HomeMy WebLinkAbout1994-006291 - demo �'E�MIT
� CITY OF ORONO R ' '# - PERMIT TYPE:
2750 Kelley Parkway • P.O. Box 815 Permit Number: `"��°'�!�'#�'�
Orono, Minnesota 55356-0815 i-'�'�`��_=��
(612) 473-7357 Date Issued: ;�;;,;;�:_,.;,��
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REMARKS:
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CITY OF ORONO APPLICATION FOR DEMOLITION PERMIT
P.O. Box 66 .
Crystal Bay, MN 55323
SPECIAL CONDITIONS & HOLD HARMLESS AGREEMENT
**�***:***:*:�*******t***:���******�****�****�************�****���**�*****
General Instructions
l. You may be required to obtain other permits, i.e. burning, well.
abandonmment, etc.
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.
*�*********t****�*#**�*�****�:***�*******�**�*******��******�*��*********:*
Jos sz� �nx�ss:������L�,� % ��e lA,y�1�%/� �,v �-�39'i
Occupancy Type: �Re idential ommercial
OWNSR'S NAME:������,.�c 7s ,�ff i. f�i�iL/ Phone: �����,,����
Mailing Address: City:
CONTRACTOR'S NAtKE:����_��_�X -�./ Bu s. No. : �' �i�s Y'-�i� '�
Mailing Address:�:.7�_.� f1��:;����f?y ;_ City:�1�N�.l�,�-�.tl ��3�y
*�*t*****�****��*****t*****:�*****�****:****�**�**�*:*:***:*****�*� *�****�
Demolition if planned by means of: manual disassembly �c heavy equipment
burning (by fire department)
Permits Issued:
# Burning Fire Department
# �'�Tell Abandonment ;;;;)r_'��.�i f%f>j f/i'i.=i�=i; j%�i2 j�f1�%� I �E.�:c�f'�_
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 reguirements.
5 . Water wells must be abandoned in accordance with State Health
Department regulations.
6. Inspection required when all debris has been removed, before
backf illing.
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).
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8. The undersigned owner shall and �ereby does indemnify and hold
harmless the City of Orono, its agents, employees and assigns from and
against all claims, damages, losses or expenses, including attorney
fees, against the City, its agents, employees and assigns arising out
of or resulting from the demolition described herein as performed by
the property owner, his employees, agents, subcontractors or assigns.
*::::*::t::*�*:::��*:*:�r*******:*t*�*:�***:***��t*�**:******:::*�:�::**t:::
PERMIT TYPE AND FBE CALCIILATION
$50.00 Principal Structure �O,
$30.00 Accessory Structure
1. Subtotal of above permit requested $
2. State Surcharge $ .50
3. TOTAL PERMIT FEE (add lines 1-2 above) $ '7 Q . ���
***�***���***�*:*#*�*:******�*�:�*�************�*�:*******�**���** �*�*:**�
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 Minnesota, and
certifies that all statements made on this application are complete, true
and correct.
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SIGNATURB OF APPLICANT: Date:
' D� �ATE � TIME
CITY OF ORONO CALLED IN 9 y
INSPECTION NOTICE SCHEDULED 8"-/'� /��
PERMIT NO. �a�,�_ COMPLETED
ADDRESS �D o�S 1�u�� /� �
OWNER f�TG�-r,u�'� �� CONTR. �,�ho�r, �Jr.e,a.J
TELEPHONE NO. �7Q� t/D�
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� DESCRIPTION �U`��-�'��+-�� ��`�T��-
l� 01 FOOTING 11 MECHANICAL RI 16 WELLTEST PUMP
H� 02 FRAMING 11 MECHANICAL FINAL 18 EXCAVIGRADINGIFILLING
03 INSULATION 24/25 WOOD BURNER/FIREPLACE 19 LAKESHOREIWETLANDS
� 04 WALL BD. 12 WATER HOOK-UP 34 TREE REMOV
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Q 05 FINAL 13 METER SETITURN ON 17 SITE INSPEC�.ION
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� 07 DEMO—SITE 14 SEWER HOOK-UP 06 PROGRE S
`� 07 DEMO—FINAL 27 SEPTIC MAINT. 21 COMPLAINT
= 09 PLUMBING RI 15 SEPTIC INSTALL. 22 FOLLOW-UP
J 10 PLUMBING FINA� 23 SEPTIC FINAL
� OWNERICONTRACTOH TO MEET YOU:_YES_NO
� COMMENTS:
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d ❑WORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLETE
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� ❑CORRECT WORK E�PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
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� �IECORRECT WORK,CALL FOR REINSPECTIOM TEMPORARY
0 ��EFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. r pHOTO TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR C CITATION ISSUED
� INSPEC710N REQUIRED.CALLTO ARRANGE ACCESS.
Cali for the next inspection 24 hours in advance.473-73�J7
OwnerlContrac n�s�te:
Inspector. ��1
White Copyllnspector's Fi e Canary CopylSite Notice