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Home My WebLink About2005-P09315 - demo PERMIT CITY OF ORONO 2750 Kelley Parkway- PO Box 66 Permit Number: Po9315 Crystal Bay, Minnesota 55323 Permit Type: Demolition (952) 249-4600 Date Issued: 10/21/2005 SITE ADDRESS: 920 Brown Rd S Unit# Wayzata,MN 55391 PID: 10-117-23-12-0002 DESCRIPTION: Proposed Use: Residential Census Code 645 Permit Class: Building Permit Type: Demolition Permit Sub-type(s): Demo-Principal 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: $ 50.00 valuation: $ 0.00 State Surcharge Fee: $ 0.50 TOTAL FEE: $ 50.50 APPLICANT: Stonewood Design Build OWNER: J. Sven Gustafson 4420 Shoreline Dr. 4420 Shoreline Spring Park,MN 55384 Spring Park,MN 55384 j� THE UNDER�fGNED 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 MINNESO A BUILDING CODE REQUIREMENTS. � i' t P C T PE MITEE SIGNATURE S ED BY SIGNATURE ./ Copies: 1-File(Signatures Required), 1-Applicant, 1-Monthly Reports, l-Assessing,(If Septic, 1-Septic) Page 1 ► 1 ' � �l vc�f .i� ��. Y ' /b -/��4(� 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 l. You may be required to obtain other permits, i.e. well abandonment, 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 (952) 249-4600. JOB SITE ADDRESS: �o�U ,(;�w�i ��c�.�� S. . O�U^�v ,�r`�l� ��'l I Occupancy Type: _�Residential Commercial OWNER'S NAME: �_'l��s�;,�,�, ,��,��%r;,�� :�� Phone: 9f`1- 17/-��% MailingAddress: �S',�� c"r,�.�'z'��ic-� ,0•2�v'c' City: �.��,��.�— �.�,� CONTRACTOR'S NAME: s�� r�1o�.%c' Bus.No.: Mailing Address: City: Demolition if planned by means o£ manual disassembly �c heavy equipment Permits Issued: # Well Abandonment In return for issuance of said Demolition Permit,the undersigned owner hereby agrees as follows: 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 adjoining 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. 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. . � 8. 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). 9. 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. 10. 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 l. Subtotal of above permit requested $ 2. State Surcharge $ .50 3. TOTAL PERMIT FEE(add lines 1-2 above) $ The undersigned hereby applies to the � f Orono for issuance of a Demolition Permit, agrees to do all work in strict accordance wit o dinances of the City and the regulations of the State of Minnesota,and certifies that all s t made on this application are complete,true and correct. APPLICANT'S SIGNATU Date: ( �- �"l OWNER'S SIGNATURE: Date: �a -�� APPROVED BY: � Date: (Bui dmg Official) *ZONING DISCLOSURE REQUIRED? ❑ YES ❑ NO * This Must Be Filled Out By Zoning Department - For Either Answer, A Zoning Official Must Sign All Applications *APPROVED BY: G�GG�G{� Date: �OJ/�`1��15' (Zoning Official) % �� Reset Form � � �� '� � �,� . . � 3. Company and/or individual that conducted the building inspection and the procedure used to determine the presence or absence of ACM (inc(uding analytic method): '�Prior to demolition all buildings must be inspected by an EPA accredited inspector. /./G/�/G`� 4. Description of planned demolition and the specific method(s) that will be used: T'c'"<<,,-.;�. ,>z. �•—/� � � ' ��`� /S4`!� v s' C-'� v r.��--��../i 5. If the demolition was ordered by a government agency, please identify the agency and attach a copy of the order: Name: Title: Authority: Date of Order(M/D/Y): Date Ordered to Begin(MID/Y): * Notification for an emergency demolition must be submitted as early as possible before demolition begins,but not later than the following working day. A demolition is considered an emergency ONLY when the facility has been deemed structurally unsound and in danger of imminent collapse. If the structurally unsound building is known to contain any regulated ACbt or is suspected to contain any regulated ACNI,special procedures bfLJST be followed. If you are unaware of the special procedures, instructions/regulations can be obtained by contacting the NfPCA at the address or phone number listed below. 6. Description of procedure to be followed in the event that unespected R.ACM is found or Cat. II nonfriable ACM becomes crumbled, pulverized or reduced to powder: ' � f' �)�-�-„ - ,'r..�� ' � t � - - �Ll.v%�'�� S�L:Tv/lJ ' Nir�-''� �� .+�/ ///�['�3-.�f'+-y `_r v�� J7 � �i � Si� ..� • 7. Waste Transporter Information: 8. `Vaste Disposal Information: Transported�Name: � ��%w�' W'�`�"'�C �� 'C /�"�`Y��'^=�- Landfill Name: �-'4"�`�'2�i- ��✓ Transporter Contact: �� '`1(��f�� Owner/Operator: __ Transporter Address:1�'�;C� � /v r i ff .1>�_c f`% AddresslLocation: City, State,Zip:__/`��-w�-- � ,•��-i�� . cti �'� {1 y-�� City, State,Zip: ,i�--��,�cr L', •�• •✓ Phone Number: �� - i/`�� - L' y� `/ Phone Number: 9. I cee-tify that the above informati ' c rrect and I am a bonafide representative of the demolition contractor or building o�vner d author'�y to enter into agreements for my employer. Signature of Contractor/Owne Date Send or FaY to: For questions call: Asbestos Coordinator-Air Quality Division 612-296-7300 Nfi�1 Pollution Control Agency 1-800-657-3864 520 Lafayette RaadNorth Fax: 612-215-1593 St. Paul, �1 55155-4194 . . Minnesota Pollution Control Agency . Notification of Intent to Perform a Demolition �� Type of Plotification [ ] Original ( ) Amended [ ) Project Cancellation Demolition Contractor• Building Information• Name: �%c;%� c.��i�ir.� C�C.4-.i��.../ /!� Building Name:_ �/ r Address:__ �`7s'c w /C��i,`�� .Sj7�c�7' Address/Location: �7,1G /_Si'�oc.��1 �v�aa� S City,State,Zip: �/�v�✓�' t-Lr_,J S J�.3/ City,State,Zip:/SC_�%��ir�G �-�✓�. �� N S-j—y r; County: /�iV�t�c�'r.:' _ Contact Person: � �/''�"�� i-��1�»� l�/,A- Phone Number(s):__ Phone Number(s): ��.5� ' `1�i,�i - L `�'�� Age of Bldg.(years): D� Size of Bldg.(sq. ft.): Number of Floors Including Basement Level(s): � Building Owner' Present Use of Bldg.: �Z��Jt .y�ri.'}�. Name: �%�,✓G��%v�� i��c�•��-i �S�.�ii,Y) GL<. / Prior Use of Bldg.: >�.��F� Address:_�'/KLc> S�N�2c;� /�✓�` l�/i.. Dates when demolition or intentional burn�ng , will Begin /`�%��- / & End N/''�/. � S pr N� �','�'�.iL �;� �, ., City, State,Zip: ' � < S � -� Notification must be postmarked or received ten(10)working days Contact person: SU�� t'r �T�S �"J before demoli[ion begins. 'See item#5 for emergency demolitions. Phone Number(s): �� 2 " `9�� " �'� c`/ Boch Beginning and Ending dates should be amended in writing as necessary to reflect current project dates. If there is>260 linear feet or>160 square feet of Regulated Asbestos-Containing Material (RAC1Vn in the building to be demolished, it must be removed by a licensed asbestos contractor prior to demolition. The State of IVI�i 1- Notice of Intent to Perform an Asbestos Abatement Project must be used to notify for the asbestos removat. Is nonfriable ACM present in the structure to be demolished ? [ ] YES [�NO If YES complete items 1-9. If lr'O complete items 3-9. �� 1. If ACM will be left in place for the demolitio❑ indicate the amount of Category I and/or Category II nonfriable ACM left in place. Categ, I Linear Feet Categ. II Linear Feet Square Feet Square Feet Cubic Feet Cubic Feet Categorv I nonfriable A�'M means asbestos-containing packings, C'.ategorv IT nonfriable A l��means any ma[erial,excluding gaskets,resilient floor covering,and asphalt roofing products Category I nonfriable ACM,containing more than one percent containing more than one percent asbestos. �sbestos thac,when dry,cannot be crumbled,pulverized,or '`Category I nonfriable ACM is not allowed to remain in place reduced to a powder by hand pressure. for demolition if it is in poor condition. °Category II nonfriable AC�1 is not allowed to remain in place for demolition if it has a high probability of becoming crumbled, pulverized,or reduced to a powder during demolition,transport, or disposal. (ex transite,cement,slate roofing) 2, Deseription &r. �.acation c4'��i�� remaining in place (including fioor# and room #}: c��`��o . ��,� Principal Dwelling Demolition Permit '� ��f'��"� F ZONING DISCLOSURE & DECLARATION G~ �� To the property owner: Demolition of the principal dwelling structure on a property may automatically terminate certain rights which may have accrued to the property by virtue of the continued existence of that building. >Rebuilding on a substandard lot of record(i.e. a lot that does not meet the zoning district required lot area or width standards) will, with few exceptions, require variance approval by the City Council, and such approval is not automatic nor guaranteed but requires that a hardship be demonstrated. >Additionally, all current zoning standards will have to be met by the new principal dwelling including setbacks, lot coverage by structures, hardcover (impervious surface), height limits, etc. >Where municipal sewer is not available, provision of two (2) sites for a conforming on-site sewage treatment system is mandatory. >Unless specifically approved by the City,all accessory structures must be removed at the time of principal dwelling demolition. This also applies to seasonal and permanent docks,which may not be re-installed until a new principal dwelling has reached the framing stage. The following information is presented for the purposes of advising the property owner of the implications of removal of the rinci al dwelling on the ro ert : 1. Property Address �� N K�"� � PINS # f� -��7-Z�" �Z"�O�Q (�/ 2. Zoning District 2�.' � Required Lot Area ��5 Required Lot Width �� Actual Lot Area 0-��S Actual Lot Width �� Lot area varianc is is not required. �Lot width varianc is is not required. r �g,� 3. Required Setbacks: Front� Rear 5�� Side ��l �J+ Side Street� Lakeshore Lot: Lake (Front) �- Street(Rear) �— Average Lakeshore Setback: must be met is not a licable. � 4. Lot Coverage by Structures: limited to 15% of lot area does not a 1 lot area>2 acres 5. Hardcover limitations: are a licable are not a licable. 0-75'zone= 0%allowed 75-250'zone=25%allowed 250-500'zone=30°/o allowed 500-1000'zone=35%allowed 6. �Munic�ipal sewer is ava}'�able. Municipal sewer is not available; on-site system testing and design must be 1(�,��l�Q�1 �,(,�'d'Y1 -f�(S Q,� vided confirming that two conforming drainfield sites are available. 0�� r5 ��rv V� �;��,� Z�U��n�) �. �� )C The un d property owner hereby acknowledges receipt of the above information. Staff Initials , (C �2j_ �` � du P ner's Signature Date Form ZDD—Revised 5-23-OS (Original: Street File; Copy: Property Owner)