HomeMy WebLinkAbout2004-P08069 - demo PERMIT
CITY OF ORONO Permit Number:
27.50 Kelley Parkway - PO Box 66 Poso69
Crystal Bay, Minnesota 55323 Permit Type: Demolition
(952) 249-4600 Date Issued: ioi29izooa
SITE ADDRESS: 3015 Casco Point Rd
Wayzata,NIN 55391
P I D: 20-117-23-34-0003
DESCRIPTION:
Proposed Use: Residential
Census Code 645
Permit Class: Building
Permit Type: Demolition Perniit Sub-type(s): Demo-Principal Structure
DETAILS:
Approved per resolution#:
Separate pernuts required:
NOTICES/REMARKS:
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m.�st be abondoned. Insnection befare backfilline.
FEE SUMMARY: Perniit Fee: $ 80.00 Valuation: $ 0.00
State Surcharge Fee: $ 0.50
TOTAL FEE: $ 80.50
APPLICANT: Lemmerman Const. Inc. OWNER: R Laurie
9037 Cty.Rd 17 SE 3015 Casco Point Rd
Delano,MN 55328 Wayzata MN 55391
THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS 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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APPUCANT PERMITEE [GNATURF, ISSUED BY SIGNATURE
Copies: 1-File(SiQnitures Reauired). 1-Applicant, 1-Monthlv Reports, 1-Assessine, 1-Finance Page 1
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CITY OF ORONO APPLICATION FOR DEMOLITION PERMIT
P.O. Box 66 (2750 Kelley Parlcway)
Crystal Bay, MN 55323
SPECIAL CONDITIONS & HOLD HARMLESS AGREEMENT
General Instructions
1. You may be required to obtain other permits, i.e. well abandoninent, etc.
2. Worlc inust not begin unless the perinit card is available on the job site.
3. A 24 hour notice is required for all inspections. Call (952) 249-4600.
JOB SITE ADDRESS: 3U)5 C�i-�5�.� (�i'��} (�pc;�� t,,;n.,��?���eti �ld,J �S 3��
Occupancy Type: ✓ Residential � Commercial
OWNER'SNAME: `�0.t���.1 �� �e�n� ����� Phone: �5'1-�(�� -�.5�75
Mailing Address:a�5y� pw'lu;�c�'-� � City: ;,�i.�'2a,�ti
CONTRACTOR'SNAME: �pM �,rMe�rr��.; ,,� Bus.No.:_c�� ���-��aq -�3�0
Mailing Address: �03 7 �o R� �7 5E City: ��,(�-�
Demolition if planned by�neans of: manual disassembly
�avy equipinen�
Permits Issued:
# Well Abandomnent
In return for issuance of said Demolition Permit,the undersigned owner hereby a�rees as follows:
l. The structure(s) shall be kept enclosed and/or secured until such tiine as demolition is
coinplete.
2. Demolition debris will be kept offadjoining property and/or the public rights-of-way unless
specific priar approval is obtained in writing for teinporary use thereof.
3. Foundations shall be coinpletely reinoved froin the ground.
4. All deinolition debris shall be completely disposed of off site in accordance with all
applicable PCA requirements.
5. Water wells inust be abandoned in accordance with State Health Department regulations.
6. Inspection required when all debris has been reinoved, 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. 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 deinolition described herein as performed by the property owner,
his employees, agents, subcontractors or assigns.
9. Septic systems inust be abandoned 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.
PERMIT TYPE AND FEE CALCULATION
� $50.00 - Principal Structure
✓ $30.00 - Accessory Structure
1. Subtotal of above permit requested $ �� , �p
2. State Surcharge $ .50
3. TOTAL PERMIT FEE (add lines 1-2 above) $ ��;�
The undersigned hereby applies to the City of Orono for issuance of a Deinolition Permit,agrees to
do all worlc in 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 coinplete,true and correct.
APPLICANT'S SIGNATURE:�.e� ��t ;�� � Date: �d-� -e y
OWNER'S SIGNATURE: � �.X Date: �p_� -o y
APPROVED BY: Date: ld •2(g - (3 y
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