HomeMy WebLinkAbout2005-P09103 (Demo) < � PERMIT
CITY OF ORONO
2750 Kelley Parkway- PO Box 66 Permit Number: po91o3
Crystal Bay, Minnesota 55323 Permit Type: Demolition
(952) 249-4600 Date Issued:
9/8/2005
SITE ADDRESS: 1376 Baldur Park Rd Unit#
• Wayzata,MN 55391
P��� 08-117-23-31-0005
DESCRIPTION: UBC Occupancy R3
Construction Type VN
Proposed Use: Residential
Census Code 649
Permit Class: Building
Permit Type:
Demolition Permit Sub-type(s): Demo-Accessory Structure
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
Foundations/all demo debris to be removed from ground&disposed of off site per PCA regulations. Wells
must be abondoned. Inspection before backfilling.
FEE SUMMARY: Pernut Fee: $ 30.00 Valuation: $ 0.00
State Surcharge Fee: $ 0.50
TOTAL FEE: $ 30.50
APPLICANT: Larkin Construction OWNER: Sandy Benson
5140 Greenwood Cr 1376 Baldur Park Rd
Greenwood,MN Wayzata,MN 55391
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 P R 7 EE SIGNATURE ISSUED BY SIGNATURE
Copies: 1-File(Signatures Reguired), 1-Applicant, 1-Monthly Reports, 1-Assessing,(If Septic, 1-Septic) 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 abandonment, etc.
2. Work must not begin unless the pernut card is available on the job site.
3. A 24 hour notice is required for all inspections. Call (952)249-4600.
JOB SITE ADDRESS: 13 (o �C,1 U lr �C,�,�''� l�G
Occupancy Type: Residential Commercial
OWNER'S NAME: �0.�►O���- i✓�„S 6 n Phone:� c1S��-- �1� '' � �"f'��
Mailing Address: �jc�.►.,�-�, City: O r 0 V�O
CONTRACTOR'S NAME: �.--�4�-I+e I�l i^ 6 Vl`J�' Bus.No.: Co � a-" �� t`3�7 Z7
MailingAddress:�/�D [1-I'�+-'1'� Wd� Gr City: (r'rdeh Z+/o
Demolition if planned by means of: manual disassembly
_�heavy equipmen;
Permits Issued:
# Well Abandonment
In return for issuance of said Demolition Permit,the undersigned owner hereby agrees as follows:
l. The structure(s) sha11 be kept enclosed and/or secured until such time as demolition is
complete.
2. Demolition debris will be kept offadjoining property and/orthe 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. Sewer and water must be disconnected at the services at the street by qualified contractors.
7. Inspection required when all debris has been removed,before backfilling.
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8. Within 5 working days of superstructure removal,a final inspection shall be requested. The
site shall be left clean and clear of a11 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).
9. The undersigned owner sha11 and hereby dces indemnify and hold harn�iless the City of
Orono, its agents, employees and assigns from and against all claims, damages, losses or
expenses,including attomey fees,against the Ciiy,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.
10. Septic systems must be abandoned per Minnesota Rules Chapter 7080. All sepric tanks must
be pumped,crushed and filled with native soils. An inspection is required after the tanks aze
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 Swcharge $ •S4
3. TOTAL PERMIT FEE(add lines 1-2 above) $
The undersigned hereby applies to the City of Orono for issuance of a Demolition Pernut,agrces to
do all work in strict accordance with the ordinances of the City and the regulations of the State of
Minnesota,and certifies that a11 statements made o is pplication are complete,true and correct.
APPLICANT'S SIGNATURE: �(VG� Date: ��� 7���
OWNER'SSIGNATURE: D�e: �� 7�G S�
APPROVED BY: Date: `� - ( - � S
uilding Ot�icial)
�*ZONING DISCLOSURE REQUIRED? • •YES • �i0
• This Must Be Filled Out B Zo ' artment - For Either er, A Zoning Official Must Sign All
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Appiications
*APPROVED BY• - � • D��
(Zoning Official)
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