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Home My WebLink About2011 - 00149 - demo • CITY OF ORONO PERMIT NO.: 2011-00149 2750 KELLEY PARKWAY ORONO, MN 55356- DATE ISSUED: 03/04/2011 (952) 249-4600 FAX: (952) 249-4616 ADDRESS : 2875 WEAR CIR PIN : 33-118-23-34-0004 LEGAL DESC : UNPLATTED 33 118 23 : LOT 000 BLOCK 000 PERMIT TYPE : DEMOLITION PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : DEMO- PRINCIPAL STRUCTURE ACTIVITY : 645-SINGLE FAMILY HOUSES(ATT&DET NOTE: HOUSE ORIGINALLY LOCATED AT 2900 WATERTOWN RD. NOTE: 1. FOUNDATIONS/ALL DEMO DEBRIS TO BE REMOVED FROM GROUND&DISPOSED OF OFF SITE,PER PCA REGULATIONS. 2. WELLS MUST BE ABANDONED. 3. INSPECTIONS DONE BEFORE BACKFILLING. NOTE: A 24-48 HOUR NOTICE IS REQUIRED FOR ALL INSPECTIONS. CALL(952)249-4600. SEWER MUST BE DISCONTINUED AT THE CITY SERVICE BY QUALIFIED CONTRACTOR BEFORE DEMO PERMIT IS ISSUED. CHECK TO MAKE SURE THIS PERMIT HAS BEEN PULLED BEFORE ISSUING THIS PERMIT. APPLICANT DEMOLITION-PRINCIPAL STRUCTURE 75.00 MILLER TRUCKING & LANDSCAPE STATE SURCHARGE DEMO 5.00 491 LABEAUH AVE NE HANOVER,MN 55341 MISC FEE 0.00 (763)498-8342 TOTAL 80.00 OWNER GUIMOND ET AL, SHARON R 2875 WEAR CIR LONG LAKE,MN 55356- AGREEMENT AND SWORN STATEMENT The work for which this permit is issued shall be performed according to the approved plans and specifications,applicable City approvals,and the State Building Code. This permit is for only the work described and does ` not grant permission for additional or related work which requires separate permits. All provisions of laws and ordinances governing this type of work shall be compied with whether or not specified herein.This permit will expire and become null and void if construction authorized is not commenced within 180 days of the date of issuance,or if construction is suspended for a period of 180 days at any time after work has commenced. The applicant is responsible for assuring all required inspections are requested in conformance with the State Building Code.This permit may be revoked at any time for due cause. / / f/ 1 Applicant Permitee Signature Date Issued y Signature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. CITY OF ORONO PERMIT NO.: 2011-00149 2750 KELLEY PARKWAY ORONO, MN 55356- DATE ISSUED: 03/04/2011 (952) 249-4600 FAX: (952) 249-4616 ADDRESS : 2875 WEAR CIR PERMIT APPLICANT: PIN : 33-118-23-34-0004 MILLER TRUCKING&LANDSCAPE LEGAL DESC : UNPLATTED 33 118 23 491 LABEAUH AVE NE : LOT 000 BLOCK 000 HANOVER, MN 55341 PERMIT TYPE : DEMOLITION PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : DEMO-PRINCIPAL STRUCTURE ACTIVITY : 645-SINGLE FAMILY HOUSES(ATT& HOUSE ORIGINALLY LOCATED AT 2900 WATERTOWN RD. NOTE: 1. FOUNDATIONS/ALL DEMO DEBRIS TO BE REMOVED FROM GROUND& DISPOSED OF OFF SITE, PER PCA REGULATIONS. 2. WELLS MUST BE ABANDONED. 3. INSPECTIONS DONE BEFORE BACKFILLING. NOTE: A 24-48 HOUR NOTICE IS REQUIRED FOR ALL INSPECTIONS. CALL(952)249-4600. SEWER MUST BE DISCONTINUED AT THE CITY SERVICE BY QUALIFIED CONTRACTOR BEFORE DEMO PERMIT IS BUILDING INSPECTION RECORD 48 HOUR NOTICE REQUIRED FOR ALL INSPECTIONS. CALL FOR INSPECTIONS WEEKDAYS: INSPECTION TYPE DATE INSPECTOR INSPECTION TYPE DATE INSPECTOR FINAL INSPECTION COMMENTS: IN ACCORDANCE WITH CITY ORDINANCE,NEW OR SUBSTANTIALLY REMODELED BUILDINGS SHALL NOT BE OCCUPIED UNTIL ALL WORK HAS BEEN APPROVED,AND A CERTIFICATE OF OCCUPANCY HAS BEEN ISSUED BY THE BUILDING DEPARTMENT. THIS CARD MUST BE POSTED AND VISIBLE AT ALL TIMES UNTIL WORK IS COMPLETE. -70, City of Orono Fp jt C�TY USE ONLY P.O.Box 66 Date Received: q 1 Permit# a O{l- t�df ' � `2750 Kelley Parkway i '!. Ij Crystal Bay,MN 55323 Amount: S SAC Credit: • 1,c, (952)249-4600 Homeowner(s)Signed: ❑Yes Resolutions(if any)Signed:0 Yes 0 None Required Zoning Disclosure Signed: 0 Yes 0 None Required CITY OF ORONO- DEMOLITION PERMIT f�E�!�1 �® (All permits must be approved by the Building Official and/or Zoning Department) V 0 Job Site/Owner Information: MAS 2011 ciry of ORON° Type: ® Residential n Commercial• 6713 75 l/t),Lah 00 de Site Address: %1 r 5� ` Owner: Mailing Address: City: Zip: Home Phone: Alternate Phone: Contractor/Applicant Information: Contractor/App.: M tx —VC VAlfICS4V1r),SCap>L Contact Person: LaYry Address: PO go' l51 State License #: City: Nor-over Zip: SS 341 Expiration Date: Phone: -1103 `Ac-16-te a- Alternate Phone: 1't3 .Q c\- 30`\1 SPECIAL CONDITIONS & HOLD HARMLESS AGREEMENT General Instructions: 1. You may be required to obtain other permits, i.e.: well abandonment, sewer, etc. 2. Work must not begin unless the permit card is available on the job site. 3. A 24-48 hour notice is required for all inspections. Call (952)249-4600. 4. Sewer must be discontinued at the City service by qualified contractor before demo permit is issued. Demolition by means of: ❑ Manual Disassembly F1 Heavy Equipment ❑ Other Permit(s) Issued: ❑ Sewer Disconnection n 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. Septic systems must be abandoned per Minnesota Rules Chapter 7080. All septic tanks must be pumped, crushed and filled with native soils. An inspection is required after the tanks are pumped and before the tanks are crushed and filled. 9. 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. PERMIT TYPE AND FEE CALCULATION $75.00-Principal Structure n $50.00-Accessory Structure (how many) (what) 1. Subtotal of above permit requested $ n 2. State Surcharge $ 5.00 3. TOTAL PERMIT FEE (add lines 1-2 above) $ (z3:3O� The undersigned herby applies to the City of Orono for issuance of a Demolition Permit, agrees to do all the work in a 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: Date: 1- 2-A - J Owner's Signature: - - Date: Approved By: L11 M%, Date: 3 2-0 (Building Official) * Zoning Disclosure Required f, YES 1:1 NO *This must be filled out by Zoning -� ent-For either answer,a Zoning Official must sign all applications. * Approved By: ( / .I Date: 3- y` (Zoning Official) A AK_ I I .1 o bey\ ctelytd,i/sk ., No nekoi Reset Form co( cmyvic.s (' 1 rt.