HomeMy WebLinkAbout1993-005249 - demo accessory structure PEI�MIT
' �iTY OF ORONO PERMIT TYPE:
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2750 Keiley Parkway • P.O. Box 815 PermitNumber: :ii;5'�Q.°�
Orono, Minnesota 55356-0815 -
(612) 473-7357 Date Issued: ����!f�:''����'
SITE ADDRESS:
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REMARKS: Foundations/ all demo debris to be removed from ground and disposed of
�ff site per PCA regulations. Wells must be abandoned. Inspection befo-re back-
filling.
FEE SUMMARY:
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CONTRACTOR: OWNER: — ��'�� ���r�t� —
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APP I ANT/PERMITEE SIGNATURE ISSUED BY:SIGNATURE
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CITY OF ORONO APPLIGATION FOR DSMOLITION PERMIT
P.O. Box 66 (1335 So Brown Rd)
Crystal Bay, MN 55323
� , SPECIAL CONDITIONS & HOLD HARMLESS AGREEMENT
***************:****�*#****:**�****************************�**********f***
General Instructions
1. You may be required to obtain other permits, i.e. burning, well
_ _:-- --_=. abandonmment, etc. �-- - __.._ ,. _ �.. __.�_.. . .r_,m-�- ..�..yz. ,r_�-. .-�� - .- - ---- - . .--_- _
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 473-7357.
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Jos sITS ADDREss: l C� r > J� �C_ r"C I i r i� -��► . ���C��I =S C.�'� �r.
Occupancy Ts rs: Residentzal CommerciaTl�
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OWNER'S NAME: �'_�� 1 G i 5 �l__�C C ��_� Phone: � 1 �...) � �
Mailing Address: , Q� I �7Lo City: �
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CONTRACTOR'S NAME: (�' �[� � � > ' Bus. No. :
Mailing Address: City:
********�******�***::******:�**:*******:**t*******#**:t*****�*****t::******
Demolition if planned by means of: manual disassembly �heavy equipment
_burning (by fire department)
Permits Issued:
� Burning Fire Department
# Well Abandonment
In return 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 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 f or 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 al 1 app licable 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
backfilling.
7. Within 5 working days of superstructure removal , a final inspection
shall be requested. The site shall be left clean and clear of all
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 ar.: reby does indemnify and hold
harmless the City of Orono, its aa , employees and assigns from and
against all claims, damages, los: :�r expenses, including attorney
fees, against the City, its agent� ��loyees and assigns arising out
of or resulting from the demoliti �scribed herein as performed by
the property owner, his employees, �ts, subcontractors or assigns.
******�**********t*****��**:*********t� .:*�****�*********�***tt*�#:*****
. . _ __� _ - _.._._ ___._.__�_.__.<.. PERMIT�TYP$ AND F: `_1LCDI,ATION _ --_ - -. _ - -_ _._ -_ -
� $50. 00 Principal Structure
$30.00 Accessory Structure 1� �
1. Subtotal of above permit requested $ ��% - CC,`
2. State Surcharge $ . 50
3� TOTAL PERMIT FEE (add lines 1-2 abc $ ":���. '• ��-
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the undersigned hereby app lies to thE ity of Orono f or issuance of a
Demolition Permit, agrees to do all w in strict accordance with the
ordinances of the City and the regulat= s of the State of Minnesota, and
certifies that all statements made on t � application are complete, true
and correct.
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SIGNATIIRE OF APPLICANT. l�l � Date: �%--- ' � C �