HomeMy WebLinkAbout1998-010535 � . PERM
�CITY OF ORONO PERMIT TYPE:
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2750 Kelley Parkway- P.O. Box 66 ��-
Crystal Bay, Minnesota 55323 Permit Number: t�.t=::.�'.�"'4 _
(612) 473-7357
Date Issued: i r i;'��:'��`'j��;
SITE ADDRESS: �.�7...J�
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DESCRIPTION:
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REMARKS: _
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FEE SUMMARY:
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APPLICANT�PERMITEE SIGNATURE �I ISSUED BY:SIGNATURE `��
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CITY OF ORONO APPLIC TION FOR DEMOLITION PER��iIT
P.O. Box 66 (2750 Kelley Parkway)
Crystal Bay, i��N 5�323 �
SPECIAL CONDITIONS & HOLD H 1�7I.ESS AGREE�ti"T
General Instructions
1. You may be required to obtain other permits, i.e. burnin�, well abandonmment, etc.
2. Work must not be�in unless the permit card i available on the job site.
;. A 24 hour notice is required for all inspectio . Call a73-7357.
JOB SITE ADDRESS: .3 S 1� �� ,� � e '
Occupancy Type: �Residential Co ercial
O�i�'ER'S N�tiIE: l Phone: �7� � 2�J 7
Nlailin� Address: Ciry: /_,� .. . L 4��
CON'I'RACTOR'S NAi�: S' Bus. No.: �,��- y/.�3
Nlailing Address: / City:—�2���,s
Demolition if planned by means of: m nu disassembly
_� heavy equipment
burni (by fire department)
Permits Issued:
# Burning Fire Department
## Well Abandonment
In return for issuance of said Demolition Permit, e undersigned owner hereby agrees as
follows:
1. The structure(s) shall be kept enclosed and/o secured until such time as demolition is
comple[e.
2. Demolition debris will be kept off adjoi�ina property and/or the public ri?hts-of-way
unless specific prior approval is obtained in 'ting for temporary use thereof.
3. Foundations shall be completely removed fro the ground.
4. All demolition debris shall be completely d sposed of off site in accordance with all
applicable PCA requirements.
5. Water wells must be abandoned in accordanc with State Health Department rewlations.
6, Inspection required when all debris has been removed, before backfilling.
�
7. Within � workin� 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 buildin� and such new building is actually under construction).
8. The undersi�ned owner shall and hereby does indemnify and hold harn�less the Ciry of
Orono, its agents, employees and assigns from and aQainst all claims, damages, losses
or expenses, including attorney fees, aaainst the City, its a�ents, employees and assijns
arisin� out of or resuir.in� from the demolition described herein as performed by the
property owner, his employees, a;ents, subcontractors or assigns.
PER1ti1IT TYPE AND FEE CALCULATION
$50.00 =�Principal Structure
_� $30.00 - Accessory Structure ����� � ���`�(����+n S1�
1. Subtotal of above permit requested $ �D , d o
2. State Surcharae $ .50
3. TOTAL PERMIT FEE (add lines 1-2 above) $ .�p S"-�
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.
A.PPLICANT'S SIGNATLJRE:�����,�� Date: �
OtiWi ER'S SIGNATURE: `�- �' � �/,P,� Date: � L�7 rjd�"
l�va�,/
APPROVED B�.': Date: � -�3- S�
DAT�E 4 TI
CITY OF ORONO CALLED IN /� ��
INSPECTION OTIC SCHEDULED /-_� •�3��
PERMIT NO. �� J COMPLETED �_ �
ADDRESS J`✓ . �C�-�c� � -t�
OWNER ��'�,�L��� `�� CONTR. , �� lC/�z�L C��,,;��"'
TELEPHONE NO. c� 3 �-- ��'G
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�SCBIQTION _ 2�2t'.-� �(, �
01 FOOTING� 11 MECHANICA�RI 18 EXCAV/GRADIN FILLING
� 02� 13 MECHANICAL FINAL 19 LAKESHORE/W LANDS
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03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMbVAL
12 WATER HOOK-UP 17 SITE INSPFCTIO
Q OS FINAL 14 SEWER HOOK-UP 06 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
� 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
= 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD CO�ER R MOVAL
J 10 PLUMBING FINA� 36 FOUNDAT�ON/R MOVAL
� OWNERICONTRACTOR TO MEET YOU:_YES_NO I
� COMMENTS: i
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W� WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE
W ❑CORRECT WORK&PROCEED C ISSUE CERTIFICATE OF O CUPANCY
� ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPOFjARY
� BEFORECOVERING
PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. C pHOTO TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR i- CITATION ISSUED j
❑ INSPECTIONREOUIRED.CALLTOARRANGEACCESS.
Call for the next inspection 24 hours in advance.473-!3�J
OwnerlContract r site:
Inspector.
White Copyllnspector's File Canary CopylSite Nqtice