HomeMy WebLinkAbout2003 - P06496 - demo PERMIT
CITY OF ORONO
2750 Kelley Parkway- PO Box 66 Permit Number: P06496
Crystal Bay, Minnesota 55323 Permit Type: Demolition
(952) 249-4600 Date Issued: 7/1/2003
SITE ADDRESS: 325 Willow Dr N
Long Lake,MN 55356
PID: 33-118-23-41-0014
DESCRIPTION:
Proposed Use: Residential
Permit Class: Building Census Code 645
Permit Type: Demolition Permit Sub-type(s): Demo-Principal Structure
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
Foundations%all demo debris to be'unloved from gioumid Sc.disposed of off she per PCA regulations. Wells
m.lst be abondoned. Inspection before backfilling.
FEE SUMMARY: Permit Fee: $ 50.00 Valuation: $ 0.00
State Surcharge Fee: $ 0.50
TOTAL FEE: $ 50.50
APPLICANT: Doboszenski and Sons OWNER: MN DOT/STATE OF MN
6450 Pioneer Trail Director R/W Operations
Loretto,MN St.Paul,MN 55155
THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED
AND AGREES TO DO ALL WORK IN STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF
MINNESOTA BUILDING CODE REQUIREMENTS.
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APPLICANT PERMITEE SIGNATURE [ ISSUED BY SIG 7TURE
Copies: 1-File(Siinitures Required), 1-Applicant, 1-Monthly Reports, 1-Assessing. 1-Finance Page 1
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CITY OF ORONO APPLICATION FOR DEMOLITION PERMIT
P.O. Box 66 (2750 Kelley Parkway)
Crystal Bay, MN 55323
SPECIAL CONDITIONS & HOLD HARMLESS AGREEMENT
General Instructions
1. You may be required to obtain other permits, i.e. 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 (612) 249-4600.
JOB SITE ADDRESS: . .PS W.
Occupancy Type: ✓ Residential Commercial
OWNER'S NAME: M Dad- Phone:
Mailing Address: City:
CONTRACTOR'S NAME: J 4szr.,.,-A' o..�o ‘e.__s Bus.No.:
Mailing Address: sv P,;. r 177,0,% City: •Cooze,
Demolition if planned by means of: / manual disassembly
heavy equipment Pa`#.17 v 141
Permits Issued:
# 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.
9. 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.
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 PERMIT 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 Date: ‘7:///o---
OWNER'S SIGNATURE: Date:
APPROVED BY: e ( Date: U?
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I hereby certify that this is a true and correct representation of a survey of the boundaries of
Lot 3 , Block 1 , Spruce Acres , according to the recorded plat thereof and the proposed location of
a proposed house. It does not purport to show any other improvements or encroachments .
COFFIN & GRONBERG , INC . 0
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