HomeMy WebLinkAbout2010 - 00407 - demo CITY OF ORONO PERMIT NO.: 2010-00407
2750 KELLEY PARKWAY
•
ORONO, MN 55356- DATE ISSUED: 06/02/2010
(952) 249-4600 FAX: (952)249-4616
ADDRESS : 170 WEAR LA N
PIN : 33-118-23-34-0015
LEGAL DESC : ROLLING MEADOWS 3RD ADDN
: LOT 002 BLOCK 002
PERMIT TYPE : DEMOLITION
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : DEMO-ACCESSORY STRUCTURE
ACTIVITY : 649-ALL OTHER BUILDING&STRUCTURES
NOTE:
1. FOUNDATIONS/ALL DEMO DEBRIS TO BE REMOVED FROM GROUND&DISPOSED OF OFF SITE,PER PCA REGULATIONS.
2. INSPECTIONS DONE BEFORE BACKFILLING.
DEMOLITION OF ORIGINAL FARM HOUSE WHEN ADDRESS WAS 115 OLD CRYSTAL BAY ROAD
APPLICANT DEMOLITION-ACCESSORY STRUCTURE 50.00
SCHOENING EXCAVATION INC. STATE SURCHARGE DEMO 0.50
4875 BRADFORD ROAD TOTAL 50.50
MAPLE PLAIN,MN 55359
0
OWNER
BERKEY, SCOTT G
170 WEAR LA N
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
rev, ked at any time for due cause.
J / / / /
A plicant Permite�ature Date Issued B S'
By ature ..3 )ate
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABO t.
• , oA City of Orono FOR CITY USE ONLY /n e7/i 7
1.,,,:- P.O.Box 66 Date Received: Permit# 6r-WV-0�
2750 Kelley Parkway
Crystal Bay,MN 55323 Amount: $�Q 5w SAC Credit:
{i so. (952)249-4600
I�� Homeowner(s)Signed: es
Resolutions(if any)Signed:❑Yes e Required
Zoning Disclosure Signed: ❑Yes one Required
CITY OF ORONO - DEMOLITION PERMIT
(All permits must be approved by the Building Official and/or Zoning Department)
Job SSi / er In rmatio �' rs .
Type: r fR�jesidential Commercial
Site Address: / / 0 Wea-r //J , N. zoNla //e1 IW i. SS3s-K ori pAdi f4.,
Owner: Seo f 83ePi "e y Mailing Address: SAMS- N
(0
City: Zip:
0
Home Phone: 9So2-V25/t,`9 Alternate Phone: 0-.
Contractor/,.App at In ormation -' - sa---
Contractor/App.:S, e en�i1G
Ch •bXea-v&-+rn, Contact Person: bo6., 66,4,f Ci g
Address: 010020 C ciii y Rci, gD State License #: A.A .
City: phQ is P644 Zip: 5-5-317 Expiration Date: . A.
....
Phone: 61.Z pi.. 930? Alternate Phone: 743- 4/99- 3a/6
t
, �P CI .:,. NDS �, ® SOL H RMLESS,�AGRE MENT �: �+
E
General Instructions:
1. You may be required to obtain other pelinits, 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 Gs
issued. 0-0-
::::7
Demolition by means of: n Manual Disassembly a Heavy Equipment I I Other c�,
Permit(s) Issued:
Lj Sewer Disconnection n Well Abandonment#
In return for issuance of said Demolition Permit, the undersigned owner hereby agrees as follows:
?✓J
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 Depainnent 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
nv�$50.00—Accessory Structure (how many) (what)
1. Subtotal of above permit requested $ ,60
2. State Surcharge $ .50
3. TOTAL PERMIT FEE (add lines 1-2 above) $ <5-0
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: je /3
Date: oU 7— 94
Owner's Signature: u44,41(,) Date: 6 /-020/0
Approved By: - Q Date: t' - 1 - A v 1 0
( ildin Official)
)
* Zoning Disclosure Required? n YES 17 NO
*This must be filled out by Zoning Depaitiuent/•r 'ther answer,a Zoning Official must sign all applications.
* Approved By: Date: 67//Z.0/0oning Official)
DATE TIME V
CITY OF ORONO CALLED IN
INSPECTION NOTICE SCHEDULED 40'I/"2-4 I O
PERMIT NO. ZOi O-00 Li 0/ COMPLETED
ADDRESS /7 C- 412 CAN e_ ND
OWNER TELEPHONE NO.
CONTRACTOR 5c-14-0E14-1Nq �:/c Cst v,4 T,o
is DESCRIPTION J
❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING
Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS
(2 ❑ FRAMING ❑ MECHANICAL FINAL
❑ TREE REMOVAL
• ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION
• ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS
0 FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT
v 0 DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP
_ DEMO-FINAL ❑ SEPTIC INSTALL 0 HARD COVER REMOVAL
❑ PLUMBING RI ❑ SEPTIC FINAL 0 FOUNDATION/REMOVAL
Z OWNER/CONTRACTOR TO MEET YOU: YES_NO
o COMMENTS:
W
Q..
O
0
W
W
W
Lu CI . PR
WORK SATISFACTORY:PROCEEDPROJECT COMPLETE
W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
CI CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
_CI• BEFORE COVERING
PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTO TAKEN
INSPECTOR WILL RETURN
CI CITATION ISSUED
CISTOP ORDER POSTED.CALL INSPECTOR
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (952) 249-4600
Owner/Contractor on site:
Inspector.
White Copy/Inspector's File Canary Copy/Site Notice