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Home My WebLink About2000-P02412 - demo � - � PERMIT CITY OF ORONO 2750 Kelley Parkway- PO Box 66 Permit Number: Po2ai2 Crystal Bay, Minnesota 55323 Permit Type: Demoiition (612) 249-4600 Date Issued: si2ioo SITE ADDRESS: 2016 Shadywood Rd WAYZATA,MN 55391 P I D: 17-117-23-31-0002 DESCRIPTION: Proposed Use: Permit Class: Building Permit Type: Demolition Permit Sub-type(s): Demo-Accessory Structure DETAILS: Approved per resolution#: Separate permits required: NOTICES/REMARKS: ��:^.'.^.w;�.^.,^.��:�:��^.:.^.��.^.�:O��;�.^.:^Y�.��, .. .1 R.�;�.,�.�o.i.,F�FF�.��..or DvA r l�t;..,,� \l/�ll� .b,..::.^....�., t....,....... i..., ..�.U^::.....,.....,. m ist be abondoned. Inspection before backfilling. FEE SUMMARY: Permit Fee: $ 30.00 Valuation• $ 0.00 State Surcharge Fee: $ 0.50 TOTAL FEE: $ 30.50 APPLICANT: �CHARD KOZICKY OWNER: R W&C M KOZICKY 2016 SHADYWOOD RD 2016 SHADYWOOD RD WAYZATA,MN 55391 WAYZATA MN 55391 'TI�UNDERSIGNID HEREBY REQUESTS PERMISSION TO MAKE TI�REAL IMPROVEMENTS SPECIFIED AND AGREES TO DO ALL WORK IN STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF MINNESOTA BUII.DING CODE REQUIREMENTS. � UEDBYSIGNATURE ° �� Copies:City,Applicant,Assessor,Finance Page 1 . � t. � CITY OF ORONO APPLICATION FOR DEMOLITION PERNIIT P.O. Box 66 (2750 Kelley Parkway) . Crystal Bay,MN 55323 SPECIAL CONDITIONS & HOLD AA�t1VILESS AGREEMENT GeneralInstructions � � � 1. You may be required to obtain other permits, i.e. well abandonmment, etc. 2. Work must not begin unless the permit card is available on the job site. 3. A 24 hour notice is required for all inspections. Call(612)249-4600. JOB SITE ADDRESS: v�0/ L� ��%�,�, r� �(� - Occupancy Type: Residential Commercial OWNER'S NAME: �c.�•�,�.c� 0 2� � �� i Phone: �7/ �/l 9 a Mailing Address: �-o �� S E,�,.9-r�� v t� �rJ City: lv9-y Z�^� CONTRACTOR'S NAME: Bus. No.: Mailing Address: City: Demolition if planned by means of: manual disassembly . heavy equipment --� �'°� �^� Permits Issued: # Well Abandonment In return for issuance of said Demolition Pernut, 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. 5. Water wells must be abandoned in accordance with State Health Department regulations. 6. Inspection required when all debris has been removed,before bacl�'illing. � i � 7. Within 5 working days of superstructure removal, a final inspection shall be requested. The site shall be left clean and cleaz of a11 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. 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. PERlVIIT TYPE AND FEE CALCULATION . $50.00 -Principal Structure $30.00 -Accessory Structure � � 1. Subtotal of above permit requested $ �.00 2. State Surcharge $ .50 3. TOTAL PERNIIT FEE(add lines 1-2 above) $ 3U-5 v The undersigned hereby applies to the City of Orono for issuance of a Demolition Pernut, agrees to do all work in strict accordance with the ordinances of the City and the regulations of the State of Muinesota, and certifies that all statements made on this application are complete, true and correct. APPLICANT'S SIGNATURE: � � Date: �" a-^v d OWNER'S SIGNATURE: - Date: �� a'' � � APPROVED BY: � Date: S � Z � �� DATE TIME CITY OF ORONO CALLED IN INSPECTION NOTI � SCHEDULED ��l /� /� PERMIT N0. coM LETED ADDRESS �d S _�L�,� OWNER CONTR. TELEPHONE N0. � DESCRIPTION � Ot FOOTING 11 MECHANICAL RI 18 EXCA�//GRADING/FILLING Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS y 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL Z04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION Q OS FINAL 14 SEWER HOOK-UP 06 PROGRESS � 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT J 07 DEMO-FINAL 15 SEPTIC INSTAIL. 22 FOLLOW-UP = 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL � OWNER/CONTRACTOFi TO MEET YOU:_YES_NO � CO M EN S: � r � � �/ � � � O� / � � �+ � �' S � �S �� 3 � , � ., ,_ Q S - s � e� � z ' � �v �l � � W � � d � ❑WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLEtE W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY � RRECT WORK,CAIL FOR REINSPECTION TEMPORARY � BEFORE COVERING V /�� PERMANENT �GORRECTUNSAFECONDITIONWITHIN "�HOURS. p pHOTOTAKEN �� INSPECTOR WILL REfURN ❑CITATION ISSUED ❑STOP OROER POSTED.CALL INSPECTOR ❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS. Cail for the next inspection 24 hours in advance. (g52) 249-46�� OwnedContractor on site- Inspector. �C- G�.�''I� White Copyllnspector's File Canary CopylSite Notice