HomeMy WebLinkAbout2015-01194 (Demo) CITY OF ORONO * 2 0 1 5 - 0 1 1 9 4 *
2750 KELLEY PARKWAY DATE ISSUED: 09/18/2015
ORONO, MN 55356-
� 952) 249-4600 FAX: (952) 249-4616
ADDRESS : 1400 BALDUR PARK RD
PIN : 08-117-23-31-0001
LEGAL DESC : BALDUR PARK
: LOT O15 BLOCK 001
PERMIT TYPE : DEMOL[TION
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : DEMO-PRINCIPAL STRUCTURE
ACTIVTTY : 645-SINGLE FAMILY HOUSES(ATT& DET
NOTE: SAC GRANDFATHERED IN-PERMIT#1250 8/22/1965&HOME PRIOR-ALWAYS CHECK CURRENT MET COUNCIL
REGULATIONS
I. 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[NSPECTIONS. 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
STATE SURCHARGE DEMO 1.00
E.S. HOMES
13170 UTICA AVE TOTAL 76.00
SAVAGE,MN 55378- Payment(s)
76.00
(612)239-4317
Minnesota State License#: BUIL-20638592
OWNER
ELLIOTT, STEVE
1400 BALDUR PARK RD
WAYZATA, MN 55391-
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 aze " ��
requested in conformance with the Sta[e Building Code.This permit may be �i'
revoked at any time for due cause. �4
�`'�� ' f� �.� �' ,��i (� /.�1 � �' '�l�'.-�►r��.' L� l � � l ` -�
� �- i
Applicant Permitee Signat Date Issued By Signature Date
�O� City of Orono F R CITY�E ONLY �� �,� �9
P.O.Box 66 Date Received: Permit#��11LLJ"'C/ ��
� 2750 Kelley Parkway �,�
Crystal Bay,MN 55323 Amount: $� SAC Credit:
(952)249-4600
y ,�' Homeowner(s)Sigaed: ❑Yes
�� �G` Resolutions(if any)Signed:[]Yes ❑None Required
'�ESH�4 Zonin Disclosure Si ed: ❑Yes ❑None Re uired
_ ��r��ti� �����k.l� t 5��f��t(`-�
CITY OF ORONO - DEMOLITION PERMIT
�-(�ClZ�ti' j��t U�
(All permits must be approved by the Buiiding Official and/or Zoning Department)
Job Site t Owner Information:
Type: � Residential ❑ Commerciat
Site Address 1y�Z� t�Ll►L �c-( R �U ( �C�
Owner. Sj�v� ��Lr Q ��" Mailing Address: l�ld�0 baLc�K��5� R�C ��
City: Q�.p 1�.9 � Zip:
Phone: 952 ��D 2� S�� Email: �G��i�0��" 11.��7���t. �'Q�/
Con#ra�J�p�l�can# In#ormata�n:
Contractor/App.: �� �-f w� Q ��C Contact Person: �C7� �-' Ke���
Address: ?O� $ �'��,-,�Q� ;�/ �, Q State License#: e 6 3 S�� 2
City: �c�e N PRQ i 2�t Zip: ��6 Expiration Date: �� /_ Q Gr, 2,p�,�
Phone: h!� 2�-�3 � � Email:�s tr{�cl�-4 ,��i� l�/�'..a.�4 �L• ��
SPECIAL CONDIT1t3N5 & HOLD HARMLESS AGRE�MfNT
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 �Heavy Equipment ❑ Other ��;��� ��i��,�
Permit(s) Issued: �] Sewer Disconnection ❑ Well Abandonment# `'��£ �`v��`'���,� ��r'
��� ��� �
'T j<,���L ��(l.Y(1`�
In return for issuance of said Demolition Permit, the undersigned owner hereby agrees to:
1. Submit a survey, aerial photo or sketch showing all structures on the property. Note which structures are
to be demolished.
2. Submit a survey, aerial photo or sketch showing proposed erosion control measures in accordance with
Chapter 79, Construction Site Runoff Confrol.
3. Submit a copy of permit approval from the Minnehaha Creek Watershed District (MCW .] iy��rill
not issue a demolition permit without a copy of the permit(s) from the MCWD or docu���i���at�j
permit(s) are not required.
Form Last Updated.� Ju/y 2015 �� ����� ��� � � ?��5
iso�ga CITY OF O�ONO
4. Submit a $2,500 escrow and an escrow agreement signed by the property owner(copy attached).
5. Keep all structure(s) enclosed and/or secured until such time as demolition is complete.
6. Keep all demolition debris off adjoining property and/or the public rights-of way unless specific prior
approval is obtained in writing for temporary use thereof.
7. Completely remove foundation(s)from the ground.
8. Completely dispose of all demolition debris off site in accordance with all applicable PCA requirements.
9. Abandon water wells in accordance with State Health Department regulations.
10. Call for an inspection when all debris has been removed, before backfilling.
11. 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).
12. Abandon septic systems 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.
13. 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 $ 7�� �
��� ❑ $50.00 —Accessory Structure x (how many)
1. Subtotal of above permit requested $ 7 .� • �
2. State Surcharge 1.00
3. TOTAL PERMIT FEE (add lines 1-2 above) $ �� ' �
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: fX�'- l 7,'zP f S�
�Owner's Signature: � ' Date: �" �7� ��
/ ` "C `
Approved By: '� � Date:
Building Official)
* Zoning Disclosure Required? ❑ YES �NO `.�� �.'�- � ��� 3 7 �
*This must be filled out by Zoning epartment-For ei er answer, a Zoning Official must sign all applications.
'' ApProved By: / ���������.�� Date: � � � l � ��
(Zoning Official)
Form Last Updated: July 2015
150784
Call 48 Hours before digging
G � F�~T'I �' IGA'T'� O �' SUI���Y GOPHER STATE ONE CALL
• � 2 Twin Cities Area 651-454-0002
� 20� pRONO MN. Toll Free 1-800-252-1166
93
\ � I � � � � I I - -- - _ _ a1>� - - - - - 0 30 60
� � � �I � � � � k9A1,95 -/'r2 .-_
/
�C`� I � � I� 11 �'t��Yr \9 ��A�o �/ � � I k932��
� I I `� ;���1;i `�� o � q�� // � � I 1 � \ A . SCALE IN FEET
o� I I �� q ,`'; � � �\ �q3 o i �/ � � � � � !n,,� �C/
o � ��� , `� � \
/ u�V,�'-
�'�� I I � � � \ \9"9 � �C) #1396 �� /q3� o�/ �� � � / � � • � •` �i� ,
�� 1 \ �� \9 9�,� ��� � EXISTING HOUSE � � ,��• // � � / / I
� � LEGEND
rn1 \� \� 9"6� �°�°\ \� \\ // //� o�/ l I �/ // �
p� \ �� \�934.0� \ � \ \ / ry�°' � -�I � � � �
I �\ �933p\ � � � � � � ��� / �°' 1�Y� ,�( � �a • DENOTES FOUND PROPERTY IRON
�p ��932p � 1 1�_\_�_��\ \� �� Ap66 � � � �� a��NkvE Y NKA\� k9 o I � DENOTES SET 1/2" X 18" REBAR
, � � � � �� � � 9 � � � �� � � ^ WITH PLASIIC CAP "PLS 25105"
���� � �\__ -� o.ss� � -_ �� ,(3�(1� ARM�' ��1 � DENOTES BOUNDARY LINE
�3,,� - - �=- . � �\� � � � N26'01'15"E 229 � 2,�o.o0(PY� SHED ���._- '� 932� � °
Q�y ' �E � � � � 31.- __-q3�'��-_931.0--� 19•d �' - DENOTES LOT LINE
W I I_ / \ ��-_ � _g � \� 6.� .o '632--- 933.5 1
- DENOTES SETBACK Un'-
r--
� � r / ---�7 ---- ��- -�:a_ � ��23 �15.8 i 931.5�BW � �
-+- A �� se_ ��3.8 i � AREA OF CUT BELLOW EL.
� � ,��/ � o �.oa�- ss.z -- -- i \ -999.9-'DENOTES EXIST�'•
N I ?i � �'X, Y�� / ��' 1400 �n u�� � 931.5 = 1.6 CY.IRD. i
y # � .� I �- DENOTE� '
��� � y �; I � ti EXISTING HOUSE N DE M�� EA BELL W EL �,_ � � � �� •\�,
�+ N �y 1� N a FFE=932.21 � 6 CY.YRD. ;; ->- DE� 1 N\
� I, d� � ����t� k9� o o ^ �n �n �931.5 = � I � - �� � ���.
� �,;�t��-+ n' �35.0 � �S.(� 1 . Ji I c^ I I
I� � ;� �, °` • �30.4 �23.6N .0 p � 92.86 I OE DENC . r��
�
� I z �. �s.5i `
i ' • .., 93' �� I � � _ �� `� DEN 0� 1� �y �
�' � 933.5 BW 75 a00o i I Qs DENOTE ` � J
� .,y �--- ---- -�-----'-� • 42.6
q , p �--�-------- � �-�`�'
� 16.4 �\ 93�56k ��3.0 � k .�'�� Oi � � a �
� I3��. ,, � 93�1$ 933.0 � �� d- DENOTE..
�� � �931. -� � � 0 DENOTES
� �n32p2 k9''�80 �/ � S26'Ol'15"W 222.70 � o\ I I pd DENOTES l
'� � 3�9 3 6� � � .00� / � � DENOTES G, .,�iER
3Ip o I � , 10•22`��/ � 9�-� . s ORDINARY H�lGHi ��� j o B DENOTES MAILBOX
a <i �`. WATER��f�PJ'� _ �929•4 1�9�0 � FFE DENOTES FINISH FLOOR ELEVATION
�; i„ `� #1404 � k�f � (M) DENOTES MEASURED DISTANCE
� Y � �=• EXISTING HOUSE � I
� I o � �< 1 I ' ` �� ^� i (P�} DENOTES PLATTED DISTANCE
� p DENOTES GRAVEL DRIVEWAY
� �i �_ ♦i ♦i i � f �
/
k93�a\' - - -X93,33 /
/
- - � LEGAL DESCRIPTION
I - - - --- _ _ _ _ � k930�3
I �. I - - Lot 15, Block 1, BALDUR PARK, Hennepin County, Minnesota
�� a
0
� o I
i o
I � I i NOTES
o � � 1.THE BASIS OF THE BEARING SYSTEM IS ASSUMED.
I � I o �� „' 2. NO SPECIFIC SOIL INVESTIGATION HAS BEEN COMPLETED
, i O CO
I QR�� 3.NO TITLE INFORMATION WAS PROVIDED FOR THIS SURVEY.THIS
I 1 ii SURVEY DOES NOT PURPORT TO SHOW ALL EASEMENTS OF RECORD.
�� 4. EXISTING UTILITIES AND SERVICES SHOWN HEREON OWNER LOCATED
� ' EITHER PHYSICALLY ON THE GROUND DURING THE SURVEY OR FROM
EXISTING RECORDS MADE AVAILABLE TO US OR BY RESIDENT
TESTIMONY.OTHER UTILITIES AND SERVICES MAY BE PRESENT.
BUILDING SETBACKS HARDCOVER REFERENCE BENCHMARK VERIFICATION AND LOCATION OF UTILITIES AND SERVICES SHOULD BE
OBTAIN FROM THE OWNERS OF RESPECTIVE UTILITIES BY CONTACTING
ZONING: LR-1C = ONE-FAMILY LAKESHORE EXISTING IMPERVIOUS SURFACES 3,292 SQ. FT. ELEVATION = 931.76 � SEWER MANHOLE GOPHER STATE ONE CALL AT(651)454-0002 PRIOR TO ANY DESIGN,
HOUSE: FRONT = 30 FT TOTAL LOT AREA 12,308 SQ. FT. RIM AT 1392 BALDUR PARK RD. PLANNING OR EXCAVATION.
SIDE = 10 FT EXISTING HARDCOVER 26.7 %
REAR (OHW) = 75 FT
1 10/29/13 MEET NEW REQUIREMENTS EP
N0. DATE DESCRIPTION BY
ENGINEERING DESIGN Hc SURVEYING I HEREBY CERTIFY 1HAT THIS SURVEY WAS PREPARED BY ME OR UNDER MY DIRECT SUPERVISION,
ED� AND hiAT I AM A DULY LICENSED LAND SURVEYOR UNDER THE LAN5 OF THE STATE OF MINNESOTA. JOB NAME: STEVE ELL.IOTT FIELD WORK DATE: 02/19/13 DRAWN BY: EP PROJECT NO.: 12-116
g 6480 Wayzata Blvd. Minneapolis, MN 55426 /
in OFFICE: (763� 545-2800 FAX: (7b3) 545-2801 ��aU ��L'Y<U p�t DATED: 70/29/13 LOCATION: 1400 BALDUR PARK RD.
� � � EMAIL: inFo�edsmn.com WE851TE: http://edsmn.tom V�ADIMIR SIVRIVER L.S. N0. 25105 ORONO, MN 55391 FIELD BOOK NO.: EDS-10 CHECKED BY: VS SHEET N0. 1 OF 1 0
�gpp 6(ti,tr '�rK
2015-olt94- G�r►o
�� � �
/ DATE TI�
CITY OF ORONO CALLED IN ��
INSPECTION N�TICE SCHEDULED �'�
PERMITNO. �--�%! c,_�.� �c1� COMPLETED
ADDRESS I `� �%�� �{� �C�! � �I- �C.._ �
OWNER TELEPHONE NO.�%�� �3 "�l `�3J�
CONTRACTOR �S 1�►�'`'
� DESCRIPTION ��j � ��Cti- � '
lt� ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL
Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING
Q ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL
Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION
Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ RATED WALLS
� ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT
Q ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP
41 ❑ AS BUILT-SURVEY ❑ SE ER HOOK-UP ❑ FOUNDATION/REMOVAL
_
v ❑ DEMO-SITE ❑ S TIC INSTALL
2 OWNERlCONTRACTOR TO�U: YES_NO
c�i, COMMENTS:
�
a �� �i s C v�n�.GL 44 S� e 1��2`•r'�c s G -
o a �P GJ�6� _
'' ,�3� �e r�a ve a !l �4wt� / ,pa�ro l� ,�
� �E
� ,�r�i�,G�i,S , t c��n�.a•�,e ,p�[d✓ S-
W
� �e� —
Q
�
W � �
� C6rrcvE--E � << � . r�,Ks�����a.-.,
W
�
J
d
W ❑WORK SATISFACTORY:PROCEED ❑PROJECT COMPLEfE
� ❑CORRECT W'ORK 3 PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY
W
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECdVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑pHOTO TAKEN
INSPECTOR WFLL REfURN
❑STOP ORDE STED.CALL INSPECTOR �CITATION ISSUED
,�,�SP TION REQUIRED.CALL TO ARRANGE ACCESS.
L/
Ca11 for the next inspection 24 hours in advance. (g52) 249-46��
OwnerlCa�traator on site: �� �
Inspector: '�^-
White CopyAnspectw's Flle Cenary CopylSite NWke
C - � ✓
� D E TIME
CITY OF ORONO CALLED IN
INSPECTION N �I� � SCHEDULED 9-d S !S �
PERMIT NO. co L ED
ADDRESS
OWNER TELEPHONE NO a� `7
CONTRACTOR
� DESCRIPTION
t~N ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL
Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING
O ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL
Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION
Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ RATED WALLS
� ❑ I SULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT
� ❑ INAL ❑ WATER HOOK-UP ❑ FOLLOW-UP
= AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL
J DEMO-SITE ❑ SEPTIC INSTALL
2 lfTRACTOR TO MEET YiOU:_YES_NO
y COMMENTS:
� � c� �T f� �
� �
�
0
�.
�
0
W
�
Q
�
W
�
W
�
�
J
W KSATISFACTORY:PROCEED ❑PROJECTCOMPLEfE
� RECT WORK 8 PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY
W
0 O CORRECT WORK,CALL FOR RE�NSPECTION TEMPORARY
V BEFORE CONERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑p�.{OTO TAKEN
�NSPECTOR WFLL REfURN
�STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hou in adva ) 249-460�
OwneNContractor on site:
Inspector:
WhiM CopYAnspector's Fik ✓ Canary CopYlSfte Notke
� � V
DATE TIME
CITY OF ORONO CALLED IN � �
INSPECTION NOTICE SCHEDULED
PERMIT NO. �: G�.C-(��l/��COMPLETED
ADDRESS / L.�� ; �`� � I c��< �� :i (."th /�
OWNER TELEPHONE NO. �/ r� �'�39-y3/�
CONTRACTOR �—�-- �'��
� DESCRIPTION � ��f'��' /� /� �
ly ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL
Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING
O ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL
Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION
Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ RATED WALLS
� ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT
Q ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP
4J ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL
_
J ❑ DEMO-SITE ❑ SEPTIC INSTALL
� OVYNERICONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS: ✓'�,�� �.`2�2 �ii�l t �'I ;� C1�Y��
W
a
O �� � �QG�.S�+ �� ,jl��-
�' � '�'��S 'f�_s�vt 2
�
O
�
W
�
Q
�
2
W
�
W
�
J
� ❑WORKSATISFACTORY:PROCEED �JECT COMPLETE
w ❑CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ pHOTO TAKEN
INSPECTOR WILL REfURN
❑STOP OfiDER POSTED.CALL INSPECTOR �CITATION ISSUED
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Ca11 forthe next inspection 2�,hours in advance. (952) 249-4600
OwnedContractor on site: l'���e �
�
Inspector. �
White Copyllnspector's File Canary CopylSite Notice