HomeMy WebLinkAbout1999-011186 - demo PERMIT
� CITY OF ORONO PERMIT TYPE:
' 2750�(elley Parkway- P.O. Box 66 - ' ��-_��';'v`=�
Crystal Bay, Minnesota 55323 Permit Number:
(612) 473-7357 Date Issued: ,_,,- _ : i
SITE ADDRESS:
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REMARKS:
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AP LICANT/PERMITEE SIGNATURE ISSUED BY:SIGNATURE ��C�"��
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CITY OF ORONO APPLICATION FOR DEMOLITION PER��IIT ;
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P.O. Box 66 (2750 Kelley Parkway) G
Crystal Bay, i�SN 5�323 �
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SPECL�iL CO��ITIOti'S & HOLD HARiI�ILESS AGREEMEN'T
General Instructions
l. You may be required to obtain other permits, i.e. burnin�, well abandonmment, 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 ADDRESS: i ol 3 C� �1 �c� C; l�,�i c �� f , �� �
Occupancy Type: Residential Commercial T rr y Y� �
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Oti��ER'S NQu�IE: �4�Je z � S f�� �rn � �% _ Phone: �.�- y�3 - < �� �
Mailin� �ddress: yL� poNd�i ,d<, L'.�i c/� ClCy: /-�/�^yla fr` ^..",
CO�"IRACTOR'S NAME: Bus. No.:
Nlailing Address: 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 undersigned owner hereby agrees as
follows:
1. The structure(s) shall be kept enclosed and/or secured until such tune as demolition is
complete.
2. Demolition debris will be kept off adjoining 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.
$, Water wells must be abandoned i.n accordance with State Health Department rewlation�.
6. Inspection required when all debris has been removed, before bac�'�lling.
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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 �vith the adjacent �round 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 aQents, employees and assigns from and a�ainst all claims, dama�es, losses
or expenses, including attorney fees, against the Ciry, its a�ents, employees and assiQns
arising out of or resulti.n' from the demolition described herein as performed by the
property owner, his employees, a?ents, subcontractors or assi?ns.
PERi1�iIT TYPE AND FEE CALCULATION
i/� �50.00 -�Principal Structure
$30.00 - Accessory Structure
1. Subtotal of above permit requested $
2. State Surcharge $ .50
3. TOTAL PERNIIT FEE (add lines 1-2 above) $
The undersigned 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 Ciry and the regulations of the
State of Minnesota, and certifies that all statements made on this application are complete, true
and correct.
APPLICANT'S SIG�'A�'URE: Date:
OWNER'S SIGNATLTRE: ` � � Date: � —�� >>
APPROVIED BY: , ' Date: p2 - � —��_