HomeMy WebLinkAbout1997-009015 - demo . . . - PERMIT
4 �I�1( OF ORONO PERMIT TYPE:
2750 Kelley Parkway- P.O. Box 66 ~��.. ��..,�.����-��
Crystal Bay, Minnesota 55323 Permit Number: :,::,,._,:-;F;;� �
(612) 473-7357 Date Issued: _ I
SITE ADDRESS:
DESCRIPTION:
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REMARKS:
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FEE SUMMARY:
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; APPLICANT%PERMITEE SIGNATURE ISSUED BY:SIGNATUFiE
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CITY OF ORO�'O APPLICATION FOR DEMOLITION PER�tiiIT
P.O. Box 66 (2750 Kelley Parkway)
Crystal Bay, iViN 5�323
SPECL4L CONDITIONS & HOLD HARlti1I.ESS AGREEI�IEti'T
General Instructions
1. You may be required to obtain other permits, i.e. burnin„ well abandonmment, ecc.
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.
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JOB STTE ADDRESS: -
Occupancy Type: Residential Commercial
OtiYti'ER'S NQu�IE: ���.1�-�,.L.� G—tDl� C��v 6 Phone:�otZ-�4Z�, 4��
Mailin� Address: -?ov S�e1t,- N�� TZ� � Ciry:���.C' �'Vl�.,
CON'TRACTOR'S NAlI�: K�.vlfit �GP►tJA�r�� Bus. No.: Sq�- 3,,�57
Mailing Address: ���� F�n�v��� r.�in. Aa�� N City: ���-�t- Mrv
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Demolition if planned by means of: manual disassembly
�heavy equipment
burnin� (by fire department)
Permits Issued:
# Burning Fire Department
# Well Abandonment
In return 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 adjoining properry 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 regulations.
6, Inspection required when all debris has been removed, before backfillin;.
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7. Within 5 workin� 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 eleva[ion (except when such excavation is to be used as
part of a new buildin� and such new building is actually under construction).
8. The undersi�ned owner shall and hereby does indemnify and hold harmless the Ciry of
Orono, its aQents, employees and assigns from and against all claims, dama�es, losses
�'—�or expenses, includin; attorney fees, a�ainst the Ciry, its avents, employees and assi�ns
arisin� out of or resultin� from the demolitio� described herein as performed by the
properry owner, his employees, a?ents, subcontractors or assiQns.
PERtiIIT TYPE AND FEE CALCULATION
✓ $50.00 =�Principal Structure «��.,,�c.� G.��.��
V $30.00 - Accessory Structure - l-buS� �,.,+) '��N
1. Subtotal of above permit requested $_ I�(�,00
2. State Surcharge $ .50
3. TOTAL PERMIT FEE (add lines 1-2 above) $ 13�•�
The undersigned 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 Miruiesota, and certifies that all statements made on this application are complete, true _
and correct.
APPLICAN'I''S SIG�1A Date: �
OWiYER'S SIGNA Date: S
APPROVED BY: Date: s-Z$-5 7
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