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Home My WebLink About2011-00933 - demo , CITY OF ORONO PERMIT NO.: 2011-00933 � � 2750 KELLEY PARKWAY ORONO, MN 55356- �ATE IssuEn: 08/26/2011 952 249-4600 FAX: 952 249-4616 ADDRESS : 1978 SHADYWOOD RD PIN : 17-117-23-24-0026 LEGAL DESC : SHADY-WOOD : LOT 000 BLOCK 000 PERMIT TYPE : DEMOLITION PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : DEMO-ACCESSORY STRUCTURE ACTIVITY : 649-ALL OTHER BUILDING&STRUCTURES NOTE: 1. FOUNDATIONS/ALL DEMO DEBRIS TO BE REMOVED FROM GROUND&DISPOSED OF OFF SITE,PER PCA REGULATIONS. 2. INSPECTIONS DONE BEFORE BACKFILLING. DEMOLITION OF GARAGE APPLICANT DEMOLITION-ACCESSORY STRUCTURE 50.00 PETERS, BRIAN 1978 SHADYWOOD ROAD STATE SURCHARGE DEMO 5.00 WAYZATA, MN 55391- TOTAL 55.00 OWNER PETERS, BRIAN 1978 SHADYWOOD ROAD 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 conforma ewith the State Building Code.This permit may be revoked at an'y'�p�ime f� cause. r'�- l ;r/ ,z/ �'�._-- �l '-k- l�/ ��j�O L Applicant Perm�tee Signature Date Issued Signature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. , ` � � `�? � 7� �`� �� Q j\ City of Orono SE ONLY �z l O `rO.' P'O.Box 66 Date Received:��Permit#o'�l�l!-D� w �:, � 2750 Kcllcy Parkway r � �� ;1��J !�J Crysta]Bay,MN 55323 Amounr. $�'�• SAC Credit: ' � ,7%>�}�ae' (952)249-4600 ��s�O� Homeowner(s)Signed: ❑Yes Resolutions(if any)Signed:Q Yes ❑None Required Zonin Disclosure Si ned: 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: � ��C: ' �� Owner: ��G�,1� \ �� Mailing Address: �� -�� City: V��,C� Zip: Home Phone: �%�Zr��-�l� �l ��Z Alternate Phone: ��.�� -�� ' ��Z Contractor/Applicant Information: Contractor/App.:T� ,� �j��,,,�f�� Ci-�� Contact Person: ��E� Address: `�� VJ�S�' �f� �"'� State License#: '""'- City: ``��Lti�Zip: �3�� Expiration Date: --_ Phone: �� 1 �7 S " / 7 7� Alternate Phone: ��Z-�Z�� '"� < �� 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) Issued: ❑ Sewer Disconnection ❑ Well Abandonment# In retzu-n for issuance of said Demolition Permit,the undersigned owner hereby agrees as follows: 1. The structure(s)shall be kept enclosed and/ar 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. 5. Water wells must be abandoned in accordance with State Health Department regulations. 6. Inspection required when all debris has been removed, before backfilling. 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 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). 8. 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 are pumped and before the tanks are crushed and filled. 9. 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 ar 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, subcontractars or assigns. PERMIT TYPE AND FEE CALCULATION ❑ $75.00—Principal Structure �$50.00—Accessory Structure�_(how many) (what) 1. Subtotal of above permit requested $ �; G G 2. State Surcharge $ 5.00 3. TOTAL PERMIT FEE (add lines 1-2 above) $ ,_�,,s,c:� U The undersigned herby applies to the City of Orono for issuance of a Demolition Permit, agees 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 st�m s made on this application are complete, true and correct. '� � Applicant's Signature: � Date: �s�/ � � 1 Owner's Signature: � - �. �?-�--• Date: ��f�% Approved By: Date: � 'LS- Z01� (B 'lding Official) * Zoning Disclosure Required? ❑ YES NO *This must be filled out by Zoning Department—For eit r answer,a Zoning Official must sign all applications. *Approved By: � ,�j�/If/�(/t, Date: �-v �� (Zoning Official) Reset Form � � � DATE TIME � CITY OF ORONO �C� CALLED IN 4/4/ �i INSPECTION NOTICE SCHEDULED T"�� %1 �1 PERMIT NO. ��-�� CCJ�� COMPLETED ADDRESS � � � �' �� '-lc--� (�%�''`�/ ��/ OWNER f�I�l � {��t�l� � TELEPHONE NO. ��a��4U--I u��- CONTRACTOR �- a DESCRIPTION �-e✓n�? f=��I � � ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS y ❑ FRAMING ❑ MECHANICAL FINAL Q ❑ TREE REMOVAL Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS � ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT � ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP _ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL J ❑ PLUMBING RI ❑ SEPTIC FINA ❑ FOUNDATION/REMOVAL ZOWNE�R/CONTRAC�TO�R�TO MEET YOU:_YES�L NO �( � � COMM�T : ��i'L1 (�?"�u ) 1�� W a � � O � � O � W � Q � 2 W � W � � � �k�dORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLEfE W ❑CORRECT WORK�PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY � ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITNIN HOURS. ❑ pHOTOTAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED ❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. �95Z� Z49-4600 OwnerlContractor on sit : ' Inspector. ��/i �S White Copy/lnspector's File Canary Copy/Site Notice