HomeMy WebLinkAbout2004-P07933 - demo ' PERMIT
CITY OF �RONO Permit Number:
2750 Kelley Parkway- PO Box 66 P07933
Crystal Bay, Minnesota 55323 Permit Type: Demot�t�on
(952) 249-4600 Date Issued: 9n��2ooa
SITE ADDRESS: 4475 Forest Lake Landing
Mound,MN 55364
PI D: 07-117-23-24-0023
DESCRI PTION:
Proposed Use: Residential
Permit Class: Building
Census Code 645
Permit Type: Demolition Permit Sub-type(s): Demo-Principal Structure
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
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m zst be abondoned. Insnection before backfilline.
FEE SUMMARY: Permit Fee: $ 50.00 Valuation: $ 0.00
State Surcharge Fee: $ 0.50
TOTAL FEE: $ 50.50
APPLICANT: Owner/Self OWNER: Jon&Gail Blackstone
M� 4475 Forest Lake Landing
Mound,MN 55364
THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED
AND AGREES TO DO ALL WORK IN STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF
MINNESOTA BUILDING CODE REQUIREMENTS.
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APPLICA T PERMITEE SIGNATURE SUED BY SIGNATURE
Conies: 1-File(SiQnitures Required), 1-Apvlicant, 1-Monthlv Reports, 1-Assessin�, 1-Finance Page 1
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CITY OF ORONO APPLICATION FOR DEMOLITION PERMIT
P.O. Box 66 (2750 Kelley Parkway)
Crystal Bay, NIN 55323
SPECIAL CONDITIONS & HOLD HARMLESS AGREEMENT
General Instructions
1. You may be required to obtain other permits, i.e. well abandoiunment, etc.
2. Work inust not begin unless the perinit card is available on the job site.
3. A 24 hour notice is required for all inspections. Call (612) 249-4600.
JOBSITEADDRESS: �y7J ��,�sf Lakz La��'��s , (�1�0� �
Occupancy Type: �Residential Commercia�
OWNER'S NAME: �vv� t- �t�( � (',t ,��, Phone: 9so� ' �}�o7"�.Sc�S
Mailing Address: ' ` re rc, City:�rD� v
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CONTRACTOR'SNAME: �-ti1a�'IL �J'C��►'►�� EX�S�us� ���
Mailing Address: City:
Demolition if planned by means of: manual disassembly �o�er� �jcc,t/Sivr� F!�
heavy equipment ✓ol�hft'�/'T/`arlh����
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Permits Issued:
#�Well Abandonment
In return for issuance of said Deinolition Permit, the undersigned owner hereby 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 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
' with an excavation filled with earth level with
site shall be left clean and clear of all debris, y
und elevation exce t when such excavation is to be used as art of a new
the ad�acent gro ( p P
building and such new building is actually under construction).
� 8. The undersigned owner shall and hereby does indemnify and hold harmless the City of
Orono, its agents, employees and assigns froin and against all claims, damages, losses or
expenses,including attorney fees,against the City,its agents,employees and assigns arising
out of or resultin from the demolition described herein as performed by the property owner,
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his employees, agents, subcontractors or assigns.
9. Septic systeins must be abandoned per Minnesota Rules Chapter 7080. All septic tanks must
be puinped,crushed and filled with native soils. An inspection is required after the tanks are
pumped and before the tanks are crushed and filled.
PERMIT TYPE AND FEE CALCULATION
�
$50.00 - Principal Structure
$30.00 - Accessory Structure
1. Subtotal of above permit requested � �� D U
2. State Surcharge $ .50
3. TOTAL PERMIT FEE (add lines 1-2 above) $ `��• '��
The undersigned hereby applies to the City of Orono for issuance of a Demolition Permit, agrees to
do all work in 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:
OWNER'S SIGNATURE: ,�,���"]1��'.P��e�n�.C� Date: � � _
�
APPROVEDBY: Date: 9 - l0 - o�-(
/ \ 1111innesota l�ollution Control /� enc
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October 4, 1996
Dear Sir/Madam:
The Minnesota Pollution Control Agency (MPCA) is writing to request assistance in informing
the general public of federal regulations and state rules regarding demolition projects. Recently
MPCA staff have enc;ountered numerous instances in which a demolition contractor had obtained
a permit from a city c�r county office and commenced the demolition unaware of the state and
federal rules and regtilations governing demolitions. Often contractors believe that by obtaining
a city or county demc�lition permit they have satisfied all requirements.
In an effort to addres:� this problem, the MPCA would appreciate it if you could hand out the
enclosed documents �ilong with your demolition permits. If the demolition permit applicants
have additional questions, please ask them to contact the MPCA Asbestos Team at the telephone
numbers listed below. The MPCA is aware that many cities may already supply contractors with
this information and �Ne appreciate your efforts.
Phone Numbers
(612)296-7300 or 1-(300)857-3864
Enclosures
520 Lafayette Rd. N.; St. Paul, MN 55155-4194; (612)296-6300 (voice); (612)282-5332 (TTY)
Regional Offices: Duluth •Brainerd• Detroit Lakes• Marshall • Rochester
Equal Opportunity Employer•Printed on recycled paper containing at least 10%fibers from paper recycled by consumers.
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Guidance o�.�n�ranmen�al �oi�cerns A,�socia�ec�; ,
� with �uilc�ing �1ema�itrQn
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�'o�luE�vn Contz-o� 04t18�96.:::; ;
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This document offers guidance on environmental concerns that need to be addressed prior to the
demolition of a building. The environmental concerns include: asbestos, hazardous wastes, special
hazardous wastes, underground storage tanks,wells, refrigerants/CFCs/HCFCs, fire extinguishers,
and other concerns. This document also includes guidance on what kinds of waste can and cannot
be accepted at a demolition landfill.
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' ; ` <=4.�BES'T�S ;......
Asbestos-Containing Material (AC1Vn is a special consideration in the demolition of old buildings.
Through the 1970s asbestos �vas used in over 3000 different building materials. Some of the more
common materials are:
♦ pipe, duct, and boiler insulation (includes many different types of AC1Vn
♦ ceiling tiles, textured spray, fireproofing, scratch coats or other treated areas
♦ cement asbestos board: also l:uown as Transite0, this material was used estensively as siding on
homes, ceilings and walls in commercial buildings, and any area where heat or moisture is
present.
♦ vinyl asbestos floor tile, old linoleum, and other resilient floor coverings
ACM can be found almost anywhere and a thorough inspection for ACM must be performed prior
to any demolition. The MPCA Air Quality Division Asbestos Team maintains a list of companies
that can perform this service for you. You can reach the Asbestos Team at the phone number
belo�v. --
In a demolition a notification form must be filled out and sent to the MPCA Asbestos Team ten
working days before any demolition is started whether the building contains ACM or not. If you
don't have this form, contact the Asbestos Team. The Notification form for a demolition contains
specific information on the dates of demolition and on the different types of ACM and conditions
for ho�v the ACM needs to be handled if ACM is present.
If any of the demolition materials are to be recycled it is necessary to remove any ACNI that may be
present. The recycling process could result in previously resilient AC�I becoming crushed,
crumbled, or reduced to a powder. If the ACM is not removed prior to demolition then the
building materials containing, mired in `vith, or coated with ACM may not be used for recycle.
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Hazardous Waste is any waste that displays one or more of the following characteristics:
• Ignitable (will ignite at less than 140° F), solvents, petroleum products, thinners
• Corrosiv�(pH of 2 or less or 12.5 or more), concrete cleaner, paint stripper, bleach
• Toxic Characteristic Leaching Procedure (TCLP) a test to determine if a material will leak
heavy metals or other toxic materials
� Reactive, examples include carbides, sodium hydrosulfide, magnesium, potassium
Hazardous Wastes must be removed prior to demolition and can not be disposed of at a demolition
or sanitary landfill. If you identify any containers or materials that you believe may be hazardous
you must have them tested before proceeding. If you have any question please contact the MPCA
Hazardous Waste Division at the number below.
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SF��IAL�-IA�ARDOT,�S W,AS�'E5'. '
Special Hazardous Wastes are materials that may not meet the above requirements but have been
given special consideration because of their specific properties. The following is a list of special
waste types and the materials in which you might find them. Special Hazardous Wastes must be
identified and removed prior to demolition.
♦ Dry Cell Batteries (button, nickel cadmium, small lead acid rechargeable and other dry cells
♦ Antifreeze
♦ Circuit Boards (old electrical equipment)
♦ Polyclorinated Biphenyls (PCB) found in light ballasts, small capacitors in old appliances, and
transformer oils
♦ Mercury (fluorescent lamps, mercury switches, mercury vapor lamps, thermostat probes, metal
halide lamps, relays, high pressure sodium lamps, thermometers, neon lamps, thermostats,
manometers, and gauges). Many mercury containing materials we?-e ►�sed iu appliunc�s, oi-
industrial switches or controls.
If you have any questions regarding the identification, transport, or disposal of special hazardous
waste contact the Hazardous Waste Division at the phone number below.
,: :;: ; ' TI�I��It.GRQUND S`TO�tA.GE T,A.I�t�,S
In a demolition any underground storage tank (UST) must be identified and removed prior to
demolition. In most facilities the presence oi USTs wil! be l:nown from the types of operations
performed at the facility. The most common type of UST that you will be concerned with is old fuel
oil tanl:s that have been abandoned. The following are some clues as to hoFv to identify a potential
UST. •
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A site walkover may provide clues as to the presence of an abandoned UST. Heating oil tanks
_ usually exhibit spillage during filling, especially if the tank is old and has been filled repeatedly over
a number of years. Staining of the soil with or without the characteristic odor of fuel oil may be an
indicator of the presence of an abandoned fuel oil tank. If the soil appears to be undisturbed, check
for the presence of a fill pipe or a fill pipe that may have been cut off below ground level and
covered over.
Fuel oil tanks are generally buried near the foundation of the building. Check the basement of the
structure for the placement of the furnace and any piping to an outside wall that may remain. If
the piping has been removed, look for a hole or patched hole in the wall in the general vicinity of the
furnace or the area where the furnace once resided. The fuel oil tank, if present, should be on the
other side of the wall, near the foundation. Fuel oil tanl:s of greater than 1,100 gallons capacity
should be registered by the tank owner with the MPCA. Contact the Tanks and Emergency
Response Section at (612) 297-8679 to see if there is any information that indicates the presence or
former presence of a tank at this site.
USTs are generally buried 36"-42" below ground. Metal detection devices such as those used by
NSP to locate metal gas lines and electrical�vires may be capable of detecting the presence of an
UST if it isn't buried too deep.
Soil borings in an area of the site suspected to contain an UST can be conducted, but this can be a
costly option. If the soil is sandy or othernise relatively porous, a metal rod may be driven into the
ground to a depth of 48" or so in areas suspected to contain a buried UST. Escavation may also be
an option, ho�vever, this is labor intensive, may be costly and will be disruptive of the integrity of
the site.
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The presence of unsealed wells is a concern in many older buildings. Any unsealed or improperly
sealed wells need to be identified and a licensed well contractor needs to be contacted to properly
seal the well(s). The following information includes some clues on how you might locate an
unsealed well and who to contact to learn more about them.
Locating unsealed wells is a combination of research and educated guesses. There are three areas
�vhere records of old wells may be located:
♦ Minnesota Geological Survey (612) 627-478�1,water well records by section, township and
range, and sometimes by address,
♦ Minnesota Department of Health Well Management Unit (612) 21�-0811, Pre-1990 the wells are
classified by year and the contractor that drilled the well,
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. City Inspections Department and local well contractors.
Another way in which to identify unsealed wells is to look for clues: some clues are: -
♦ windmills, usually would use wind power to draw water out of a well
♦ unaccounted for pipes or areas in the foundation where pipes used to run
♦ the building was constructed and occupied prior to municipal water being available to that area
♦ well pits or shacks
a magnetometer may be used to identify metallic objects within 3-4 feet underground
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I��RIG�RAN'TSI�CsfHC`F`�� ,;.
�CFCs (chlorofluorocarbons) and HCFCs (hydrochlorofluorocarbons) are man-made refrigerants
that destroy the ozone layer.
•CFCs and HCFCs must not be released into the atmos�here. These refrigerants must be
recovered by technicians certified by a U.S. EPA approved program using proper refrigerant
recovery equipment.
• Esamples of appliances that contain CFCs and HCFCs include:
♦ refrigerators ♦ dehumidifiers ♦ central air conditioners
♦ room air conditioners ♦ vending machines ♦ heat pumps
♦ freezers ♦ chillers ♦ ice machines
♦ food display cases ♦ water coolers
�Refrigerant substitutes (including HFC-134a) must also be recovered and not vented to the
atmosphere.
' < ' ��R:E �X�`T�T��SII�ER�
•Some fire estinguishers contain halons which destroy the ozone layer.
•Halons must be recaptured when recharging, servicing, or retirin�the unit. There are a number
of companies in Minnesota that have the proper halon recovery equi�r�Pnt.
•Halons cau be used as total flooding agents in areas such as computer rooms, libraries, spaces
floors, and near electronic and medical equipment.
•Halons are also found in some portable fire extinguishers.
Halon fire extinguishers must be removed from the facility prior to demolition.
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n���a��o��,�rrn���, Acc��r�.B��.�� �Aec�TA�r����asr�s
In the disposal of demolition debris, certain materials may or may not be acceptable at the
Demolition Land Disposal Facility (Demo LDF). Certain Demo LDFs have Industrial Solid `Vaste
Management Plans (ISWMP) that allow them, under special provisions, to accept some of the
following materials.
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� Acceptable Materials:
♦ dry�vall (demolition only) ♦ untreated wood ♦ ceramic fixtures
, ♦ plastic ♦ conduit ♦ glass
♦ insulation (fiberglass/cellulose) ♦ wiring ♦ roofing, shingles
♦ tile (ceramic, floor, vinyl) ♦ metal ♦ built-in cabinetry
♦ asphalt ♦ butiminous concrete ♦ masonry
♦ concrete (including rebar) ♦ masonry/bricks ♦ tree stumps
Burned out buildings: must be sure that no hazardous materials or asbestos-containing materials
remain and that the threat of smoldering or reigniting is controlled. Some Demo LDFs may not be
able to accept burnouts because of the potential for hazardous materials to be present. In addition
burnouts pose a serious threat of smoldering or reigniting at the landfill. Check with the Demo
LDF before brin�ing the material to the landfill
Unacceptable Materials:
♦ infectious waste (needles, body parts, dressings, etc. from hospitals, mortuaries, nursing homes)
♦ untreated sewage (sewage sludge, sludge compost, and septic tank pumpings)
♦ street sweepings (should be tested to determine if they are hazardous (TCLP))
♦ tires (compaction difficulties, floating effect, and waste landfill space)
♦ major appliances (all hazardous materials must be removed including mercury, PCBs, and
chlorofluorocarbon (CFC) refrigerant gas, commonly I:uown by the trade name FreonO
♦ yard waste (creates lecchate, gas, settlement problems, and wastes landfill space)
♦ household waste ♦ paint cans ♦ construction waste
♦ cardboard ♦ caulk tubes ♦ agricultural chemicals
♦ machinery or engine ♦ mattresses or ♦ treated lumber
parts furniture
♦ railroad ties
Some types of Industrial Waste may be accepted at a demo LDF depending on the individual
landfill's permit. Industrial`Vaste typically accepted at Demo LDFs includes,
♦ asbestos-containing materials
♦ construction waste that is the same as demolition waste, such as wood or insulation
If you have any questions about acceptance of any waste at a Demo LDF please contact your nearest
MPCA Solid Waste Specialist.
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' ' ° ` OT�ER ISS�S ;
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Other issues that may arise include local demolition permits, gas lines, and electrical connections.
The Gopher one-call can be used to identify gas lines. Also,you are reminded that for all `
demolitions, whether asbestos is present or not, the notification form must be sent to the MPCA
asbestos team.
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For more information about any of the above listed programs please feei free to contact the
individual program or call the MPCA at 1-800-6�7-3864.
Asbestos Team: (612) 297-86$5
Underground Storage Tanks: (612) 297-8679
Hazardous Waste: (612) 297-8511
Refrigerants/CFCs/HCFCs: (612) 297-71�3
Demolition Debris Disposal: 1-800-6�7-3864 (identify the location in question for the�proper region)
Minnesota Department of Health Well Nianagement Unit: (612) 2I�-p813.
This guidance document is not intended as a substitute for reading the rules or regulations and
making your own independent determination of its applicability to your demolition. Examples in
the guidance document do not represent an eshaustive listing of types of materials or projects to
which the rules or regulations might apply.
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� . Minnesota Pollution Control Agency
Notification of Intent to Perform a Demolition
� �� Type of Notification [ ) Original [ ] Amended ( ] Project Cancellation
I?emolition Contractor• Building Information:
Name: Building Name:
Address: Address/Location:
City,State,Zip:
City,State,ZiP� County:
Contact Person: � Phone Number(s):
Phone Number(s): Age of Bldg.(years): Size of Bldg.(sq.R.):
Number of Fioors Including Basement Level(s):
Building Owner: Present Use of Bid
g.:
Name: Prior Use of Bld
g.:
Address:
Dates when demolition or intentional burning
will Begin & End
City,State,Zip:
Notification must be postmarked or received ten(10)working days
Contact person: before demolition begins. 'See item#5 for emergency demotitions.
Phone Number(s): Both Beginning and Ending dates should be amended in writing as
necessary to reflect current project dates.
If there is>260 linear feet or>160 square feet of Regulated Asbestos-Containing Material (RAC1Vn in the building
to be demolished, it must be removed by a licensed asbestos contractor prior to demolition. The State of M'�1i -
Notice of Intent to Perform an Asbestos Abatement Project must be used to notify for the asbestos removal.
Is noofriable ACM present in the structure to be demolished ? [ ] YES [ ] NO
If YES complete items 1-9. If NO complete items 3-9.
1. If ACM will be left in place for the demolition indicate the amount of Category I and/or Category II
nonfriable ACM left in ptace.
Categ.I Linear Feet Cate II
g• Linear Feet
Square Feet Square Feet
Cubic Feet Cubic Feet
CateE�I nonfriable A M means asbestos-containing packings, Catepory II nonfriable ACM means any material,excluding
gaskets,resilient floor covering,and asphait roofing products Category I nonfriable ACM,containing more than one percent
containing more than one percent asbestos. asbestos that,when dry,cannot be crumbled,pulverized,or
"Category I nonfriable ACM is not ailowed to remain in place reduced to a powder by hand pressure.
for demolition if it is in poor condition. 'Category II nonfriable ACNI is not allowed to remain in piace
for demolition if it has a high probability of becoming crumbled,
pulverized,or reduced to a powder during demolition,transport,
or disposal. (es transite,cement,slate roofing)
2. Description & Location of ACM remaining in place (including floor# and room#):
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3. Company and/or individual that conducted the building inspection and the procedure used to d'etermine the i
presence or absence of ACM(including analytic method): 'Prior to demolition ali buildings must be inspected by an EPA
accredited inspector. �
4. Description of planned demolition and the specific method(s) that will be used:
5. If the demolition was ordered by a government agency, please identify the agency and attach a copy of the
order:
Name: Title: Authority:
Date of Order(M/D/Y): Date Ordered to Begin (M/D/'Y):
* Notification for an emergency demolition must be submitted as early as possible before demolition begins,but not later than the
folfowing working day. A demolition is considered an emergency ONLY when the facility has been deemed structurally unsound and
in danger of imminent collapse. If the structurally unsound building is known to contain any regulated ACN1 or is suspected to
contain any regulated ACNf,special procedures i�fUST be followed. If you are unaware of the special procedures,
instructions/regulations can be obtained by contacting the NIPCA at the address or phone number listed below.
6. Description of procedure to be followed in the event that unexpected RACN1 is found or Cat. II noofriable
ACM becomes crumbled, pulverized or reduced to powder:
7. Waste Transporter Information: 8. `Vaste Disposal Information:
Transported Name: �vV�Du1' �1�GL.� J�c�C(/✓` Landfill Name:�,�(�PY�S✓� �Jp �Q/'1f �l y L��
Transporter Contact: Owner/Operator:
Transporter Address: Address/Location:
City, State,Zip: City,State,Zip:
PhoneNumber:��c� ' /o�p�— � �3 PhoneNumber: ���— � [ U-��5_tJ
9. I certify that the above information is correct and I am a bonafide representative of the demolition
contractor or building owner and have authority to enter into agreements for my employer.
Signature of Contractor/Owner Date
Send or Fax to: For questions call:
Asbestos Coordinator-Air Quality Division 612-296-7300
MN Pollution Control Agency 1-800-657-3864
520 Lafayette Road North Far: 612-215-1593
St. Paul, MN 55155-4194