HomeMy WebLinkAbout2016-01007 - demo CITY OF ORONO * z 0 1 6 - 0 1 0 0 � *
2750 KELLEY PARKWAY DATE ISSUED: 08/30/2016
ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 1700 BOHNS POINT RD
PIN : 16-117-23-22-0003
LEGAL DESC : AUDITOR'S SUBD.NO. 349
: LOT 003 BLOCK 000
PERMIT TYPE : DEMOLITION
PROPERTY TYPE : RESIDENTIAL
COIVSTRUCTION TYPE : DEMO-PRINCIPAL STRUCTURE
ACTIVITY : 645-SINGLE FAMILY HOUSES(ATT&DET
NOTE: (SEWER DISCONNECT PERM[T#2016-00933&WELL ABANDONMENT PERMIT#H341643)
1. FOUNDATIONS/ALL DEMO DEBRIS TO BE REMOVED FROM GROUND&DISPOSED OF OFF S[TE,PER PCA REGULATIONS.
2. WELLS MUST BE ABANDONED.
3. INSPECTIONS DONE BEFORE BACKFILLING.
NOTE: A 24-48 HOUR NOTICE IS REQUIRED FOR ALL INSPECTIONS. CALL(952)249-4600.
SEWER MUST BE DISCONTINUED AT THE CITY SERVICE BY QUALIFIED CONTRACTOR BEFORE DEMO PERMIT IS ISSUED. CHECK
TO MAKE SURE TH[S PERMIT HAS BEEN PULLED BEFORE[SSUING THIS PERMIT.
SAC GRANDFATHERED IN-PER 1966'SEWER PROJECT MAP 30-PER ROGER P 08/30/16. SEWER PROJECT WAS IN AND THEY
HOOKED UP. HOME WAS ALREADY THERE F3ECAUSE ADDITION WAS ADDED ON PERM[T#1872 12/OS/1966 AND A SEWER REPAIR
PERMIT#766 OS-03-1988
APPLICANT DEMOLITION-PRINCIPAL STRUCTURE 75.00
STATE SURCHARGE DEMO 1.00
D[RT DEVILS SERVICES LLC TOTAL 76.00
6447 SUNSET TRAIL
LORETTO, MN 55357- Payment(s)
CHECK 20521 76.00
(612)366-4876
Minnesota State License#: cont-
OWNER
SANTRACH&MELISSA KREIMER-SANTRACH, PETER
1700 BOHNS PT RD
WAYZATA, MN 55391-
AGREEMENT A1vD SWORN STATEMENT
The work for which this permit is issued shall be performed according to
the approved plans and speci6cations,applicable Ciry 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 goveming this type of work
shall be compied with whether or not specified herein.This permit will
expire and become nuli 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 180 days at any time after work has commenced.
The applicant is responsible for assuring all required inspections are
requested in conformance with the State Building Code.This permit may be
revoked at any time for due cause.
.
< ��a/ �� � �'' ,�,��
A plicant Permitee Signature Date Issued ignature Date
�O�T City of Orono �,pox ITY USE ONLY �
�y P.O.Box 66 Date Received� Permit�! �� � �
� 2750 Kelley Parkway d�
Crystal Bay,MN 55323 Amount: $ !` , SAC Credit:
(952)249-4600
� ,` Homeowner(s)Signed: ❑Yes
ci' �,� Resolutions(if any)Signed:�Yes ❑None Required
��KESH�R� Zonin Disclosure Si ed: ❑Yes ❑None Re uired
� �GYGV✓✓'„ � ��`1 I��
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CITY OF ORONO - DEMOLITION PERMIT
(All permits must be approved by the Building O�cial and/or Zoning Department)
��������
.lob Site / Owner Information: AUG 2 2 2016
Type: �Residential ❑ Commercial CITY OF ORONO
� (�
Site Address �� U� '_J Uk n j Pt��� n� ��
Owner. r�e'�•� �an,�r�.C...�1. Mailing Address: �C'^„�� ��,� a �'�� �o,•t�
/�1` �`/O
c�ty: �,,. ��,��) ► ; z�p: �'S y�i �
Phone:�- S l "��,� ���� � Email:
Contractor/Applicant Information:
Contractor/App.:!n;�-t ������> S P�v�"t P�� LZL Contact Person: ��P� S'�o�'}"'-�"�
Address: �`�`�7 �w�Sc�� I��%1 State License#:
City: L���}'�U Zip: /�'' � Expiration Date:
Phone: b�� �3�C yC� �� Email: � 'i r-1 c���� �5 S�r�i r�:.s(� �i�G��,, , ��n�.
�T—
SPECIAL CONDITIONS & H�LD 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.
Demolition by means of: ❑ Manual Disassembly �J-leavy Equipment ❑ Other
Permit(s) Issued: Sewer Disconnection ❑Well Abandonment# �/ .3 ����'7 �
,�f�►�►�i-( Z c%I tc -C�3 3
In return for issuance of said Demolition Permit, the undersigned 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.
2. Submit a survey, aerial photo or sketch showing proposed erosion control measures in accordance with
Chapter 79, Construction Site Runoff Control.
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 MCWD or documentation stating
permit(s) are not required.
Form Last Updated: July 2015 I� - �3q
150784
4. Submit a$2,500 escrow and an escrow agreement signed by the property owner(copy attached).
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 performed by the property owner, his employees, agents, subcontractors or assigns.
PERMIT TYPE AND FEE CALCULATION
$75.00 — Principal Structure $
f
❑ $50.00 —Accessory Structure x (how many)
1. Subtotal of above permit requested $
2. State Surcharge 1.00
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: g I�� � 6
Owner's Signature: � Date: �' q
Approved By: Date: �`� �
( ing icial)
ZUI� �l (.� t � —� 3 8�14-
* Zoning Disclosure Required? ❑ YES NO (���{--�,�n �C) , LPLr I 3
'`This must be filled out by Zoning Department- For eit nswer, a oning Official must sign all applications.
* Approved By: Date:
(Zoning Official)
Form Last Updated: July 2015
150784
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PROPERTY IS VACANT � \ \` 1� 1� I � I � '—"—���v "—- '
�o�.a� //I // roeo.»;i '� � • : denote:
11 I �"''��,,,,,� ',Iy,I
.... rosa,)1 1� I 1 j I I� � i��C.�►V/1 �'(L(,��(� S�']'� l�i�� (908.3) : denote:
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Township Name Township No. Range No. Section No. Fraction(sm.-�Ig.) Date Sealed , s`i�f J Date Weil or Boring Constructed
_ � r 7 ..., -t i Prrx �� ;,irti: /� � + =�' �t�0
,� �'.:m�...
GPS IOCATION-decimal degrees(to four decimal placesJ � � �
1
Depth Before Sealing - k. Original Depth ft.
Latitude Longitude
AQUIFER(S) STATIC WATER LEVEL
Numerical Street Address or Fire Number and Ciry of Well or Boring Location v Singte Aquifer ❑Multiaquifer ,_ .
•�t.'
. ._,,_� _ _¢ -_ - WELLJBORING easured ❑Estimated Date Measured ��, � f�1i� ��/=r
_ ` � � ��Water-Supply Well �.
r]Monil Well
Show exac[location of well or boring � Sketch map of well or boring ` ���"'a
in section grid with"X" location,showing property ❑Env.Bore Hole ❑Other � ft. below ❑above land surface
N lines,roads,and buildings. CASINGTYPE(S)
..L----'-----`-----'- °..� ���. ,
Steei ❑Plastic ❑Tile ❑Other
--;---"�----�-----�-- " . f._.. : ELLHEAD COMPLETION
, � � � , ( �� -.
w � � � � E `' �
4 � ���.,
� � � � �1 _�.�7 � Outslde: ❑Well Nouse ❑A1 Grade Inside: �Basement Offset
--- --- ----------- 'h Mi�e � � ' ❑Pitless Adapter/Unit ❑Buried ❑Weli Pit
� . � � '
--.-----r----------=-- 1 ..___....___-�
❑e����a
S ❑Well Pit
❑Other
�--i Mae� ❑Othet
PROPERTY O A / MPANY NAME CASING(S)
'�""`�� ^�::_ �.'- : .� �``_'L`7?-C`:'S x�Y� DiamQter - � Depth • Set in oversize hole? Annular space indially grouted?
Property owoer's mailing addiess if dilterent than well location address indicated above L/ � � [� �
7 in.trom (_...-' to_r._�__fl. ❑Yes �]No ❑Yes ❑No ❑Unknown
: . � •
G..,,�.,",' �'':.�.tl`3;��. �''p"� ❑Unknown
�r-,nrlt'_l�'__1�� ---
in.from to ft. ❑Yes ❑No ❑Yes ❑No
: ,
in.from to ft. ❑Yes ❑No ❑Yes ❑No ❑Unknown
WELL OWNER'S NAME/COMPANY NAME SCREEWOPEN HOLE
��� t
Well owner's mailing adtlress it diMerent than property owner's address indicated above �reen from � to T`��� $. Open HOIe from t0 ft.
OBSTRUCTIONS
��Rods/Drop Pipe ❑Chedc Valve(s) ❑Debris ]FII ❑No Obstruction
'"!-- / �
Type of Obstructlons(Describe) /iL�/(,/F�� �^T,�i� `7''" i"�[�`�'�"���
GEOLOGICAL MATERIAL COLOR HFORMATONR FROM TO Obstructions removed? Yes ❑No Describe
If rwt known,indicate eslimated formation I irom nea PUMP „
og rby well or boring- -, �i h ,,,�
,,.'",� i���� �, f } TYPe ��(' i U t� 1�-�
'� � � �Removed ❑Not Present ❑Other
METHOD USED TO SEAL ANNULAR SPACE BETWEEN 2 CASINGS,OR CASING AND BORE HOLE:
No Annular Space Exists ❑Annular Space Grouted with Tremie Pipe ❑Casing Perforation/Removal
in.from to ft. ❑Pedorated ❑Removed
in.from to tt. ❑Periorated ❑Removed
Type of Pertorator
VAFiIANCE
Was a variance granted from the MDH for this well? �Yes p No TN#
GROUTING MATERIAL(S) (One bag ot cement=94 Ibs.,one bag oi bentonite=50 ibs.)
9 �ff--•:_`i. � .. ,�.� `Y r p
Groutin Material t`:^-;`i i��,:'Ifrom to " f ft. yards � bags
from to ft. yards bags
from to ft. yards bags
OTHER WELLS AND BORINGS
REMARKS,SOURCE OF DATA,DIFFICULTIES IN SEALING Other unsealed and unused well or boring on property? ❑Yes No How many?
LICENSED OR REGISTERED CONTHACTOR CERTIFICATION
This well or boring was sealed in accordance with Minnesota Rules,Chapter 4725.The information contained in this report
is true to the best of my knawledge.
�.- '� ��_l,., :�s
Licensee Business Name License or Registration No.
� 7`-T`���/-•yf. .._..� i '.
(o,—L.:• _-J �4 �'.�
iCertified Representative Signature Certi(ed Rep.No. , Date
_ � . i
IMPORTANT-FILE WfTH PROPERTY H •� ;! "� F f� � '� `:{,,�,.,_., '"-, i.`z.,�, _
.._`��,--�.
PAPERS-WELL OYVNER COPY "�' "� �-►_�f`t ^ Name ol Person Sealing Well or Bonng
HE-01434-14 ID#53159 5/13R
M I N N E 5 0 T A Minnesota Department of Health SEALING NOTICE VERIFICATION
' Wep Management Section
P.O.Box 64975 This is to verify that this office received a notification on 8/9/2016 that a well
St.Paul,Minnesota 55164-0975 (Minnesota Unique Well No. H000341643) is to be sealed by
DEPARTMENTo1HEALTH �6���201-4600or 1-800-383-9808 DON STODOLA WELL DRILLING, INC. at:
Well or Boring Location Address: 1700 BOHNS POINT ROAD ORONO
Location: County Hennepin Township Name ORONO No. 117 Range 23 Section 16 NW
This well must be sealed in accordance with the Minnesota Rules on Wells and Borings.
MDH staff may be on site to inspect the well sealing.
DIRT DEVELOPMENT SERVICES, LLC
6447 SUNSET TRAIL
GREENFIELD, MN 55357
M,� NNEHAHA CREEK � WATERSHED DISTRICT
QUALITY OF WATER �=� QUALITY OF LIFE
Fursuant to Minnesota Statutes Chapter 103D, and on the basis of statements and information
contained in the permit application, correspondence, plans, maps, and all other supporting data
submitted by the applicant, and made a part hereof by reference, PERMISSION IS HEREBY
GRANTED to the applicant named below for use and development of land in the Minnehaha
Creek Watershed District.
��,rn� ?-bt�o -b(Oo�
Issued to: Peter Santrach Permit No: 16-439
Location: 1700 Bohns Point Rd Orono
Purpose: Erosion Control. Sinqle Family Home
Date of Issuance: 8/12/2016 D te of Ex ir ti n: 8/12/2017
(
B d r of the Bo d of ana rs
orkin
P itting Technician
,�
This permit is not transferable without District approval, and� valid to the date of expiration. No
activity is authorized beyond the expiration date. If the permi ee requires more time to complete
the project, an application for renewal of the permit must be received by the District at least 30
days before expiration.
The applicant is responsible for compliance with all District Rules and for the action of their
representatives, contractors, and employees.
Conditions: Project to be completed as described in plans submitted to the
MCWD office on August 9, 2016 according to the provisions of this permit.
• Properly install and maintain all erosion control measures as needed, until
the disturbed areas are re-stabilized
• When the site is re-stabilized and MCWD staff have performed a final
inspection, all perimeter control must be removed
(Statement concerning fees for inspections, violations, etc... on following page)
We collaborate with public and private partners to protect and improve land and water for current and future generations.
............................................................................................................................................................................ ........
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15320 Minnetonka Boulevard,Minnetonka,MN 55345 • (952)471-0590 • Fax:(952)471-0682 • www.minnehahacreek.org
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WATER RESOURCE P�RMIT APPLICATION ORM
Use this form to notify/apply to the Minnehaha Creek Watershed District(MCWD)of a propo ro�ect or work which may fall withi
their jurisdiction.Fill out this form completely and submit with your site plan, ��cta tathe MCyV_D at;
15320 Minnetonka Blvd.Minnetonka,MN 55345. �------
Keep a copy for your records.
YOU MUST OBTAIN ALL REQUIRED AUTHOWZATIONS BEFORE BEGINNING WORK.
1. Name of each property owner: Peter Santrach
Mailing Address: 222 Hennipen Ave S#407 C�ty; Minneapolis State: MN Zlp; 55401
Email Address: Phone: 651-303-3810 Fax:
2. Property Owner Representative Information (not required) (licensed contractor, architect, engineer, etc...)
Business Name: Dirt Devils Services, LLC Representative Name: �ared Stotts
Business Address: 6447 Sunset Trail C�tY: Loretto State: MN Zip; 55357
Email Address: dirtdevilsservices@yahoo.com Phone: 612-366-4876 Fax:�63-498-7825
3. Project Address: 1700 Bohns Point RD City: Orno
State: MN Zip: 55391 Qtr Section(s): Section(s): Township(s): Range(s):
Lot: Block: Subdivision: pID; 1611723220003
4. Size of project parcel (square feet or acres): •63 acres 27,249 sq ft
Ac•ea of disturbance (syuare feet): •4 acres Volume of excavation/fill (cubic yards):100
Area of existing impervious surface: Area of proposed impervious surface:
Length of shoreline affected (feet): Waterbody (&bay if applicable):
5. Type of permit being applied for(Check all that apply):
� EROSION CONTROL ❑ WATERBODY CROSSINGS/STRUCTURES
❑ FLOODPLAIN ALTERATION ❑ STORMWATER MANAGEMENT
O WETLAND PROTECTION ❑ APPROPRIATIONS
❑ DREDGING ❑ ILLICIT DISCHARGE
❑ SHORELINE/STREAMBANK STABILIZATION
6. Project purpose(Check all that apply):
❑ SINGLE FAMILY HOME � MULTI FAMILY RESIDENTIAL(apartments)
❑ ROAD CONSTRUCTION � COMMERCIAL or INSTITUTIONAL
❑ UTiI.,ITIES ❑ SUBDIVISIONS (include number of lots)
❑ DREDGING ❑ LANDSCAPING(pools,berms,etc.)
❑ SHORELINE/STREAMBANK STABILIZATION � OTHER(DESCRIBE): ;�-�� i'. t ,,„
7.NPDES/SDS General Stormwater Permit Number(if applicable):
8. Waterbody receiving runoff from site:Lake Minnetonka
9. Project Timeline: Start Date: ASAP Completion Date:8/31/2016
Permits have been applied for: City, ❑County �MN Pollution Control Agency �DNR �COE ❑
Permits have been received: City—�County�MN Pollution Control Agency—�DNR�COE—�
By signing below,I hereby request a permit to authorize the activities described herein. I certify that I am familiar with MCWD
Rules and that the proposed activity will be conducted in compliance with these Rules.I am familiar with the information
contained in this application and,to the best of my knowledge and belief,all information is t�•ue,complete and accurate. I
understand that proceeding with work before all required authorizations are obtained may be subject to federal,state and/or local
adr�i trative,civ �dfe;criminal penalties.
�� �--�
's�� _���— �
Signature of Each Property Owner Date
i<c�� i�.,�rl i,�I_�.�i_ ��:�.:��_� 1 t�t� i
Received
AUG 0 9 2016
EROSION CONTROL SUPPLEMENTAL INFORMAT ON FORM
���.
INSPECTION PLAN REQUIREMENTS
1. Routine Inspections:
• Once every seven days during active construction
• Within 24 hours of a half inch or more precipitation
2. Completed Field Inspection Reports:
• Reports available within 24 hours ofrequest until MCWD determines project is complete&
stabilized
Failure to submit r•eguested inspection inforrnation will result in a site inspection and may be subject to
reimbursement for MCWD staff time.
Who will inspect your site regutarly'!
NAME: �v,r r J .� �v•}'�S ORGANIZATION: ( r�- �t�s►��
IU' S P�v'--�'1
PHONE: �!�"���� � y� r� ALTERNATE PHONE:
EMAIL: `} ;�`����llj�(°�J'(-('S� %iOl�1U�� , c:-.'r►'1
Where is the concrete washout location?
❑ OFF SITE OR CONTAINED ON TRUCK
❑ INDICATED ON SITE PLAN(with required impe�meable liner)
� N/A
What is the final stabilization method?
(seed,sod,etc.): 5 oc�
6 inches of topsoil must be added/replaced prior to final stabilization
Will protective fencing for retained vegetation be installed?
❑ YES
C� NOT APPLICABLE
❑ OTHER(describe)
I certify that I am familiar with the requirements of the MCWD Erosion Control Rule and that the
pro acti 'ty will be conducted in compliance with this rule.
� `�� lb
Signa re of Applicant or Authorized Agent Date
MINNEHAHA CREEK
WATERSHED DISTRICT
OUAl1TY Of WAiER.OUALITY OF LIFE
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. , , Page 1 of 2
MINNEHAHA CREEK WATERSHED DISTRI
15320 MINNETONKA BLVD
MINNETONKA, MN 55395
952-471-0590
MINNEHAHA CREEK WATERSHED DIST
0010050008028397774067
Date: 08/09/2016 01:35:23 PM
CREDIT CARD SALE
°ISA hns �b��.+ �d.
CARD NUMBER: **********6009 S `� vO B�
TRAN AMOUNT: $10.00
APPROVAL CD: 583938 �rO�,O
RECORD #: 000
CLERK ID: chris
� ,,�I y' •�',�—
.�''�,�1 � � �I,�� -%'
�� j �
;r
JARED STOTTS
I AGREE TO PAY THE ABOVE TOTAL AMOUNT
ACCORDING TO THE CARD ISSUER AGREEMENT
(MERCHANT AGREEMENT IF CREDIT VOUCHER)
Merchant Copy
httn��//www.mvvi rt,�a 1 m erchant.c�mNirtual Merchant/transacti on.do?di snatchMethod=nrint... 8/9/2016
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b� �zo:o;--... I � � � '�;r��� �� �� '' �� \� \ 1�1 That part of Lot 3,
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96 � � � � described as follows:
�a, `" �. : t�^ � .: ,�'�,i ` �zo Y ` �\ �� ` � �'; a� (ine of Lot 11 in sai
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f � o ARBORVIT�AE HEDGE �H� — � � � part of the Westerly
�•. � 'I
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! � 1 ,d S J \ � ` 1 1 � � � I a I I in said "Auditor' s S
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� /^ __ �___ _, �_� � ` � ` xI � deed Doc. No. 3166�
/� / r•-•� PROPERTY IS VACANT ��\ �` 1` 11 � �' I � • : denote:
�oes.e) / � / (aeo.i>�/ ��i .
.... �ose.,>l � � � � � ��
` � � � � � (908.3) : denote:
1 I I I �__. I '' �� . ,,.,..,,�„
� - � ��- ►/
p _�� TIME
CITY OF ORONO CALLED IN -
INSPECTION OTICE scHEDULED - —
PERMIT NO�(�, olCY�7 C MPLETED
ADDRESS � 76D � .'R;��S � +�Y
�NNER - TELEpHONE NO. l�� 7�
CONTRACTOR �
� DESCRIPTION �� - l
ty ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL
Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLINO
O ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL
Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION
Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ RATED WALLS
� ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT
a ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP
W ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL
_
J ❑ DEMO-SITE ❑ SEPTIC iNSTALL
i OMfNERICOf�ITRACTOR TO MEET Y�OIl:_YE$_NO
� COMMENI''�
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�`�TISFACTORY:PFiOCEED ❑PROJECT COMPLETE
W ❑CORRECT WORK a PROCEED ❑ISSUE CEATIFICATE OF OC(XJPYINCY
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPOFiARY
V BEFORE Cd1/ERINO PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. p pHpTO TAKEN
INSPECTOR WFLI RETURN
❑STOP ORDER POSTED.CALL INSPECTOR �GTATION ISSUED
❑INSPECTION RE(]UIRED.CALL TO ARRANGE ACCESS.
Cab tor the next inspectfon 24 hours in advance. (g52) 249-4600
Owr�e�fContractor on site:
Inspector: � �r�- ��
Whit opYAnspecM�'s Fib Can�ry CopyfSib Notia
�� V
� f
DATE TIME
CITY OF ORONO CALLED IN --���
INSPECTION NOTIC� �.�CHEDULED
PERMIT NO. �-�- ��'� �/��'/cOMPLETED
ADDRESS s 7� �' �'�'l�/� 7 1�t��r�� rC_ �
OWNER TELEPHONE NO.`���� ���'`y�`���
CONTRACTOR 1����� CI k-V� I �-f�t V 1 C �'S
� DESCRIPTION �mC� ���a �
W ❑ FOOTING �EMO-FINAL ❑ SEPTIC FINAL
� ❑ 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 ❑ RATED WALLS
� ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT
Q ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP
W ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL
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v ❑ DEMO-SITE ❑ SEPTIC INSTALL
2 OWNERlCONITRACTOR TO MEET YOU:_YE3_NO
v�i COMMENTS:
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W J�WORK SATISFACTORY:PROCEED PROJECT COMPLETE
W �O CORRECT WORK 6 PROCEED �ISSUE CERTIFICATE OF OCCUPANCY
0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFOREC01/ERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTO TAKEN
INSPECTOFi WILL RETURN
❑CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (952) 249-46��
OwnedContractor on site:
Inspector. ����'��� G '
White Copyllnspector's Ffle Cenary CopylSMe Noties