HomeMy WebLinkAbout2011-01320 - demo � . CITY OF ORONO PERMIT NO.: 20��-0�320
2750 KELLEY PARKWAY
ORONO, MN 55356- DATE ISSUEu: 10/26/2011
952 249-4600 FAX: 952 249-4616
ADDRESS : 3095 CASCO POINT RD
PIN : 20-117-23-34-0005
LEGAL DESC : REG. LAND SURVEY NO. 1311
: LOT 000 BLOCK 000
PERMIT TYPE : DEMOLITION
PROPERTY TYPE : RESIDENT[AL
CONSTRUCTION TYPE : DEMO-PRINCIPAL STRUCTURE
ACTIVITY : 645-SINGLE FAMILY HOUSES(ATT& DET
NOTE: PRINCIPAL STRUCTURE
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.
NOTG: 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.
CI-[ECK TO MAKE SURE THIS PERMIT HAS BEEN PULLED BEFORE ISSUING THIS PERMIT.
APPLICANT DEMOLITION -PRINCIPAL STRUCTURE 75.00
FINAL GRADE, INC STATE SURCHARGE DEMO 5.00
3441 BLUFF DR.
JORDAN, MN 55352 MISC FEE 0.00
(952)492-5100 TOTAL 80.00
Minnesota State License#: 1442
PA[D WITH CC# 1510
OWNER
WHIPPLE,PHILLIP � �
3095 CASCO PT RD
WAYZATA, MN 55391-
AGREEMENT AND SWORN STATEMENT
The work for which this permit is issued shall be perFormed according[o
the approved plans and specifications,applicable City approvals,and the
State Building Code. This permi[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 goveming 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 wnformance with the State Building Code.This permit may be
revoked a[any time for due c use.
� ���� ��� /O/ a-� /
Applicant Permitee Signature Date Issu By Signature Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
�,¢(j��� City of Orono �Fa �t v usE ov►,v h
� P.O.l3ox 66 ' ..
0 Q'� Date Received: z `� Pem�it# � {,/� �
� �,, � 2750 Kelley I'ark�aay �/7
�'��'R1�� Crystal Bay,MN 55323
�' Amount $ Q(/� SAC Credit
���+ �'���r,;Y.�o/ (952)249-4600
"t4assH�!
�i-- Homeowner(s)Signed: ❑Yes
Resolutions(if�ny)Signed:❑Yes ❑None ftequired
Zonin Disclosure Si ned: ❑Ycs ❑None Re uired
CITY OF ORONO - DEMOLITION PERMIT
(All nermiis musl be approved by the l3uilding Official and/or"Loning Deparlment)
Job Site/Owner Information:
Type: (�Residential ❑ Commercial
Site Address: �� 1� �__l�/�-Jl�� Y ���� I�IJ
Owner: ������Q �� � P � Maili�ig Address: ��D�1�'J ��0 ��-� K���''��
c�ty: vVi,��2.�-- z,p: ��53°� �
Home Phoue: V�l�f� Alternate Phone: Y� � f�-�
Contractor/Applicant Information:
Conh•actor/App.: � \�Cl�� ��"lV(./�1•1�� '1���� Contact Persou: �_��l,�lY1�l-Q�t�IYJ�/
Address: ,7��`�� ��U-� -� �V-1�'� State License #: �
C �
City: � �� �N� Zip: � J �S� Expiration Date: �"
Phone: �� ��� �-���j � �7��[.� Alternate Phone: � ���C�
11.12 '3�`�'2�� � I
SPECIAL CONDITIONS & HOLD IiAR1VILESS AGREEMENT
Ceneral Instructions:
1. You may be required to obtain other permits, i.e.: well abandoiunent, sewer; etc.
2. Work must not begin unless the permit card is available ou 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 qualitied contractor before demo pecmit is issued.
Demolitiou by means of: ❑ Manual Disassembly � Heavy Equipment ❑ Other
Pennit(s) Issued: � Sewer Discounection ❑ Well Abandonment# � i�l �r UC�f`��
In return for issuance of said Demolition Permit, the undersigned owner hereby agrees to:
1. Submit a survey, aerial photo or sketch showing all structuces on the property. Note whiel�
structures are to be deinolished.
2. Submit a survey, aerial photo or sketch showing proposed erosion control measui•es in
aecardance with Cl�apter 79, Construction Site Rur�off Control.
3. Submit a $2,000 escrow and an escrow agreement sigiled by the property owner.
4. Keep all structure(s),enclosed and/or secured until such tiine as demolition is complete.
5. 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.
6. Completely remove foundatioi�(s) from the ground.
7. Completely dispose of all demolition debris off site in accordance with all applicable PCA
requirements.
8. Abandou water wells iu accordance witli State Health Departnleut regulatio��s.
9. Call for an inspection wheu all debris has been removed, before backfilling.
10. Witl�i❑ 5 working days of superstructiu-e removal, a tival inspection shall be requested. The site
sllall be left clean and clear of all debris, with any excavation filled with earth level witll the
adjacent ground elevation (except wheu such excavation is to be used as part of a new building
and sucll new building is actually�under construction).
1 1. Abandon septic systen�s per Miunesota Rules Cl�apter 7080. All septic tanks must be pumped,
crushed aiid f111ed with native soils. An iiispection is required after the tanks are pumped and
before the tanks are crushed and filled.
12. 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,
iucluding attorney fees, against the City, its agents, employees and assigns arising out of or
resulting fronl tl�e demolition described herein as performed by the property owner, l�is
employees, agents, subcontractors or assigns.
PERMIT TYPE AND FEE CALCULATION
[� $75.00—Principal Structure $ ' I �5��
❑ $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) $ � ✓ � ��
Tl�e 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 ordi�lances 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: �����:.-e`�"'v�/�/�� Date: �b �� L �
_ Owner's Signature: Date:
Approved By: Date: � � - ZS -� (
uilding Officiai)
' (,t 6(�,0 l6l.C� Zt�1'�(`
* Zoning Disclosure Required? `� YES ,�, NO ��s�?�
*This must bc filled out by Zoning Departinent—For either answer,a Zoning Official must sign all applications.
* Approved By: � Date: I.v �L� ' L I
(Zoning Official)
OCT-26-2011 (�ED) 12; 36 Final Grade Inc (FAK)952Q925101 P. 0021003
5. Keep all demolition debtis off ndjoiu[ng ptopei�ty and/or�l�ti public cighcs��of way unlees epecific ,
prior apnroval is obc�in�d in►Vriting for tenal�orary use the�eof
6, Complo�cly remov��Loundation(s) Erorn the ground.
7. Completely disposa af all demolltion dobris off site in aCaordtinca wi11� all applicable PCA
requiremeat9.
8. Abandon w�ter walls in aceotcla,eica witl� 5tate H�ul�h D�pertmen[r'egul�ti��ns,
9. ealL fur�n i�tspection when all debrls has been remo�ecl,boforc bockt�llin�s,
L0.Wicl�in � working cJnys of superstruuhn•e ren,ov�l, a G��1 inspeetlon shall hd eequeaud, Tlle sit�
9ba11 be loft clean ,tnd cle�r oP a!i debr(s, with ac►y exe�vation tjlled wi�h oerth. level with the
ac�jncent gcound elev�ttian (�xcept wllcn aucb exc8veti�n is to be usecl as x►art Qf a new�uilding
Ql]CI 9uC�1 nCW 17U1�dIRg 19 FICCUDlIy 4t1dC1 COtI�TI'IICL'1011},
]I,Ab�nclon 5opti� syateins per lvtiztnesar.a itulas Cl��ptrr 7b&o, All s�p�ic it�ulcs must pc lyum{�ed,
ecusl�ad arid f'tlled witu nstli��e aoils. Art inspeCtiou i� rec�uirCC! Btt�r [hc: tanlcs aro pumped and
beEoro tho tanks are crusl�ed nncl P'illed,
12,Tl�e uildersigned nwner ehall E+ncl hereby does indeizy�ufy and LwI+J h�ru�le:.�iWo City ofOcuno,i�a,
' age�iis, �si»ployo�s aticl assi�ns �rotn �nd a�ainst�all claim9, damage,�,�losaes or cxpense�, ^ �
Lncludiug &ttornay fcaR, ag�iU�t Ute City, its agtnts, employees a�id acsignR e�yisiug nut of ar
rosulrin� t'torn tlu de��so(i�ion descrIl�ecl tierai�l e.s perfornlyd by di�� property own�r, his
enzptoyECS,�gents,BU�CC1n[rACtOr9 oi'9981gn5.
��itn�TT T�i�PE AND F�t; CAr.Cu'�.aT�aN
[�+ $75.00—Principe]Structw•e $ r .G,u���
❑ �SO.qO�Accessary Structure x (hnw�nauy} _
1. Subto�al at'above permit reqwesc�d � �FJ�
_.�.,�
2. Sta[o 9nrchurgC �
' 3. TO"rAY,�'�RMIT�'EE (add line9 1-Z above) $ V �� '
R/ -.
The undersigutd ha•by applies to the Ciry of Orono f�r issuau�e oF a DomoliCion Pecmie,a�nnes to dp all !
the woi�c in a 4trict accorclanea wlt� Cha ordin�q�as of flie City and rhe re�ulotions of tha Stau of
1Vlinnosota,E1C�d ae��tifies din�nll�tate��enc�made on thiy a�plicadott are coinpl�ce,crue an�co�rect, '
�ppllcttirtt's Si�nae��t'e; ��� Ar�us; `�� �� ;
�
� Qwncr's Slgnmtucet �� p�«; � �
�• �j'�' . , .
�.ppruved B7� D��c: � '� - ?S•1 ( �
�uld �g:O.ff►CiAI) ..- � �
�'Zonin�D�sci�eure izequlracl? `� ��S ,,,_, Np �''����6� '-�laea���!�q
brFsUtP
*THia musi be fl Ilod out by 2on(ng Depprtm'bnP—For ei�her anAWe�•,a 2o»In�OfFlclnl mu9i ylgn ull uppl Ico�lom. �
*APproved By: L ,1 1` ��-- Date: �v '�' 1 � �
Zoning cinl) �
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Carrie Rahbain
From: Molly Robertson <Molly.Robertson@KyleHuntPartners.com>
Sent: Thursday, October 20, 2011 8:35 AM
To: Carrie Rahbain
Subject: RE: DEMO PERMIT
Attachments: image002.jpg; Whipple Permit Survey 10-4-11.pdf
Hi Carrie,
I just chatted with Glenn...
I am attaching the survey for you. It actually has the silt fence marked on it already. There is a line that has little "x"
marks on it, that is the silt fence. And Glenn said the city already has the $2,000 escrow from the
homeowner. Apparently he had to include that with the building permit and they will only need it once-so that part shou�l
be good to go.
Thanks!
I�Y I.� �-�I �.1 N'I' �` T't�kt'�'I�1 k�1t,��
� , � {:� xr �� h ,� � � ��
����� �"�,�.��� a:_,_.
Molly Robertson
Assistant Project Manager
Kyle H�mt&Partners, Inc.
18324 Minnetonka Blvd.
Deephaven, MN 55391
Phone: 952.476.4564 x22
Fax: 952.476.2134
Email: mollv.robertson(cUkylehuntpartners.com
Web: kylehuntpartners.coin
From: Carrie Rahbain [mailto:crahbain@finalgrade.com] ��
Sent: Thursday, October 20, 2011 8:25 AM
To: Molly Robertson
Subject: DEMO PERMIT
Morning Molly. Can you let Glen know that there are items needed from him before we can apply for the demolition
permit. On page#1 of the application at the bottom we need items#1 & 2 completed.
The disconnect permit has been sent in.
Carri¢ Ra��aiti
Final Grade, Inc.
3441 Bluff Drive
Jordan, MN 55352
952-492-5100 (o)
952-492-5 l01 (�
i
, � � RIVERLAND 30435
O Q 700 SEVILLE DR.
JORDAN,MN 55352
75-1751/919 10/20/2011
FINAL GRA�E, INC_
3441 BIuH Drive•Jordan,MN 55352•(952)492-5100
PAY TO THE City of Orono I �"75.00
ORDER OF
Seventy-Five and 00/100******.,****�******,***.*******,***,******,****�**.***,.*�**,.,*****,.�.<***�************„�*****�*
DOLLARS �
City of Orono
2750 Kelley Parkway
PO Box 66
Crystal Bay MN 55323 " .
MEMO Demo Permit/ 3095 Casco Point Road ��1 UL./',���C��'�i'�
_ L��L __ , _ ._ __.
AUTHORIZED SIGNATURE
��■030435��' �:0919L7513i: 730L922��'
30435
City of Orono 10/20/2011
Date Type Reference Original Amt. Balance Due Discount Payment
10/20/2011 Bill Demo Permit 75.00 75.00 75.00
Check Amount 75.00
RiverLand Bank/ Gen Demo Permit/ 3095 Casco Point Road 75.00
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. . �: ,r�-... ^' an cx�st��y housa. 9arage. Forch. . . .. . .- ,^° , , �
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11-14BA