HomeMy WebLinkAbout1997-009066 (demo) PERMIT
•�ITY OF ORONO PERMIT TYPE: _�_ ::: - -
2750 Kelle Parkwa P.O. Box 66 � "?={''��
� y y- Permit Number: ;_';-'.='�-'=�'w�
Crystal Bay, Minnesota 55323 Date Issued: _ .. . _ . .
(612) 473-7357
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APPLICANT/PERMITE SIGNATURE ISSUEDBY:SIGNATURE '�i ,
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CITY OF OROti'O APPLICATIO�' FOR DEMOLITION PER�tiIIT
P.O. Box 66 (2750 Kelley Parkway)
Crystal Bay, i�fN 5�323
SPECIAL CO�'DITIONS & HOLD HAR:�ILESS AGREEI�iE`TT'
General Instructions
1. You may be required to ob[ain other permits, i.e. burninQ, well abandonnunent, etc.
2. Work must not be�in unless the permit card is available on the job site.
3. A 24 hour notice is required for all inspections. Call 473-7357.
JOB SITE �,DDRESS:. .�2 3� l�u S C� �� 2�- � �
Occupancy Type: Residential Commercial
OW��R'S N��LE: �t�V� � [�.,r� �i.�� �i �us Phone:
I1�Iailin� Address: Ciry:
co•rrxACTOR�s �ra�,�: .�� � � � � ►� ►� I��,,�� Bus. No.: 4 7 ��- � � � �'
Nlailing Address: ( � (� So �b r--m�+c���-n--. City: •
Demolition if planned by means of: manual disassembly
� heavy equipment
burnin� (by fire department)
Permits Issued:
# Burning Fire Department
# Well Abandonment
In return for issuance of said Demolition Permit, the undersi�ned 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 adjoirun� 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 re�ula[ions.
6. Inspection required when all debris has been removed, before backfilling.
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7. Within � workin� 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 Qround elevation (except when such excavation is to be used as
part of a new buildin� and such new building is actually under construction).
8. The undersi�ned owner shall and hereby does indemnify and hold harrnless the Ciry of
Orono, its aQents, employees and assi�ns from and aaainst all claims, dama�es, losses
or expenses,yincluding attorney fees, aQainst the Ciry, its agents, employees and assijns
arisin� out of or resultin� from the demolition described herein as performed by the
property owner, his employees, ajents, subcontractors or assians.
PER�IIT TYPE A�'VD FEE CALCULATION
� �50.00 ��Principal Structure
$30.00 - Accessory Structure
1. Subtotal of above permit requested $
2. State SurcharQe $ .50
3. TOTAL PERNIIT FEE (add lines 1-2 above) $
The undersi�ned hereby applies to the Ciry of Orono for issuance of a Demolition Permit, agrees
to do all work in strict accordance with the ordinances of the City and the re�ulations of the
State of Minnesota, and certifies that all statements made on this application are complete, true
and correct.
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APPLICANT'S SIG\'ATURE: ate: � � 9 7
O`VNER'S SIG\TATURE:���,��� /�;�,,�, Date: (Q-�-���`l
APPROVED BY: Date: (� - (�-�j�