HomeMy WebLinkAbout2013-00997 (demo) ' � CITY OF ORONO �Z 0 1 3 - 0 0 9 9 7 *
� ' 2750 KELLEY PARKWAY DATE ISSUED: 09/27/2013
ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 3227 CASCO CIR
PIN : 20-117-23-43-0018
LEGAL DESC : SPRING PARK
: LOT 026 BLOCK 000
PERMIT TYPE : DEMOLITION
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : DEMO-PRINCIPAL STRUCTURE
ACTIVITY : 645-SINGLE FAMILY HOUSES(ATT& DET
NOTE:
l. FOUNDATIONS/ALL DEMO DEBRIS TO BE REMOVED FROM GROUND&DISPOSED OF OFF SITE,PER PCA REGULATIONS.
2. WELLS MUST BE ABANDONED.
3. INSPECTIONS 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.
APPLICANT
DEMOLITION-PRINCIPAL STRUCTURE 75.00
D.S.M. EXCAVATING STATE SURCHARGE DEMO 5.00
2916 ENTERPRISE AVE
HASTINGS, MN 55033- DEMOLITION-ACCESSORY STRUCTURE 50.00
(651)480-1355 TOTAL 130.00
PAID WITH CC# 0444
OWNER
O'ROURKE,JAMES
3227 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 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 (80 days at any time after work has commenced.
The applicant is responsible for assuring all required inspections are
requested in conforma ce with the St Building Code.This permit may be
revoked at any ime or ue c ��
` .` � a� ��� �3 �� �� � f� Z 7� /3
Applican krmitee Signature Date Is u By Signatu e Date
SEPARATE PERMITS REQUIRED FOR WORK O ER THAN DESCRIBED ABOVE.
O City of Orono FOR CITY USE ONLY
� � P.O. Box 66 Date Received�- `j-/3 Permit# l3-.(qi0"�f 7
� 2750 Kelley Parkway
Crystal Bay, MN 55323 Amount: $ SAC Credit:
(952)249-4600
� � Homeowner(s)Signed: ❑Yes
yc� �,� Resolutions(if any)Signed:�Yes ❑None Required
`-9kFSH��� � 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: ,�esidential ❑ Commercial
Site Address: �a2�� �A-�-O � �
Owner: � ��u.C�-e Mailing Address:
City: Zip:
Phone: Email:
Contractor/Applicant Information:
Contractor/App.: �. 5 M. ���. Contact Person: 1N1,I� ��'�
Address: �1q, I6 � /�( State License#: o1'Z Yf'
.�
City: �.� Zip: Expiration Date:
Phone: 5 l — �'iC��l3 SS Email:
�4��L- q� - 34p ��,e���
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 qualified contractor before demo permit is
issued.
Demolition by means of: ❑ Manual Disassembly'�eavy Equipment ❑ Other
Permit(s) Issued: �ewer 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 specific
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 br assigns.
PERMIT TYPE AND FEE CALCULATION
$75.00 — Principal Structure $ �5�
$50.00 —Accessory Structure x � (how many) �� '�
-I-�nr�� C�ur� � Z�S, b�
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.
/ 1
Applicant's Signature: ��� l� Date: q— 15— �3
Owner's Signature: � ���'V�I/`� Date:
Approved By: Date:
(Building Official)
*Zoning Disclosure Required? ❑ YES �NO
"This must be filled out by Zoning Department— For er answer, a Zoning OfFicial must sign all applications.
* Approved By: Date: 'CJ
(Zonin Official)
.
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 specific
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
❑ $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: Date:
Owner's Signature: ����,� �J,r�"i.�-L���. Date: e a�`/ �
Approved By: Date: 9 - 2G - �-��3
Building 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: Date:
(Zoning Official)
. �
�O� City of Orono FOR CITY USE ONLY
O P.O. Box 66 Date Received: Permit#
2750 Kelley Parkway
Crystal Bay,MN 55323 Amount: $ SAC Credit:
(952)249-4600
�.
Homeowner(s)Signed: ❑Yes
yd' �,� Resolutions(if any)Signed:�Yes ❑None Required
`�'�ESH�R� Zoning Disclosure Signed: ❑Yes ❑None Re uired
CITY OF ORONO - DEMOLITION PERMIT
(All permits must be approved by the Buiiding Official and/or Zoning Department)
Job Site / Owner Information:
Type: ❑ Residentiai ❑ Commercial
Site Address:
Owner: Mailing Address:
City: Zip:
Phone: Email:
Contractor/Applicant Information:
Contractor/App.: Contact Person:
Address: State License#:
City: Zip: Expiration Date:
Phone: Email:
SPECIAL CONDITIONS 8� 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 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 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.
� TIME �
CITY OF ORONO CALLED IN �
INSPECTION NOTICE p-�c HEDULED " 3 �3 =��
PERMIT N0��.3 �/ �coM ED �
ADDRESS � c�c-�� C -���
OWNER � TELEPHONE NO. ,
CONTRACTOR
>; DESCRIPTION �� �
�
� ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING
Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS
y ❑ FRAMING ❑ MECHANICAL FINAL
❑ TREE REMOVAL
Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION
Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS
� ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT
� ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP
_ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL
J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL
� OWNER/CONTRACTOR TO MEEf YOU:_YES_NO
� COMMENTS:
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GW�DRKSATISFACTORY:PROCEED ❑ PROJECTCOMPLETE
.
W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITtONWITHIN HOURS. � pHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR � CITATION ISSUED
O INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. �95Z� Z49-4600
OwnerlContractor on site:
Inspector. / �`�
White Copyllnspector's File Canary CopylSite Notice
`�� ��� � p�� �
CITY OF ORONO CALLED IN �� `�
INSPECTI I E SCHEDULED ,
PERMIT NQ�������TCOMPLETED �_
ADDRESS �2- 2-�[ l uS CC� C��,
OWNER���S �<<�'�� TELEPHONENO. (OI�.���'1 �"3�
CONTRACTOR �m �C�-�/o�u
� DESCRIPTION����� ��6�
� � FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING
Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORFJWETLANDS
y ❑ FRAMING ❑ MECHANICAL FINAL
❑ TREE REMOVAL
Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE O SITE INSPECTION
Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS
� ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT
v ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP
_ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL
J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL
2 OWNERICONTiiACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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W� ❑WORKSATISFACTORY:PROCEED ROJECTCOMPLEfE
� ❑CORRECT WORK 8 PROCEED ❑ IS E CERTIFICATE OF OCCUPANCY
� ❑CORRECT WORK,CALL FOR REtNSPECTION TEMPORARY
� BEFORE COVERING
PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. ❑ pHOTOTAKEN
INSPECTOR W{Ll REfURN ❑CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call forthe next inspection 24 hours in advance. (952) 249-46��
OwnerfContractor on sit :
Inspector.
White Copyllnspector's File Canary CopylSfte Notice
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