ �j C�
2. State Surcharge $ .50
3. TOTAL PERMIT FEE (add lines 1-2 above) $ �° �
The undersigned hereby applies to the City of Orono for issuance of a Demolition Permit,agrees to
do all work in 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:
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OWNER'S SIGNATURE: ` Date: � 2 GU
APPROVED BY: Date: � ' �3 `�v
DATE TIME
CITY OF ORONO CALLED W ��' �� ��=�`�'�
INSPECTION NOTICE SCHEDULED �`- � 2 Gy.' 3b �m
PERMIT NO. /QU z �'�'� COMPLETED �� _l '3d
ADDRESS �7� � �-�
OWNER c°� G CONTR. l/l���t2��-�-�.-�
TELEPHONE NO. G��' _ G'��J� ���y
� DESCRIPTION ��L��� � �a'��`'' �'��"°'�'�
�
l� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
� 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
ti
Q 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q 05 FINAL 14 SEWER HOOK-UP 06 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
J 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
T09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
� 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
Z OWNERICONTRACTOR O ME YOU:_YES_NO
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❑WORKSATISFACTORY:PROCEED ! PROJECTCOMPLETE
� ❑ CORRECT WORK 8 PROCEED L ISSUE CERTIFICATE OF OCCUPANCY
W
O �, ORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
f7 CORRECTUNSAFECONDITIONWITHIN HOURS. pHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR GTATION ISSUED
❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. 249-46��
Owner/Contr r on s' :
Inspector. �
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