HomeMy WebLinkAbout1997-009014 - demo PERMIT
C�TY 0F ORONO PERMIT TYPE:
2750 KPlley Parkway- P.O. Box 66 =;i?�I'�;i�_i°�:�
Crystal Bay, Minnesota 55323 PermitNumber: ;�.;_r:�``;, :y
(612)473-7357 Date Issued: ` ; „ _—
SITE ADDRESS:
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REMARKS:
FEE SUMMARY:
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PLICANT�PERMITEE SIGNATURE ISSUED BY:SIGNATURE i
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CITY OF ORONO APPLICATION FOR DEMOLITION PER��IIT
P.O. Box 66 (2750 Kelley Parkway)
Crystal Bay, i�1N 5�323
SPECL�iI. CO�'DITI0�1S & HOLD HAR1ti1LESS AGREEIIE\"I'
General Instructions
1. You may be required to obtain other permits, i.e. burnin�, well abandonmment, etc.
2. `�Iork 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 SITE �DDRESS: �- •
Occupancy Type: Residential Commercial
O`VNER'S NQs��1E:�a iq- 6-�-�CJ� G-�DLF ��v � Phone:�olZ-�Zl�- 4��"
Mailin� �ddress: �n���i►.L��L,�, TZaa� Ciry:��l�d-C9 1'�A�.,
CO�ACTOR'S NAiVIE: I��►t"t- �-�GAi�A�r't t�.L�- Bus. No.: ��_ ��,�5 7
Mailing Address: ?�?� �.��U►�rJii.. /�a1� � City: ��T�s�-c- 11�rv
S��Z7
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 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 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 re�ulations.
6. Inspection required when all debris has been removed, before bac�illing.
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7. Within � 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 around 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 aQents, employees and assigns from and aaainst all claims, dama�es, losses
or e:cpenses, includin� attorney fees, aQainst the Ciry, its aQents, employees and assians
arisin� out of or resultin� from the demolition described herein as performed by the
property owner, his employees, aQents, subcontractors or assigns.
PERtiIIT TYPE AIVD FEE CALCULATION
� �a50.00 -�Principal Structure �'�.v.-��.-�-�.,,�-,��__ �_�,��� _ p ��
✓ $30.00 - Accessory Structure - l-fe�uS� �r� -���,
1. Subtotal of above permit requested $ ��v,do
2. State Surcharje � .50
3. TOTAL PERI�IIT FEE (add lines 1-2 above) $ I"��•f.�
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 re�ulations of the
State of Minnesota, and certifies that all statements made on this application are complete, true
and correct.
APPLICAN'T'S SIGi�'A Date: ���
O`Wi ER'S SIGNA Date: S G �'
APPROVED BY: Date: s-Z$ -5 7
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