HomeMy WebLinkAbout2006-P10428 - demo "� PERMIT
C���Y OF ORONO
Permit Number:
2750 Kelley Parkway- PO Box 66 P10428
Crystal Bay, Minnesota 55323 Permit Type: Demolition
(952) 249-4600 Date Issued: l0/6/2006
SITE ADDRESS: 3250 Fox St Unit#
Long Lake,MN 55356
PID: OS-117-23-44-0012
DESCRIPTION:
Proposed Use: Residential Census Code 649
Permit Class: Building
Permit Type:
Demolition Permit Sub-type(s): Demo-Accessory Structure
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
Foundations/all demo debris to be removed from ground&disposed of off site per PCA regulations. Wells
must be abondoned. Inspection before backfilling.
FEE SUMMARY: Permit Fee: $ 30.00 Valuation: $ 0.00
State Surcharge Fee: $ 0.50
TOTAL FEE: $ 30.50
APPLICANT: Owner/Self OWNER: Martin Lueck&Mallory Mullins
NIN 3250 Fox St
Long Lake, MN 55356
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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APPLIC P R [T A URE � � �
SSUED BY SIGNATURE
Copies: 1-File(Signatures Required), 1-Applicant, 1-Monthly Reports, 1-Assessing,(If Septic, 1-Septic) Page 1
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CITY OF ORONO APPLICATION FOR DEMOLITION PERM�T
P.O. Box 66 (2750 Kelley Parlcway)
Crystal Bay, Miv 55323
SPECIAL CONDITIONS & HOLD HARivILESS AGREEMENT
General Instructions
1. You may be required to obtain other peinlits, i.e. we11 abandonment, etc.
2. Work must uot begin unless the perniit card is available on the job site.
3. A 24 l�our notice is required for all inspections. Call (952) 249-4600.
JOB SITE ADDRESS: �2 s� �X' �T.
Occupancy Type: Residential Commercial
O�divER'S NAME: MDU�'iY1 �� C(� +�G��►L( I��k���1S �.U��lione: a5a-'-�-'II-rI��' S5�5�p
Mailing Address: Po Q�D��� Clt�': �C'' l�
��1�1�'1�C'�'OR'S NAll�IE: Bus.No.:
Mailing Address: Ciry:
Demolition if planned by tneaus of: ✓mauual disassembly
✓ heavy equipment
Pern�its Issued:
# Well Abandonment
In return for issuance of said Demolition Peirnit, the undersigned owner hereby a�rees as follows:
l. The struchire(s) shall be kept enclosed and/or secured ttntil such time as demolition is
complete.
2. Demolition debris�vill be lcept off adjoinin�property and/or the public rights-of-way unles�
specific prior approval is obtained in writing for temporary use thereof.
3. F�undations sl�all be cmm�letely removed from the ground.
4. All demolition debris shall be completely disposed of off site in accordance �vit11 all
applicable PCA requirements.
5. Water wells must be abandoned in accordance with State Health Department re�ulations.
6. Se�ver and�vater must be disconnected at the seivices at the street by qualified contractors.
7, Inspection required �,��hen all debris has been removed, before backfillina.
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8. Within 5 working days of superstnicture 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 (ehcept when such excavation is to be used as part of a new
building and such new buildiug is acnlally under constniction).
9. The undersigned owner shall and hereby does indemnify and hold hannless the Ciry of
Orono, its agents, employees and assigns from and aQainst all claims, damages, losses or
expenses,including attorney fees,a�ainst the City,its agents,employees and assigns arising
out of or resultiiig from the demolition described herein as perfonned by the property owner,
his employees, agents, subcontractors or assigus.
10. Septic systems mustbe abandoned per Minnesota Rules Chapter 7080. All septic taulcs must
be pumped,crushed and filled with native soils. An inspection is required after the tai�lcs are
pumped and before the tanlcs are cnished and filled.
PERMIT 'I'YPE AND FEE CALCULATION
$50.00 - �rincipal Structure
;i�� $30.00 - Accessory Structure
1. Subtotal of above pernlit requested $ �G • v �
2. State Surcharge $ .50
3. TOTAL PERMIT FEE (add lines 1-2 above) $ �d . S`�
The undersigned hereby applies to the City of Orono for issuance of a Demolition Pennit,agrees to
do all worlc in strict aecordance with the ordinances of the Ciry and the regulations of the State of
Miruiesota,and certifies that all statements made on this application are complete,true and correct.
�,PPI�ICAN�''S SIGNA�'LTR]E: �G%���Ga ' � � /G o�i lO
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o��iv�it�ssl�1��'rU�: ��v lG� � �G'���
t4PPROVED��': ' Date: ( U-� —d �
(Buil ing Official)
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* This Must Be Filled Out By ZoninQ Department - For Either Answer, �1 Zonin2 Official i�-lusc SiQn ,411
Applications �
*�������3�': Date:
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