HomeMy WebLinkAbout2002-|P05576 - demo PERMIT
CITY�OF ORONO Permit Number:
2750 Kelley Parkway - PO Box 66 P05576
Crystal Bay, Minnesota 55323 Permit Type: Demolition
(952) 249-4600 Date Issued: 9is�2oo2
SITE ADDRESS: 5 Brown Rd S
L.ong Lake,MN 55356
P I D: 34-118-23-34-0009
DESCRIPTION: UBC Occupancy R3
Proposed Use: Residential
Pernut Class: Building Census Code 329
Permit Type: Demolition Permit Sub-type(s): Demo-Accessory Structure
DETAILS:
Approved per resolution#:
Separate pernrits required:
NOTICES/REMARKS:
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m ist be abondoned. Insnection before backfilline.
FEE SUMMARY: Permit Fee: $ 30.00 Valuation: $ 0.00
State Surcharge Fee: $ 0.50
TOTAL FEE: $ 30.50
APPLICANT: B�ce C. Mathison OWNER: Bruce C.Mathison
5 Brown Rd S 5 Brown Rd S
Long Lake,MN 55356 Long Lake,MN 55356
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 SfATE OF
MINNESOTA BUILDING CODE REQUIREMENTS.
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APPUCANT PERMITEE SIGNATURE SSUED BY SIGNATURE
Conies: 1-File(SiQnitures Required). 1-Applicant, 1-Monthlv Reoorts, 1-Assessine, 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.
JOBSITEADDRESS: � 5� :.,��-� )_7YO�:v�I I�U �1�(�'�_ �'�i�� —
Occupancy Type: Residential Commercial
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OWNER'SNAME: �J �v► C.� �10�1 � S��,n� Phone:L - 4 Z� -_��� (
Mailing Address: �, �.� City:
CONTRACTOR'S NAME: " Bus.No.:
Mailing Address: City:
Demolition if planned by means of: �manual disassembly
heavy equipment
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Permits Issued:
# Well Abandonment
In return for issuance of said Demolition Permit,the undersigned owner hereby agrees as follo�vs:
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 adj oining 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.
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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 hannless the City of
Orono, its agents, employees and assigns from and against all claims, damages, losses or
expenses,including attoi-ney 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 SIGNATU � � Date: 5 0'
OWNER'S SIGNATURE: Date:�� � �1
APPROVED BY: Date: �T - �- °Z
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DO- �� \ Line pacalte( wi{�t S {ine �.
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/ . . c� 313.5' ----.:..�
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Cartificate of' SurvAy: `I
I hereby certif�y that this is a true and correct representat;on of a surv�ey
of th� boundaries of that paz-t of the South:rest quartsr of Section 3k, Township 118 Northl
Rang3 23 West, described as follows: �ginning at the Southeast corner of�.c� Southwest_ !
quarter; thence North on th� iast line of said quarter section a distance of 759 feet; �'
thence South 71°30' West 332.9 feet more or less to a point 313.5 £est 4Jest of said Eas#.��
� line, measured along a line drawn parallel with the South line of said quarter section; �
thence South parallel with said rast line 6�.7 feet r�ore or less to sa.id 5outh line;
? �hence �.st 313.5 feet along s�.id �outh line to the pcint of k�egirinillg; EXC��'T that part
thereof lying South of a line drawn Wast paxallel with said South line from a poir.t on
the East iine of said Southwest quarter distant 422 feat North of the Southeast ::orner _
of said Southwest quarter; said�a�boae-deaeribed�property'.heing=sub�eet�.to�-easem.ant9-�bve�
tha�--Eas�-:331feet�"and--the�I�ortkwesterlg 33�feet for road purposes. It does not purport
to show impronements or encroachments, if any.
, . Wm. S. Kslleyy Jr. Rsg. No. 1_�l+2
Bruce R. Kelley Reg. No. 5713
� Gordon R. Coffin Reg., No. f�064
Scale: 1" = 50�
Dat� s 7-2�-63 - KFZLEY & KII.LEY, Engineara & Surveyors
o : Iron marker Long Lake, Minne�ota
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