HomeMy WebLinkAbout1993-005459 - demo - PEIZMI�"
CITY OF ORONO ` � � PERMIT TYPE:
2750 Kel ley Parkway • P.O. Box 815 P �����.'.-�-€�.�`���
Orono, Minnesota 55356-0815 ermit Number: _;t_;;-.�:;,�,
(612) 473-7357 Date Issued: _ -, i; .;`�:v:
SITE ADDRESS:
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REMARKS:
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APPLI ANT/PERMITEE SIGNATURE ISSUED BY:SIGNATURE
CITY OF ORONO APPLICATION FOR DffidOLITION PERMIT
P.O. Box 66 (1335 So Brown Rd)
Crystal Bay, MN 55323
' SPECIAL CONDITIONS & HOLD HARMI�ESS AGREEMENT
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General Instructions
1. You may be required to obtain other permits, i.e. burning, well
�. abandonmment�- etc. --- -----,.
----� -__._.�._.._.._-,-..._.-..z..-�r_-.-.�.__--- - - - - ---- -
z 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 473-7357 .
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aJ�B $11'$ L�u��J$: � �� �-� ��Jr.' �� ,'. � - �� . i -
Occupancy Type: Residential �_Commercia
OWNBR'S NAME: � ��� =� � < c ` Phone: � � ; = � : -�" � /
` ' City:� ' ��
Mai Iing AddrES� �� ' r � ��i � ��`'� ����s�� ��
CONTRACTOR'S NAME: �� �� � ���,4 � f �,<. _ Bus. No. : �1;�� 3 �%�°
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Mailing Address: y�1�� � �
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Demolition if planned by means of: burning (bysfei�rbeldepa heent) eQu1pment
?ermits Issued:
tt Burning Fire Department
� 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 . Inspection required when all debris has been removed , before
backfilling.
7 . Within 5 working days of superstructure removal , a final inspection
shall be requested. The site shall be left clean and clear of alI
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).
R /lpve� O� (,Y� �-Z�/-Y3
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8 . The undersigned owner shall and hereby does indemnify and holc
harmless the City of Orono, its agents, employees and assigns from anc
against all claiins, damages, Iosses or e�enses, including attornej
fees, against the Cityr - its agents, employees and assigns arising out
- of or resulting from the demolition described herein as performed b�
the property owner, his employees, agents, subcontractors or assigns.
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. _ .. ��...__---___._�.... PERMIT�TYPS AND FSS� C,ALCI]I.ATION-,�.._�....�_..�.-- __ .-__- _- __------- - ..- -
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' $50. 00 Principal Structure �O Gv ����`' 'f
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$30.00 Accessory Structure
1. Subtotal of above permit requested $ � �, �-'�,
2. State Surcharge $ . 50
3 � TOTAL PERMIT FEE (add lines 1-2 above) $ ��� 5 t
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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 reculations of the State of Minnesota, and
certifies that all statements made on this application are complete, true
and correct. -
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SIGNATIIRE OF APPLICANT: �,� ��7� ��-� /��fL',�:'"� Date: �� /1 �
DATE TIME
CITY OF ORONO CALLED IN
INSPECTION NO C�„ SCHEDULED � `
PERMIT NO COMPLETED
ADDRESS � ��f ��� �"�� +
OWNER CONTR.
TELEPHONE NO.
� DESCRIPTION `�^'�C�a N�< _
tu 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADWG/FILLING
� 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
�
Q 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
05 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 COVER REMOVAL
J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
Q OWNERICONTRACTOR TO MEET YOU:_YES_NO
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D COMMENTS:
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d ❑WORK SATISFACTORY:PROCEED PROJECT COMPLETE
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� ❑ CORRECT WORK&PROCEED SSUE CERTIFICATE OF OCCUPANCY
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O ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
0 BEFORECOVERING PERMANENT
❑ CORRECTUNSAFECONOITIONWITHIN HOURS. � pHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR �-� CITATION ISSUED
❑ INSPECT�ON REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.47�73rJ7
OwnerlCon or n s' e:
Inspecto
White Copy/lnspector's File Canary Copy/Site Notice