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Home My WebLink About2009-00425 - demo CITY OF ORONO PERMIT NO.: 2009-oo42s 2750 KELLEY PARKWAY , ORONO, MN 55356- DATE 1ssuEn: 07/2U2009 952 249-4600 FAX: 952 249-4616 REPRINTED ON 8/12/2009 ADDRESS : 1395 BROWN RD S PIN : 10-117-23-31-0050 LEGAL DESC : MARKVILLE : LOT 005 BLOCK 001 PERMIT TYPE : DEMOLITION PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : DEMO-ACCESSORY STRUCTURE ACTIVITY : 649-ALL OTHER BUILDING& STRUCTURES NOTE: 1. FOUNDATIONS/ALL DEMO DEBRIS TO BE REMOVED FROM GROUND&DISPOSED OF OFF SITE,PER PCA REGULATIONS. 2. INSPECTIONS DONE BEFORE BACKFILLING. APPLICANT DEMOLITION-ACCESSORY STRUCTURE 50.00 KALEY, MR.&MRS. PHILIP STATE SURCHARGE DEMO 0.50 1395 BROWN RD S TOTAL 50.50 WAYZATA,MN 55391- OWNER KALEY,MR. &MRS. PHILIP 1395 BROWN RD S 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 S[ate Building Code. This permit is for only the work described and does not grant permission for additional or related work which requires separate l permits. All provisions of laws and ordinances governing this type of work � shall be compied with whether 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 construction is �� suspended for a period of 180 days at any time after work has commenced. \ `- � The applicant is responsible 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 / Applicant Permitee Signature Date '�� Issued By Signature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. CITY OF ORONO PERMIT NO.: 2009-00425 • 2750 KELLEY PARKWAY • ORONO, MN 55356- DATE ISSUEn: 07/2U2009 � 952 249-4600 FAX: 952 249-4616 ADDRESS : 1395 BROWN RD S PIN : 10-117-23-31-0050 LEGAL DESC : MARKVILLE : LOT 005 BLOCK 001 PERMIT TYPE : DEMOLITION PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : DEMO-ACCESSORY STRUCTURE ACTIVITY : 645-SINGLE FAMILY HOUSES(ATT&DET NOTE: 1. FOUNDATIONS/ALL DEMO DEBRIS TO BE REMOVED FROM GROUND&DISPOSED OF OFF SITE,PER PCA REGULATIONS. 2. INSPECTIONS DONE BEFORE BACKFILLING. APPLICANT DEMOLITION-ACCESSORY STRUCTURE 50.00 KALEY,MR. &MRS. PHILIP STATE SURCHARGE DEMO 0.50 1395 BROWN RD S TOTAL 50.50 WAYZATA,MN 55391- OWNER KALEY, MR.&MRS. PHILIP 1395 BROWN RD S 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 the 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 whether 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 construction is suspended for a period of 180 days at any time after work has commenced. The applicant is responsibie 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 �� -� �� Applicant Permit e�ignature Date � � Issued By Si ature ate SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED AB E. � � g�� City of Orono FOR CITY USE ONLY • O y O P.O.Box 66 Date Received: Permit# � ,�,,, 2750 Kelley Parkway � j�� s� Crystal Bay,MN 55323 Amount: $ SAC Credit: ��-��o�' ��sz>za9-46o0 ��xos Homeowner(s)Signed: ❑Yes Resolutions(if any)Signed:❑Yes ❑None Required Zonin Disclosure Si ned: ❑Yes ❑None Re uired CITY OF ORONO - DEMOLITION PERMIT (All pem�its must be approved by the Building Official and/or Zoning Department) � Job Site/ Owner Information: � Type: � Residential ❑ Commercial Site Address: J 3 rf 5 L3� c�w i)/' l�' �� SG' Owner: �Y, ; � .�n 'La'rrq✓Ncu I�ci� ailing Address: � 39 S� �'u ev� �.,/S�� Gr/�� c�ty: - �� z�p-� �S�'3�1 ► Home Phone: �5�r}- �J � �, �/�7 7� Alternate Phone: Contractor/ Applicant Informati�n: Contractor/App.: Contact Person: Address: State License #: City: Zip: Expiration Date: Phone: Alternate Phone: "' SPECIAL CONDITIONS & HOLD HARMLESS AGREEMENT General Instructions: 1. You may be required to obtain other permits, i.e.: well abandonment, sewer, etc. 2. Wark 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 far'issuance of said Demolition Permit, the undersigned owner hereby agrees as follows: L 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 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. 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. 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. PERMIT TYPE AND FEE CALCULATION ❑ $75.00—Principal Structure [i' $50.00—Accessory Structure �� (how many) � � � (what) 1. Subtotal of above permit requested $ 2. State Surcharge $ .50 3. TOTAL PERMIT FEE (add lines 1-2 above) $ 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: �� "�. � ' � , � Owner's Signature: � � �G Date: � �' ��0 Approved By: � Date: "�-Z�—��l uilding Official) * Zoning Disclosure Required? ❑ YES �NO *This must be filled out by Zoning Department—For e ther answer,a Zoning Official must sign all applications. * Approved By: � j �� . Date: 7 'Z� - � (Zoning Official) �— � �� -7 DA TIME ✓ CITY OF ORONO � CALLED IN /�L � INSPECTION NOTICE SCHEDULED 7 U �� PERMIT NO -m aS COMPLETED ADDRESS d OWNER ` CONTR. TELEPHONE NO. � DESCRIPTION ��'P'r�� ❑ FOOTING � MECHANICAL RI ❑ EXCAV/GRADING/FILLING � ❑ FRAMING ❑ MECHANICAL FINAL ❑ LAKESHORE/WETLANDS Q ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ TREE REMOVAL Z ❑ WALL BD. ❑ WATER HOOK-UP ❑ SITE INSPECTION Q ❑ FINAL ❑ SEWER HOOK-UP ❑ PROGRESS � ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ COMPLAINT Q ❑ DEMO-FINAL ❑ SEPTIC INSTALL. ❑ FOLLOW-UP _ ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ HARD COVER REMOVAL J ❑ PLUMBING FINAL O FOUNDATION/REMOVAL � OWNERICONTRACTOFi TO MEET YOU:_YES_NO � COMMENTS: � » W � � � O >. � O � W � Q � 2 W � W � j d W� ❑WORK SATISFACTORY:PROCEED PROJECT COMPLETE W ❑CORRECT WORK&PROCEED _ ISSUE CERTIFICATE OF OCCUPANCY 0 C CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pHOTO TAKEN INSPECTOR W4LL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED O INSPECTION REQUIRED.CALI TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. (952� 249-4600 Owner►Contractor on site: Inspector. � �� White Copy/lnspector's File Canary Copy/Site Notice