HomeMy WebLinkAbout1998-010197 - demo PERMIT
CITY OF ORONO PERMIT TYPE:
�'750 Kelley Parkway- P.O. Box 66 �:!?i i i i_�fi�,�;_
Crystal Bay, Minnesota 55323 Permit Number: f a�i+f�:�:
(612) 473-7357 Date Issued: t}��'�.j;Y;r T�;«;
SITE ADDRESS:
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REMARKS:
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FEE SUMMARY:
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APPLICANT/PER ITEE SIGNATURE `.. ISSUED BY:SIGNATURE �,
� . � _ .� ��; /� 7
� APPLICATION FOR DEMOLITION PER�viIT
! CITY OF ORO�TO .
P.O. Box 66 (2750 Kelley Parkway)
Crystal Bay, MN 5�323
SPECL�L CONDITIONS & HOLD HARi1�TLESS AGREEl�1ENT'
General Instructions
I. You may be required to obtain other permits, i,e. burnin�, well abandonmment, e�c.
2. �ork must not be�in unless the permit card is available on the job site.
3. A 24 hour notice is required for all inspections. Call 473-7357.
JOB STTE ADDRESS: .3c`�0 � u�C`r.�//rv . 111�
Occupancy Type: Residential Commercial T� n
� ��� lcl� Phone����f�3 S -�—
oti��R s �r�tir�: -J���rr c� : ,v-��r�
Ma�lm��dd�ss: � . ry ",3-S3o,
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CO�ACTOR'S NA�.I�: Bus. No.:
Mailing Address: City:
Demolition if planned by means of: ����anual disassembly
r/ heavy equipment
burnin; (by fire department)
Permiu Issued:
## Burnin� Fire Department
# Well Abandonment
In retum 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
complece.
2. Demolition debris will be kept off adjoinin� property and/or the public ri�hts-of-way
unless specific prior approval is obtained in writin� 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, Wacer wells must be abandoned in accordance with State Health Department rea lations.
6, Inspection required when all debris has been removed, before backfillin�.
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7. Within 5 workin� days of superstructure removal, a fiaal i.nspection shall be requested.
The site shall be left clean and clear of all debris, with any excavation filled with earch
level with the adjacent Qround elevation (except when such excavation is to be used as
part of a new buildin� and such new buildin� is actually under construction).
8. The undersi�ned owner shall and hereby does indemnify and hold harmless the Ciry of
Orono, its aaents, employees and assi;ns from and a�ai.nst all claims, damages, losses
or expenses,yincIuding attorney fees, aQainst the Ciry, its aaents, employees and assi�ns
arisin� out of or resultin� from the demolition described herein as performed by the
properry owner, his employees, a�en[s, subcontractors or assi�ns.
PERI�iIT TYPE AND FEE CALCULATIO�,T
�50.00 ='Principal Structure
�30.00 - Accessory Structure
1. Subtotal of above permit requested �
2. State Surcharje $ .50
3. TOTAL PERIVIIT FEE (add lines 1-2 above) S
The undersigned hereby applies to the Ciry of Orono for issuance of a Demolition Permit, agrees
to do all work in strict accordance with the ordinances of the Ciry and the regulations of the
State of Minnesota, and certifies that all statements made on th.is application are complete, true
and correct.
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APPLICANT'S SIGi�'ATURE: � .�� l ,
Datc:
OtiVNER'S SIGNATURE: Date:
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APPROVED BY: �' � , �''�' Date: �/�/sr
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