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Home My WebLink About2010-01008 - demo � L CITY OF ORONO PERMIT NO.: 20�0-o�oos 2750 KELLEY PARKWAY ORONO, MN 55356- �ATE ISSUEn: 10/18/2010 952 249-4600 FAX: 952 249-4616 ADURESS : 1985 FAGERNESS POIN"I' RD PIN : 18-117-23-14-0004 LEGAL DESC : FAGERNESS : LOT 003 BLOCK 000 PERMIT TYPE : DEMOLITION PROPERTY TYPE : RESIDENT[AL CONSTRUCTION TYPE : DEMO- PRINCIPAL STRUCTURE ACTNITY : 645-SINGLE FAMILY HOUSES (ATT& DET NOTG: 1. POUNDATIONS/A1,L DGMO DEBRIS TO BG REMOVED FROM GI20UND& DISPOSLD OP OI'F SI"I'E,PER PCA REGULATIONS. 2. WELLS MUS"I'13E nBANDONGD. 3. INSYGCTIONS DONG BLPORE BACKFILLING. APPLICANT DEMOLITION - PRINCIPAL STRUCTURE 75.00 MICHAEL GALLUS CONSTRUCTION INC. STATE SURCHARGE DEMO 5.00 6306 EHLER AVE. DELANO, MN 55328 DEMOLITION - ACCESSORY STRUCTURE 50.00 (612)709-9796 TOTAL 130.00 Minnesota State License#: 20061956 OWNER BRIGGS, MATTHEW& ALISSA 1985 FAGERNESS PT RD WAYZATA, MN 55391- ACREEMENT AND SWORN STATEMENT I�he��°ork for which this permit is issued shall be performed•according to the approved plans and specitications,applicable City approvals,and the State Building Code. This permit is for only the work described and does not arant permission for additional or related work which requires separate permits. All provisions of laws and ordinances governing this type of�work shall be compicd��ith whether or not specilied hercin.This permit will expire and become null and void if construction authorized is not commenced ti�ithin I 80 days of thc datc of issuance,or if construction is suspended for a period of 180 days at any time aiter work has commenced. "Che applicant is responsible for assuring all required inspections are requested in onformance with the S te 13uilding Code.This permit may be revokcd at� �time tor e ca se. /� i /� i Z��v �Di / �i I O Ap ica t Permitc�Signature Date Issued Signature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. ♦ 4 ¢0�` City of Orono FO CITY USE ONLY��`�� l ��.,,,,,<Y� 27050 KelleyParkway Date Received: �(J Permit# c�'�t._i��- �C� �GL J ��.`��;': � Crystal Bay,MN 55323 �� Amount: SAC Credit: ��`j��.$o (952)249-4600 �HO$ Homeowner(s)Signed: ❑Yes Resolutions(if�any)Signed:0 Yes ❑None Required Zonin Disclosure.Si ed: ❑Yes ❑None Re uired CITY OF ORONO - DEMOLITION PERMIT (All permits must be approved by the Building Officia]and/or Zoning Department) Job�Site i Owner Information:�� ` ��'�r.`� s Type: � Residential ❑ Commercial SitP Address� _'I�S �� ,,,.�_5 .�;.�� -- Owner: �� t�e �q�; S Mailing Address: /�� -�c� / ��-s-� �o� � Clty: '��`tt�."�i �ar�c vl.� Zlp: < �/� O Home Phone: 3�c � y� z - Z r°� �� Alternate Phone: Cor�tractor/Applicant i�iformation�:�� -��' ��ft ,_�� , Contractor/App.: yti�,��Q�` (,=;�,.(�c.s CU��s � Contact Person: � n... C�� s Address: �3�L c-� I.�..� .�4�.,--� StateLicense #: ao��i9SC City: `�.��, Zip: 55 3 �� Expiration Date: 3� 3 i- z c i Z Phone: C-�z-70�-`3�gb Alternate Phone: ��s 2 — `�'S'�-�7 S 3 �.�� .,�;�. SPECIAL CONDITIU� ,�� , �� LD HARMLESS AGREEMEN'��. ��,� ��:�`� _ General Ir.stnz�ti ons: 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 of: ❑ 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: l. The structure(s) shall be kept enclosed and/or secured until such time as demolition is complete. a : 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. �'. �h� ur�d�rsisr�ed ow-rter s1�ia11 and nep-eby aoes indemnify and'noici harn�less 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 [�$50.00—Accessory Structure � (how many) �� q�.�(what) 1. Subtotal of above permit requested $ 12.5 2. State Surcharge $ 5.00 3. TOTAL PERMIT FEE (add lines 1-2 above) $ � 3v � 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: �' Z`�("��u .* Owner's Signature: �i:��/�y ` Date: q .�� 06b � 1 Approved By: � Date: t�7 '"�� O (Building Official) * Zoning Disclosure Required?�YES ❑ NO *This must be filled out by Zoning Department—Rer either answ�r,a Zoning Official must sign all applications. * APProved By: J'r (� �(� L '�"�j � ' Date: I�J f�/ '� tJ (Zoning Official) -