HomeMy WebLinkAbout1994-005926 - demo PERMIT
, ��TY OF ORONO PERMIT TYPE:
2750 Kelley Parkway • P.O. Box 815 Permit Number: ``':'--�;'-���`-'
Orono, Minnesota 55356-0815 `'�.''='����=�
(612) 473-7357 Date Issued: - - �- - -
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A LICANT PERMITEE SIGNATURE ISSUED BY:SIGNATUR �.,
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^ITY OF ORONO APPLICATION FOR Dffi�SOLITION PER:iIT
�.0. Box 66 (1335 Sa Brown Rd)
Crystal Bay, MN 55323 ,
� SPECIAL CONDITIONS & HOLD HARMLESS AGREEMENT
*f***t**�r*****�********�****��***********t�**t*:�******�*#*�*****�t*�*t***
General Instructions
i. You may be required to obtain other permits, i.e. burning, well
._ -� abandorunment,- etc. �---- ----_. . -- -.._..�__...__._�.__..-,- ._...�z_ , ----- ---- - -- _, -.-= -.- -_-- - � =--
2 .� Work must not, begin unless the permit cardris available on the job
site.
3 . A 24 hour notice is required for all inspections. Call 473-7357.
�r**��***t**�****�******#**�t**t*#*#�#******ft***t**tt*:****t*�*t******�ft*t
sos sz�s Annx�ss: /7z 5 f�� ��;,-� 5 �� l��� G�'�_�,y�z_�.����. , ��til �� ���> �> �� i
Jccupancy Type: �Residential Commercial
JWNER' S NAME: �� f��,- n c ���=��- � � � �Lc� u«- /�.:�r�_S Phone: ��L�; - �;�-e,t% ��
Mailing Address: jZc, G"„ d«�.� i'� i��L 7���;:r,�t ��..y ��If� City:
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�'ONTRACTOR`S NAME: ��,��r� � , ,� ��e� ' _ Bus. No. :
�iailing Address: s��- �ti -_ �._�� �,�,- ���.� City:
�:********�********::�*�:**::�#***:****t::****�****�**f***�t********:�*t*3*t
�emolition if planned by means of: manual disassembly L-}�avy equipment
burning (by fire department)
?8i'If11tS ISSU@c3:
� Burning Fire Department
� Well Abandonment
In return for issuance of said Demolition Permit, the undersigned owner
rereby 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 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 al 1 app licable 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).
-_ :.-.-- --- - . _.... _._ • a
8 . The undersigned owner shall and hereby does indemnify and holc
harmless the City of Orono, its agents, e�ployees and assigns from anG
against aIl claims, damages, losses or expenses, including attornel
fees, against the City; - its agents, employees and assigns arising out
- of or resulting from the demolition described herein as performed bj
the property owner, his employees, agents, subcontractors or assigns.
***********�*t�**�*********:�***�t3�*�****t*#�*ff*****��ft******�#*##��***.�
� _ -___ - __� -__ .�_ PERIKIT_TYP$ AND FHB�_CAZCIII.ATION-_ ---- " - -"._ -_ `. --- _-= "--",-_-
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' $50 . 00 Principal Structure �
$30.00 Accessory Structure
1. Subtotal of above permit requested $
° 2. State Surcharge $ ' 5d
3 . TOTAL PERMIT FEE (add lines 1-2 above) $
***�*�*****�******t*�**�***f:*f****�f�***t**#*f******f*tt*******�#*tt*t�***
the undersigned hereby app lies to the City of Orono f or issuance of a
I Demolition Permit, agrees to do all work in strict accordance with the
� ordinances of the City and the rec,-ulations of the State of Minnescta, and
certifies that all statements made on this application are complete, true
� and correct. -
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SIGNATDRL OF APPI,ICANT: !.:� %;--���"-� Date: Z�Z � �`��/
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