HomeMy WebLinkAbout2015-00183 (demo) CITY OF ORONO * Z 0 1 5 - 0 0 1 8 3 *
2750 KELLEY PARKWAY DATE ISSUED: 02/13/2015
ORONO, MN 55356-
' (952) 249-4600 FAX: (952) 249-4616
ADDRESS : 3225 CASCO CIR
p�� : 20-117-23-43-0021
LEGAL DESC : SPRING PARK
: LOT 029 BLOCK 000
PERMIT TYPE : DEMOLITION
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : DEMO-PRINCIPAL STRUCTURE
ACTIVITY : �45 — SI ►'�le �2vri ly H�us�
NOTE:
1. FOUNDATIONS/ALL DEMO DEBRIS TO BE REMOVED FROM GROUND&DISPOSED OF OFF SITE,PER PCA REGULATIONS.
2. WELLS MUST BE ABANDONED.
3. 1NSPECTIONS 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 THIS PERMIT.
DEMO CREDIT-SAC PAID#5719 09/14/1979
APPLICANT DEMOLITION -PRINCIPAL STRUCTURE 75.00
STATE SURCHARGE DEMO 5.00
LLOYDS CONSTRUCTION TOTAL 80.00
7207 WEST 128TH STREET Payment(s)
SAVAGE,MN 55378- CREDIT CARD 4273 80.00
(612)363-1246
Minnesota State License#: GENR-IR654654
OWIYER
LEESTMA,MARTIN&KATHRYN
3225 CASCO CIR
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 permi[is for only the work described and does
not gran[pemiission for additional or rela[ed work which requires separate
permi[s. 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 af�er work has commenced.
The applicant is responsible for assuring all required inspections are
requested in conformance with the S[ate Building Code.This permit may be
revoked at any time for due cause. `l��
�,������ C. L�����LL �� � �.�
�����---- z ' � '
Applicant Permitee Signature Date Issued By Signature Date
�n�T City of Orono Fo� CI Y U E ONLY �
Q ����y P.O. Box 66 Date Received p2��'�,'z�l"� ermit#�
� 2750 Kelley Parkway
Crystal Bay, MN 55323 Amount: $_ l� SAC Credit:��
(952)249-4600 ��., Q��-5.71 ��
Homeowner(s)Signed: ❑Yes /����3
yE' �,� Resolutions(if any)Signed: ❑Yes ❑None Required
tqKFSH��� Zoning Disclosure Signed: ❑Yes ❑None Re uired
CITY OF ORONO - DEMOLITION PERMIT
(All permits must be approved by the Building Official and/or Zoning Department)
Job Site / Owner Information:
Type: �Residential ❑ Commercial
Site Address: 3 a 2 .� C� S�� L i 1'G��
Owner: ,�"7u r^ty MailingAddress: J� ,� �S G� SC� C: �'�/�
c�ty: �,^d n� z�p: .� �3 � 3
Phone: ��✓� � "� ��� - y� 70 Email:
Contractor/Applicant Information:
Contractor/App.: ��v j%�t°� C��� �%- Contact Person: G+��S I��,X� �
Address: �,�--b 7 �% !�-L� r� �T State License#: �� � S L/� � �/
City: �wv c��� Zip: 5 S � Expiration Date: � -.�O - �'o/�
Phone: tr2[�'3 �3-��y(� Email: � P�,,K�� �J!'�;dS�W�15TiK�T:��� .���
SPECIAL CONDITIONS & HOLD HARMLESS AGREEMENT
General Instructions:
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 qualifisd 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.
4. Submit a $2,500 escrow and an escrow agreement signed by the property owner.
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 specir'ic
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 all applicable PCA
requirements.
9. Abandon 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 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).
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
p�,�
�$75.00 — Principal Structure $ "
❑ $50.00 —Accessory Structure x (how many)
1. Subtotal of above permit requested $
2. State Surcharge 5.00
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: j/���t-✓'- Date: � - � 3 ��
Owner's Signature: � �� Date:
Approved By: Date: Z-I L - ?�o/S
( ilding Official)
* Zoning Disclosure Required? ❑ YES �NO
"This must be filled out by Zoning Department- For e her nswer, a Zoning Official must sign all applications.
* Approved By: i' �' I � Date:
(Zoning Official}
� -1 / � ��✓
DATE TIME
CITY OF ORONO CALLED IN �'� 7
INSPECTION NOTIC SCHEDULED J�./S �
PERMIT NO. �����`8�C MPLEfED —
ADDRESS �v�aS �(/,LC�� ,/LLL p�P�
OWNER TE�p HONE Q.%��^ �'z�
CONTRACTOR C%7_�� �
� DESCRIPTION
�
4� ❑ FOOTING �MO-FINAL ❑ SEPTIC FINAL
Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING
Q ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL
Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE tNSPECTION
Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ PROGRESS
� ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT
Q ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP
W ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ HARD COVER REMOVAL
v ❑ DEMO-SITE ❑ SEPTIC INSTA�L ❑ FOUNDATION/REMOVAL
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
y COMMENTS:
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W ❑WORKSATISFACTORY:PROCEED PROJECTCOMPLEfE
� ❑CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
W
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ pHOTO TAKEN
INSPECTOR WILL REfURN
�STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
❑ INSPECTION RE(�UIRED.CALL TO ARRANGE ACCESS.
Ca11 for the next inspection 24 hours in advance. (g52) 249-4600
OwnerlContractor on site:
Inspector. `
e Copyllnspector's File Canary CopylSite Notice