HomeMy WebLinkAbout2011-00373 - demo CITY OF ORONO PERMIT NO.: 2011-00373
� 2750 KELLEY PARKWAY
- ORONO, MN 55356- DATE ISSUED: OS/20/2011
952 249-4600 FAX: 952 249-4616
ADDRESS : 3409 EASTLAKE ST
PlN : OS-117-23-13-0036
LEGAL DESC : BAYSIDE ADDN TO LAKE MINNETONK
: LOT 000 BLOCK 008
PERMIT TYPE : DEMOLITION
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : DEMO-ACCESSORY STRUCTURE
ACTIVI"I'Y : 649-ALL OTHER BUILDING & STRUCTURES
NOTG:
1. POUNDAT[ONS/ALL DEMO DEI3RIS'1'O BE REMOVED F'ROM GROUND&DISPOSED OP OFP S[TE,PER PCA REGULATIONS.
2. INSPGCTIONS DONE BEI'ORL BACKFILLING.
DEMO GARAGE ONLY
APPLICANT DEMOLITION -ACCESSORY STRUCTURE 50.00
JMJ AFFORDABLE HOME IMPROVEMENT SER STATE SURCHARGE DEMO 5.00
988 6TH STREET
ST PAUL, MN 55106- M[SC FEE 0.00
(612)337-0149 TOTAL 55.00
PAID WITH CASH 55.00
OWNER
OVSYANNIKOVA, MIKHAIL& ELENA
3409 EASTLAKE ST
LONG LAKE, MN 55356-
AGREEMENT AND SWORN STATEMENT
The work for which this permit is issued shall be performed according to
the approved plans and specifications,applicable City approvals,and the
State Building Code. This permit 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 governi��g this type of work
shall be compied with whether or not specitied herein.7�his permit will
expire and become null and void if construction authorized is not
commenced�vithin 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 conformance witl�the State Building Code.This permit may be
revoked at any time for due cause.
- __ - S /�� //� / /
�;_ Ap licant Permitee Signat re Date Issued By Si n ture Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
ti
' �;�Q�� City of Orono FOR CITY OSE ONLY
�,, P.O.Box 66 Date Received: Permit#
(j�� �'i'� 2750 Kelley Parkway
��'� �� ��I Crystal Bay,MN 55323 Amount: $ SAC Credit:
��"�;,� ;�y�r (952)249-4600
����O%� Homeowner(s)Signed: ❑Yes
Resolutions(if any)Signed:❑Yes ❑None Required
Zoning Disclosure Signed: ❑Yes ❑None Required
CITY OF ORONO - DEMOLITION PERMIT
(All permits must be approved by the Building Official and/or Zoning Department)
Job Site/Owner Information:
Type: � Residential ❑ Commercial
Site Address: � T� / �a���� -��
� /
Owner: ,1'✓S��N/� �!�G �� Mailing Address: �� /1 n-(��
,
c�ty: ���-Y� o zip: ,5-s- `�� (�
Home Phone: �o �:z - :���� ' ���� � Alternate Phone: �l � � a� �� ��'� �
Contractor/Applicant Information:
y`��%'�/_,,,. {-'�•-�C',cGJF• <;. ��(t!'- -�- /
c
Contractor/App.: � l �/�.z v�r,.v� S��? ; Contact Person: ��� ���--��6�z �•-�
�
Address: �� �`�v C�� State License#: :� � � � `� Z o l �
City: �� /'� '�.�c�,. r Zip:.s-S ��� Expiration Date: 2 C3 �,�
Phone: � � � � � T� U � `� � Alternate Phone: / � Z 2' r��� � l�
SPECIAL CONDITIONS & HOLD HARMLESS AGREEMENT
General Instructions:
1. You may be required to obtain other permits, i.e.: well abandonment, sewer, etc.
2. Work 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. Sewer must be discontinued at the City service by qualified contractor before demo permit is
issued.
Demolition by means o£�Manual Disassembly ❑ Heavy Equipment ❑ Other
Permit(s) Issued: ❑ Sewer Disconnection ❑ 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 rime as demolition is
complete.
r
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.
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 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.
9. 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 demolition described herein as performed by the property owner,
his employees, agents, subcontractors or assigns.
PERMIT TYPE AND FEE CALCULATION
❑ $75.00—Principal Structure / /J
� $50.00—Accessory Structure ! (how many) (U�C- hat)
1. Subtotal of above permit requested $
2. State Surcharge $ 5.00
3. TOTAL PERMIT FEE (add lines 1-2 above) $
The 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 ordinances 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: -�' �-----� '";�� Date: ������1'/�
Owner's Signature: _ Date:
Approved By: � Date: 5' •�� 1'�
Building Official)
* Zoning Disclosure Required? ❑ YES ❑ NO
*This must be filled out by Zoning Department—For either answer,a Zoning Official must sign all applications.
* Approved By: � � Date:
(Zoning Official)
ac��s � a � ���