HomeMy WebLinkAbout2015-01229 - demo CITY OF ORONO * z 0 1 5 - 0 1 2 2 9 *
♦ ' 2750 KELLEY PARKWAY DATE ISSUED: 1U10/2015
ORONO, MN 55356-
952 249-4600 FAX: 952 249-4616
ADDRESS : 1380 BR[AR ST
PIN : 10-117-23-31-0053
LEGAL DESC : MARKVILLE
: LOT 000 BLOCK 002
PERMIT TYPE : DEMOLITION
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : DEMO-PRINCIPAL STRUCTURE
ACTIVITY : 645-SINGLE FAMILY HOUSES(ATT& DET
NOTE:
1. FOUNDATIONS/ALL DEMO DGBRIS 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 INSPECTIONS. 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 TH[S PERM[T.
APPLICANT DEMOLITION-PRINCIPAL STRUCTURE 75.00
STATE SURCHARGE DEMO 1.00
SUMMIT CRAFTSMAN LLC DEMOLIT[ON-ACCESSORY STRUCTURE 50.00
P O BOX 526
SHAKOPEE, MN 55379- TOTAL 126.00
(612)247-6997 Payment(s)
Minnesota State License#: BUIL-BC20626592 CHECK 9398 126.00
OWNER
ZITZLOFF,JEFFREY& BRENDA
1380 BRIAR ST
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[he 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 whe[her 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 construc[ion is
suspended for a period of 180 days at any time after work has commenced.
The applicant is�esponsible for assuring all required inspections are
requested in conformance with the State Building Code.This permit may be
revoked at any time for due cause.
) i ������ � �- ��� � o �l
A ' an m� e �gnatur Date Issued By S' ature Date
O City of Orono � OR CITY USE ONLY ��
�- � P.O. Box 66 �` l�� Date ReceivedL��� Permit# �G/,j-�..� �«.�,�
� 2750 Kelley Parkway ��
Crystal Bay, MN 55323 '� Amount: $�d�,� SAC Credit:
(952)249-4600
� � Homeowner(s)Signed: �Yes
yF �
�, Resolutions(if any)Signed�❑I�es ❑�Ione Required
l�kESH��� Zonin Disclosure Si ned: ❑Ye None Re uired
CITY OF ORONO - DEMOLITION PERMIT RE�EIV�D
(All permits must be approved by the Building Official and/or Zoning Department)
Job Site / Owner Information: � SEP 2 4 2015
�ITY OF ORONO
Type: � Residential ❑ Commercial
Site Address: �3 �� �����5�
Owner: �-� Zi�"z 1o�tT Mailing Address: ��SS S�1�i.�V t�� �`�•
City: �X CC' �$ i�f Zip: .SS ��%
Phor�e: 1_�Z - Z f O - O Q'S� Emai�: k� �Z C.1, Z.@ °rM�c.+� . CQ�'a'1
�
� Contractor/Applicant Information:
Contractor/App.: �Si�rhr�n;� C�D��S��'ta� Ll.Ccontact Person: ���c.I� �rP�-�'�?i
Address: � �- ��C J�� State License #: �C �Z 6 c� 9�
City: � ro�C L Zip: .SS� � Expiration Date: 3`3/' � �
Phone: d 1 Z � 247 - �°J� Emai�: $�^^m�tb:�c,��t��qm�.i I . Co�
SPECIAL CONDITIONS & HOLD HARMLESS AGREEMENT `
General I nstructions:
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
Permit(s) Issued: ❑ Sewer Disconnection ❑ Well Abandonment#
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 Control.
3. Submit a copy of permit approval from the Minnehaha Creek Watershed District (MCWD). The City will
not issue a demolition permit without a copy of the permit(s) from the MCWD or documentation stating
permit(s) are not required.
Form Last Updated: July 2015 4� �
150784
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 aii applicable PCA requirements.
9. Abandan 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 fiiled 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 $ 75�, 1p
�$50.00 —Accessory Structure x (how many) Sa� �Z�
1. Subtotal of above permit requested $
2. State Surcharge 1.00
3. TOTAL PERMIT FEE (add lines 1-2 above) � 1L� �-p
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: � - Z1'"��
�
Owner's Signature: Date: C/-�-�`-�1
Approved By: Date: �� �
uilding Official)
* Zoning Disclosure Required? ❑ YES �� NO �Q� � �� ��j����I�-��7G
*This must be filled out by Zoning Dep rtment-For eitr(el►answer,C aZoning OfFcial musi�ign all applications. �`v
* Approved By: Date: '�1 �5
(Zoning Official)
Form Last Updated: July 2015
150784
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PTION OF PREMISES SURVEYED: � O
f Lots 3 and 4, Block 2, MARKVILLE �
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vs the boundaries of the above described property, and the location
ildings, visible hardcover, driveway and selected spot elevations thereon,
d location of a proposed house, drive and pool. It does not purport to show any PROPOSED ELEVATIONS (VERIFY)
3nts or encroachments.
EXISTING AND PROPOSED
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CITY OF ORONO CALLED IN
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INSPECTION NQ����/�� SCHEDULED f —� a �� S �d•�
PERMIT NO. � OMPLETED
ADDRESS �3 g� �CQ-/' �lf
OWNER • T LEPHONE NO. �� 7 ���
CONTRACTOR �-�" �rnQ-�-
� DESCRIPTION �-�120 ��`�'`'
lt� ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL
Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING
y ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL
Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION
Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ RATED WALLS
� ❑ INSU TION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT
v ❑ FI L ❑ WATER HOOK-UP ❑ FOLLOW-UP
_ ❑ BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL
J DEMO-SITE ❑ SEPTIC INSTALL
2 ERICONTRACTOR TO MEET YOU:_YES_NO
c�., COMMENTS:
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W ❑WORKSATISFACTORY:PROCEED ROJECT COMPLEfE
� ❑CORRECT WORK 8�PROCEED �IS E CERTIFICATE OF OCCUPANCY
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� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORE CWERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTO TAKEN
INSPECTOR WILL REfURN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours i a ce. 5 ) 249-46��
OwnerlContractor on site:
Inspector.
White Copyllnspector's File Canary CopylSite Notice
�r � , �
DATE TIME
CITY OF ORONO CALLED IN
INSPECTION NOTICE _ scHEou�E� �S
PERMIT NO.�C%CS'�/faa� MPLETED
ADDRESS �r.� ��� ���r��'�' -��-
OWNER TELEPHONE NO.(l�l� �� 7�gCT
CONTRACTOR ������/,,L_ `
�: DESCRIPTION v�-✓ `���� �✓�� `�jC�-f��
l� ❑ 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
� ❑ INSU ATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT
Q ❑ FI AL ❑ WATER HOOK-UP ❑ FOLLOW-UP
_ ❑ S BUILT-SURVEY ❑ S WER HOOK-UP ❑ FOUNDATION/REMOVAL
J DEMO-SITE EPTIC INSTALL
� O ERICONTRACTOR TO MEET Y • YES_NO
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� COMMENTS•
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W ORKSATISFACTORY:PROCEED ❑ PROJECT COMPLEfE
� ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
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� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDiT10N WITHIN HOURS. ❑ pHOTO TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (g5 -46��
OwnerlContractor on site:
Inspector.
White Copyllnspector's File Canary CopylSite Notice