HomeMy WebLinkAbout2015-00730 - demo '' ' CITY OF ORONO * 2 0 1 5 - PJ 0 7 3 0 *
2750 KELLEY PARKWAY DATE ISSUED: 07/08/2015
ORONO, MN 55356-
952 249-4600 FAX: 952 249-4616
ADDRESS : 2755 ETHEL AVE
PIN : 20-117-23-24-0017
LEGAL DESC : CASCO HEIGHTS
: LOT 006 BLOCK 003
PERMIT TYPE : DEMOLITION
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : DEMO- PRINCIPAL STRUCTURE
NOTE:
1. 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.
NOTE: A 24-48 HOUR NOTICE IS REQUIRED FOR ALL INSPECT[ONS. CALL(952)249-4600.
SEWER MUST BE DISCONT[NUED AT THE CITY SERVICE BY QUALIFIED CONTRACTOR BEFORE DEMO PERMIT IS ISSUED. CHECK
TO MAKE SURE THIS PERMIT HAS BEEN PULLED BEFORE ISSUING THIS PERMIT.
APPLICANT DEMOLITION- PRINCIPAL STRUCTURE 75.00
STATE SURCHARGE DEMO 1.00
Everlast Enterprises, Inc. TOTAL 76.00
CLEARY,JIM
4109 N. SHORE DR Payment(s)
MOLJND, MN 55364- CHECK 8134 76.00
(952)472-5870
OWNER
Everlast Enterprises, Inc.
CLEARY,JIM
4109 N. SHORE DR
MOUND,MN 55364-
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 gran[permission for additional or related work which requires separate
permits. All provisions of laws and ordinances governing 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 l80 days at any time after work has commenced.
The applicant is responsible for assuring all required inspec[ions are
reque d in conformance with the State Building Code.This permit may be
rev ed at any time for du ause. .
ry
,
, � `� �," %� D -C.c�� 7 � �' �
'A icant Permitee Signature � ate Issued ignature Date
�O� City of Orono FOR CITY USE ONLY
P.O.Box 66 Date Received:(Q•k�t S Permit# ��7
� 2750 Kelley Parkway �>C
Crystal Bay,MN 55323 �V� Amount: $� SAC Credit:
(952)249-4600 . �/
y ,� 1T Homeowner(s)Signed: ❑Yes
`O� C.� � � Resolutions(if any)Signed:❑Yes ❑None Required
�kFs f{p��' /1�I���\ Zonin Disclosure Si ed: Yes
I � `�„ � ❑ ❑None R uired
ul `�f�, <-7l Cti.1�{✓ /� 1
CITY OF ORONO - DEMOLITION PERMIT �1
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(All permits must be approved by the Building Official and/or Zoning Department) <� �1�'"�`�� r"`^'Ci�
Job Site/Owner Information:
Type: �( Residential ❑ Commercial
SiteAddress: a� �� �--�4'1� � � , �v�-I.�ZG�=�, IY�Y1 J�3e� I
Owner: �VC'�� �QS��" �(}�r���1SeS Mailing Address: �1��i �l� Jrl�r� 1��' fV'�
c�ty: m�vr�c�l z�p: 5� 3�11
Phone: �Gl �.-��.��` ��1 �( �( Email: � � 'fl� �F:1,'�' c� ��� S�-Pi��-c'r�-�r iSt=S ( Oi�
Contractor/Applicant Information:
Contractor/App.: Contact Person: ��►Yl �'��'Ci�' �(
Address: \ ���� �� State License#: gC �; � t,��
,
City: Zip: Expiration Date: � �3 i�� �
Phone: Email:
SPECIAL CONDITIONS 8� HOLD HARMLESS AGREEMENT
General I nstructions:
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. �.�,,,�a�r: c.c�:�� J�yce.�iw-� t��_ l�s�� is ��
�hat c._ l s ttix� 3�.1�—v,a+.� t-� ,��_� ���st--.
Demolition by means of: [�Manual Disassembly ❑ Heavy Equipment ❑ Other
Permit(s) Issued: ❑ Sewer Disconnection ❑Well Abandonm�#O/L`L.
by e�Cca�a--1-c�-- — �o =;�z�.�.r•�.,.4 , ;t�.�,� • • �-�.�er. f��.:� �s� :`�
�' L+�:s ��. i �
In return for issuance of said Demolition Perm�t, t�ie�ndersigned owner hereby agrees to: � �
1. Submit a survey, aerial photo or sketch showing all structures on the property. Note which
structures are to be demolished. �� �c,,.�.s�- p�w,...� t�Pe�•��•� �'�, J�� �.x�.
2. Submit a survey, aerial photo or sketch showing proposed erosion control measures in
accordance with Chapter 79, Construction Site Runoff Control. ,��.. Gr.�.t:� $«-x`� �1•�-.����
3. Submit a copy of permit approval from the Minnehaha Creek Watershed District (MCWD). The
City will not issue a demolition permit without a copy of the permit(s) from the_ M,CWD or
documentation stating permit(s) are not required. S6`S� G•�.�� e�-►+ti=� 1�-p��•�.n.�
�4 t�.a a�-f-.t�— l.�\�� ��.
4. Submit a $2,500 escrow and an escrow agreement signed by the property owner.
5. Keep all structure(s) enclosed and/or secured until such time as demolition is complete.
6. 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.
7. Completely remove foundation(s) from the ground.
8. Completely dispose of all demolition debris off site in accordance with all applicable PCA
requirements.
9. Abandon water wells in accordance with State Health Department regulations.
10. Call for an inspection when all debris has been removed, before backfilling.
11. 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).
12.Abandon septic systems 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.
13. 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 pe►fiormed by the property owner, his
employees, agents, subcontractors or assigns.
PERMIT TYPE AND FEE CALCULATION
,� $75.00 — Principal Structure $ v7 �j � U �
❑ $50.00 —Accessory Structure x (how many)
1. Subtotal of above permit requested $
2. State Surcharge � � , O C�
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: '"cQ.� � � Date: r"J I o1 S� 1 ��
Owner's Signature: �.- �`1- Date:
Approved By: �" Date: � ��
( uilding Official)
"Zoning Disclosure Required? ❑ YES NO
'This must be filled out by Zoning Department—For eit er nswer, a Zoning Official must sign all applications.
*Approved By: /Y { IVuI� rr`�l�Vr Date: �'���J
(Zoning Official)
�N�nl I�vw� .��rm�L l,�ed -� oh (o ��� t5 .
�
�' �� DA E TIM� /
CITY OF ORONO CALLED IN ��
INSPECTION NO SCHEDULED �� -
PERMIT NO. ��� �� co PLEfED
ADDRESS a7sS �-�!'l�L
OWNER TELEPHONE NO. -� ��
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CONTRACTOR
�; DESCRIPTION �'�'y�� �'�-'"�-w"
�
ly ❑ FOOTING �-DEMO-FINAL ❑ SEPTIC FINAL
Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING
Q ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL
Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION
Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ PROGRESS
� ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT
� FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP
? ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ HARD COVER REMOVAL
J ❑ DEMO-SITE ❑ SEPTIC INSTALL ❑ FOUNDATION/REMOVAL
2 OWNERICONTRACTOR TO MEET YOU:_YES_NO
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� ❑WORK SATISFACTORY:PROCEED �PROJECT COMPLEfE
W ❑CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECWERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN
INSPECTOR Wlll REfURN
❑ STOP ORDER POSTED.CALL INSPECTOR O CITATION ISSUED
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (g52) 249-46�0
OwnerlContractor on site:
Inspector `
Wh�te Copyllnspector's File Canary CopylSite Notice