HomeMy WebLinkAbout1998-009946 - demo principal PERMIT
C".'Y OF ORONO PERMIT TYPE:
4 275 Kelley Parkway- P.O. Box 66 �'t j`-�INI1
Crystal Bay, Minnesota 55323 Permit Number: t)t-�`�`�
1 y Date Issued: 02 i 13 yc=,
(612)473-7357
SITE ADDRESS:
15 TONKA AVE
JG
P. I .N. ; 06-117- 1 000
DESCRIPTION:
DEMO PRINCIPAL
Building Permit. Type DEMO/PRINCIPAL
-Building Work Type DEMO-PRINCIPAL
Census sus Code 645 DEMO 1-FAM.
REMARKS:
FEE SUMMARY:
Base Fee $60 . 00
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Surcharge ---------- ',..5...
Total Fee $50. 50
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1418 `_HER I DAN 15 TONf''A AVE
MINNEAPOLIS MN 55 .11 ORONO MN 55:356
THE UNDERSIGNED HEREBY REQVESTa PERMISSI.tN TO MAKE THE REAS.
SPECIFIED AND AGREES TO 00 ALL WOW I NTR ' , ijwL
f tRt ANO ORDINANCES AND STATE, 1117 NESO TA I IL R0 � � 4
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APPLICANT/PERMITEE VNATURE ISSUED BY:SIGNATURE
CITY OF ORONO
APPLICATION FOR DEMOLITION PERMIT
P.O. Box 66 (2750 Kelley Parkway)
Crystal Bay, MN 55323
SPECIAL CONDITIONS & HOLD HA :Vv1LESS AGREEMENT
General instructions
1. 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.
JOB SITE ADDRESS:
Occupancy Type: G Residential Commercial
OtiVrER'S NAIN EE: Phone:
Mailing Address: City:
CONTRACTOR'S NAME: fmv A vA/ Bus. No.:
Mailing Address: /V SS Sif e.n,-a/.�c. City:
Demolition if planned by means of: ?4�1 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 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 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 and hereby 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.
4-1
PERMIT TYPE AND FEE CALCULATION
$50.00 --'Principal Structure
$30.00 - Accessory Structure
1. Subtotal of above permit requested $
2. State Surcharge $ 50
3. TOTAL PERi�IIT FEE (add lines 1-2 above) $
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.
APPLICANT'S SIGNATURE: ,94-Ge r Date:
OtiViNER'S SIGNATURE: Date:
APPROVED BY: Date: