HomeMy WebLinkAbout2007-P11010 (demo) PERMIT
CITY OF ORONO
2750 Kelley F�rkway- PO Box 66 Permit Number: P11o10
Crystal �3ay, Minnesota 55323 Permit Type: Demolition
(952) 249-4600 Date Issued:
5/22/2007
SITE ADDRESS: 3249 Casco Cir Unit#
Wayzata,MN 55391
PID: 20-117-23-43-0008
DESCRIPTION:
Proposed Use: Residential Census Code 645
Permit Class: Building
Permit Type:
Demolition Permit Sub-type(s): Demo-Principal Structure
DETAILS:
Approved per resolution#: 5603
Separate permits required:
NOTICES/REMARKS:
Resolutions#5603 to be signed before issuing New Home Pernut.
Foundations/all demo debris to be removed from ground&disposed of off site per PCA regulations. Wells
must be abondoned. Inspection before backfilling.
FEE SUMMARY: Pernut Fee: $ 50.00 Valuation: $ 0.00
State Surcharge Fee: $ 0.50
TOTAL FEE: $ 50.50
APPLICANT: 7udd Wesse OWNER: Robert Luesse
2144 Southview Lane 3249 Casco Cir
Mound,MN 55364 Wayzata MN 55391
THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMEN'TS SPECIFIED
AND AGREES TO DO ALL WORK IN STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF
MINNESOTA BUILDING CODE REQUIREMENTS.
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APP ICANT PERMITEE SIGNATURE ISSUED BY SIGNATURE
Copies: 1-File(Signatures Required), 1-Applicant, 1-Monthly Reports, 1-Assessing,(If Septic, 1-Septic) Page 1
�fl A` CitV of Orono / `j FOR CITY U�E ONLY
.,O p `VO P.O.Bo�66 V�� Date Received: ,S'�7-c Peimit# ��� __ ��
�,R,� 2750 Kelley Park�vay �,���'.,�>�-� . � %
���';7��;r F Crystal Bay,MN 55323 �� Amount: $� SAC Credit: <.Lt�-� �h
��^ �,������.�o` (952)249-4G00 � � >� �
�Eexo¢ Homeowner(sj Signed: [�Yes �
-��'1 •- j Resolutions(if any)Signed:❑Yes ❑Noite Required � ��j_
7onin Disclosure Si ed: [�''S'es ❑None Re uired � «�
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CITY OF ORONO - DEMOLITION PEI2NTIT r__��p ��
(All permits must be approved by the Building Official and/or Zoning Department) ��� �
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Job Site/ Owner Infornlation:
Type: �,Residential ❑ Commercial
Site Address: � � � � `-� '°� S �� �'' '•--���'� `�- `-� �_
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ll-MP. ,�f D�1R£55
OwtZer: ��ov'�/'��''�" '`>. ��.-'l � Mailing Address: ��a ��E-*�'.-�a�c�•t,r�"'d,, �p�, �'�i
Clt _�'/�r?/'!`,'� Zi _. �'!;.1!�,f'r ��-/6..��C � 'I N� � � ��5' T
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Home Phone: 1'S �- �'�,�',� �.::_ % , _.
Altenlate Phone: �=�����`� ��E�
Contractor/Applicant Information: � .�
ontractor/A ���� t ������ � ����'�''� �'��' �
c rr.. �� VD� C�n act rers�n:
Address: �1�1�{� i�U�1��� � State License#: fZ���'L � `���"
� City: ��� � �� N�.% 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 abandorunent, sewer, etc.
2. Worlc 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. discontinued at the City sei-��ice b qualified contractor before demo pennit is
issued.
Demolition by means of: � Manual Disassembly ❑ Heavy Equipment ❑ Other
Pernlit(s) Issued:,[� Sewer Disconnection ❑ Well Abandonment # �' '
C`�..�� � 5"�}�/�(� ly(U SLSZVZ� /.�r 5 G.�.�n.4 a` � �
In return for issuance of said Demolition Pernlit, the undersigned owner hereby a,�rees as ollo�vs:
l. T�le structure(s) shall be kept enclosed and/or sec�ired tultil such time as demolition is
complete.
2. Demolition debris will be kept off adjoining property and/or the public rights-of way uriless
specific prior approval is obtained in writing for temporary use thereof. '
3. Foundations shall be completely reinoved froin the ground.
4. All demolition debris shall be coinpletely 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 Mimiesota Rules Chapter 7080. All septic tanlcs
must Ue puinped, 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 assimis 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 perfoizned by the property o��mer,
his employees, agents, subcontractors o: assi�:s.
PERMIT TYPE AND FEE CALCULATION
,� $50.00—Principal Stnicture
❑ $30.00 —Accessory Stnicture (how many) (what)
1. Subtotal of above permit requested $
2. State Surcharge $ .50
3. TG�TAL PEFIl�T'I' �'E� (a�d lines 1-2 abeve) �
The undersigned herby applies to the City of Orono for issuance of a Demolition Pennit, 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 inade on this application are complete,
true and correct.
Applica�at's Signature: Date:
Owner's Signature: QC9 �CJ� �,,�*_�-r:=.�-�eGe.i Date: S - /� � � �
Approved By: Date: s"Z� ' �7
(Bu'ldin�Official)
* Zoning Disclosure Required? YES ❑ NO
*This must be filled out by ZoninQ Dep rtment—For either answer, a Zoning Official must sign all applications.
* Approved By: Date:���
(Zonin�Official)