HomeMy WebLinkAbout2001-P03644 - demo CITY OF ORONO PERMIT
2750 Kelley Parkway- PO Box 66 Permit Number: Po3644
Crystal Bay, Minnesota 55323 Permit Type: nemoiition
(952) 24�9-4600 Date Issued: 8i2o�2ooi
SITE ADDRESS: 2064 Shadywood Rd
Wayzata,MN 55391
P I D: 17-117-23-31-0015
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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mist be abondoned. insnection before backfilline.
FEE SUMMARY: Permit Fee: $ 50.00 Valuation: $ 0.00
State Surcharge Fee: $ 0.50
TOTAL FEE: $ 50.50
APPLICANT: Lecy Construction OWNER: Mr•&Mrs.Kelly
15012 Hwy.7 2064 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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APPLICANT PERMITEE SIGNATURE ISSUEDB SIGNATURE
Conies: 1-File(SiQnitures Required), 1-Annlicant, 1-Monthlv Renorts, 1-Assessine, 1-Finance Page 1
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CITY O�' O�ONO APPLIt;AT�ON FO�R DEMOLITION Y�RMIT
P.O. Box-�6(2750 Kelley Pazkway)
Crys�at Bay,N�N 55323
SPECIAL CONAITI4NS &HOLD 13ARMLESS AGkEEMEN?
GeneralInstructions �
1, You may be required to obtain other permits, i.e.well abandonmment, etc.
2, Work must not begin unless the pennit cazd is available on the job site.
3. A 24 hour notice is required for all insF►ec�ions. CaJ.I(612)249�4b00.
JOB SITE A:DDRESS: �° b 4 s116_,�.,i�� �l I�cl O r a-, �
Occupancy Type: X_Residontial C�mmercial ( /�`
/1w 1 ,�/14AfIlC/\�N �, �,�� �/� - �V-7 i•
�Nt ]F rltTil�� r Phone: 9$;�- �i�i- �ss -
OWN�R'SNAME� � �� I�I;,,� _ � „� Ssyo,
Mailing Address: ��b u �-. � �U_ _City: 9��.�� _
^ Bus.No.; �7c�3 - y�. - »U.�
CONT�tACTOR'S NAME: ��;� -1- L,,..��,s.-r -�-^�
--'"� _czry:�.�,u, . ��3 'y
Mailing Address: /y��:. �:� �k�
�aso.- /`'lu�l(�
Demolition if plaxu►ed by means of: �,,.,manual disass�mbly
�heavy equipmen�
Permits Zssued:
#�,Well Abandozument ,
In zetwrn for issuance of said Demolition Pemut,the:undersignecl ownez hereby agrees as follows:
1, The structure(s) shall be kept enclosed ancUdr secured until such time as demolition is
complete.
? Demolition debris will be kept off adjoining property and�'or the public rights-of-way uuless
specific prior approval is obtained in writii�g for tempor2u�y use thereof. ,
3, Foundations shall be completely removed fi•om the giou�d. _
4. All demolxtion debris shall be co�►pletely disposed a£ off site in accordance with all
applicable PCA requizements.
5. Water�vells must be abandoncd in.accordauice with State Health Department regulations.
b. Inspection requir�d when all debris has been remo�ed, t>efore backfilling.
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7, Witlun 5�vorking days of superstructvre iemoval,a final inspection shsll be request�d. Ihe
� site shall be leR ciean and clear of all debris,wi,th any excavation filled with earth l�v�l with
the adjacent ground elevation(except when.such exeavatioa is to be used as part of a aew
building and such new build'ung is actually u�dat constcuction).
8. The undersxgncd owner shall and hereby docs indemz�i�y and hold harm]ess the City of
Orono, its agents, �mployecs and assigns from and agaunst all elaims, damages, loss�s ox
e:c�enscs,including attomey fees,against tlne City,its agec�ts,employee�aad assigns arising
out of or resulting from the demolition described hetoin as pe�t£onned by the property owner,
his employ�es, ag�nts. subcontractors or assigns.
9. Septic systems must be abandoned per Mirmesota Rules Chapter 7080. All septic tenks must
be pumped,crushed and filled with native soils. An inspection is required aRer the tanks aze ,
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pumpcd and before the tanks are cn�sh�d a�id filled..
PERMIT TYPE AND FEE CALCULAT�ON
� �50.00 -Principal Sriucture
$30.00 -Accessory Strueture
1. � Subeotal of above p�rmit requested $ S° ' ° �
2. State Surcharge $ •�
3. TOTAL PERMIT FEE(add lines 1-2 above) $ S J, 5 �
The undorsigned hereby applies to the City of Orono for,issuance of a Demolition Permit,agrees to
do all work in strict accordar�ce with the ordin�nces ofthe City and the reguladons o�the State of
Minnesota,and certif es that all statements r�aad,e oa this application are eamplete,t=ue and correct.
APPL�CANT'S SIGNATUR�: Date: �'a o —o I
O�NER'S SIGNATURE: ' ' Date: a'�a'U �D 1 _
A,PPROYED BX: c� Date: �1 -u' - �'
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