HomeMy WebLinkAbout2001-P03643 - demo CITY OF ORONO PERMIT
2750 Kelley Parkway- PO Box 66 Permit Number: Po3643
Crysial Bay, Minnesota 55323 Permit Type: Demoiition
(952) 249-4600 Date Issued: ai2o�2ooi
SITE ADDRESS: 2056 Shadywood Rd
Wayzata,MN 55391
PID: 17-117-23-31-0014
DESCRIPTION:
Proposed Use: Residential
Permit Class: Building Census Code 645
Permit Type: Demolition Permit Sub-type(s): Demo-Principal Structure
DETAILS: '
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
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m ist be abondoned. lnsnection before backfilline.
FEE SUMMARY: Permit Fee: $ 50.00 Valuation: $ 0.00
State Surcharge Fee: $ 0.50
TOTAL FEE: $ 50.50
APPLICANT: Lecy Construction OWNER: Jacquelynn Kelly
15012 Hwy. 7 2056 Shadywood Rd
Minnetonka,MN 55345 Wayzata MN 55391
THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED
AND AGREES TO DO ALL WORK IN STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF
MINNESOTA BUILDING CODE REQUIREMENTS.
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APPLICANTPERMITEESIGNATURE ISS DBYSIGNATURE
Conies: 1-File(SiQnitures Reauired), 1-Annlicant, 1-Monthlv Renorts, 1-Assessine. 1-Finance p�e �
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, C1TY OF Ok20N0 APPLIC:AT�ON FO:R DEMOLITION PERMI2
P_O. Box 66 (2750 Kelley Parkway)
Crystal gay,N�1 55323
SPECIAL CON�DITIONS &HOLD I3ARNxI-ES�AGREEMENT
General�nstructious �
1, Xou zmay be required t� obtaia other permits, i.e.well abar�donmment, ctc.
Z, Work must not begin wnless the permit card i::avai�able orn the j ob site.
3. p� 24 hour notice is required for all insgecti�ns. Cal.l (612)249-4600.
JOB SI7E ADDRESS: a
0 S b ��a.� w oe �l iZ a �ro.� ,�
Occupancy Type: _ x_Resideniia l Cornznercial ��,I �J� _ y�9 S
(3��� S1� �I r�-+'� M°Phone:�, q S a- y�i- o s s 1
pW�1ER'SNAME• � � �� (t^� � ,� s sti��
Mailing Address: -7 61 c„)� :
-t-. h � rll City: :.��� _I, i`-
CONT�LACTOR'5NAME: c�� -I- C .�.. �.� =L��. _Bus.No.: '1c,3 - y� • �av�
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MailingAddress: /ya�o �;� la� - �`� �
So 5.� M.,� t l�r-
Demolition if plazuied by zxxeans of: �manual disass�m.bly
->C heavy equipmen�
permits Issued:
# ,�_Well Abandoz►ment ,
In xe��►for iss�an,ce of said D�molition Permit,the uudezsignecl owner hereby agrees as follows:
�,. The structure(s) shall be kept enclosed an�Vor secured unti� sueh t�zzie as demolition is
complete.
� Demolition debris will bc�Cept off adj oinin� property and/or the public righes-of-tiway unless
specific prior approval is obtained in writzn�;for temporary use thereof.
3. Foundatioas shall be completely removed fi•om the ground_
4. All demolition dcbris sha11 be completely disposed �f off site in accordance with all
applicable PCA requirements.
5, Water wells must be abandoned in accordauice with StaCe Health Depaztment z�egulations.
g, Inspection required when all debris has been removed,lbefore bacl�lling.
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• . 7. . Within 5�vorking days of super5tructurc rcmoval,a final inspeotion shall bo requested. The
site shall be lef�clean and clear of aIl d�bris,with aany excavation fil�ed with cartb�level with
the adjacent ground elevation(except wher�such excavation is to be used as part o�a aew
building aad such new building is actually under construction).
8, The uadersigncd owner shall and hereby docs indemmi�'y and hold harniless the City of
Orono, its agents, employees aad assigr�s from and agai�nst all c�aim�s, damagcs, losses oc
ex�enses,includi.ag attomey fees,against the City,its agents,enaployees aad sssigas arising
out of or resulti.ng from the demolition described herein as perfomaed by the property owner,
his employ�ecs, agents, subcontractors or assigns.
9. Septic systerns must be abandoned per Minz�esota Rules Chapter 7080. ,Aal septic tanks must
be pumped,crushed and filled with native soils, An inspection is required after the taziks are
pum�ed and before the tanks are cnuhed a�id filled.
PERMTT TYPE AND FEE CAI.CIJ�A�'ION
� $50.00 - Principal Structure
$30.00 -Accessory Structure
1. Subtotal of abovc permit requested $ S d , o �
2. State Surcharge $ •5
3. IOTAL PERMIT FEE (add lines 1-2 above) $ S J• r�
The undersigned hereby applies to the Ciry of Orono for.issuance of a Demolition Permit,agrees to
do all�vork in strict accordance tivith the ordinancE:s of tho City a�d the regulatioas of the State of
Minnesota,and certifies that all statements naade oathis application ate complete,ttue and correct.
APPLICANT'S SIG1�iATURE: Date: g'a� �°�
O�vNER'5SIGNA�LTRE: Date: �S'�D �- O 1 -
A,PPROVED BY_ u� Date: 8 - 7.0 -01
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