HomeMy WebLinkAbout1997-009764 - guest house demo PERMIT
CITY.,�F ORONO PERMIT TYPE:
2750 KelteyWarkway- P.O. Box 66 ' �'� .-
Crys�fal Bay, Minnesota 55323 Permit Number.
(612)473-7357 Date Issued:
SITE ADDRESS:
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DESCRIPTION:
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REMARKS:
FEE SUMMARY:
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APPLICA /PERMITEE SIGNATURE ISSUED BY:SIGNATURE
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' CITY OF ORONO APPLICATION FOR DEMOLITION PER�tiiIT
P.O. Box 66 (2750 Kelley Parkway) �
Crystal Bay, MN 5�323
SPECL4L CO�TDTTIONS & HOLD HARi1�TLESS AGREEME�'T
General Instructions
1. You may be required to obtain other permits, i.e. burnin�, well abandomm�ient, etc.
2. Work 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 SITE ADDRESS: �`/�o -`J" �f�« /i n� Dr i r e-
Occupancy Type: ,/ Residential Commercial
OWti'ER'S NQutiIE: Alf��d �����.s�r� Phone: y7� -8�'4'9
Mailing Address: �yio S,fo�` i,"„ � D� :�� Ciry: D�on o
COt11'IRACTOR'S NA11�: �cn��� �/o m � s .Zn� Bus. NO.: �/7�-o S s/B
Mailing Address: Go i C�.-/.�h l�k.✓y City:
Demolition if planned by means of: manual disassembly
_�/ heavy equipment
burnin; (by fire department)
Permiu Issued:
# Burning Fire Department
# Well Abandonment
In retum for issuance of said Demolition Permit, the undersi?ned 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 adjouung 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 reoulations.
6, Inspection required when all debris has been removed, before bacl�'�ilin;.
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7. Within 5 workin� days of superstructure removal, a final inspection shall be requested.
The site shall be lefr clean and clear of all debris, with any excavation filled with earth
level with the adjacent �round 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 undersi�ned owner shall and hereby does indemnify and hold harrnless the City of
Orono, its a�ents, employees and assigns from and a;ainst all claims, dama;es, losses
or expenses,vincluding attorney fees, against the City, its a�ents, employees and assi�ns
arising out of or resultin� from the demolition described herein as performed by the
properry owner, his employees, aaents, subcontractors or assiQns.
PERiI�ITT TYPE AND FEE CALCULATION
� $50.00 ='Principal Structure
$30.00 - Accessory Structure
1. Subtotal of above permit requested $ �� ��
2. State Surcharge $ .50
3. TOTAL PERMIT FEE (add lines 1-2 above) $ So �
The undersi�ned hereby applies to the City of Orono for issuance of a Demolition Permit, agrees
to do all work in strict accordance with the ordinances of the City and the regulations of the
State of Minnesota, and certifies that all tatements made on this application are complete, true
and correct. '� �'
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APPLICANT'S SIGNATURE: Date: �.'�-/ �- 91
OWiYER'S SIGNATURE• Date:
APPROVED BY: Date: