HomeMy WebLinkAbout2014-01159 - demo CITY OF ORONO * 2 0 1 4 - 0 1 1 5 9
2750 KELLEY PARKWAY DATE ISSUED: 10/08/2014
ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 3035 CASCO POINT RD
PIN 20-117-23-34-0001
LEGAL DESC REG. LAND SURVEY NO. 0394
LOT 000 BLOCK 000
PERMIT TYPE : DEMOLITION
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE DEMO-ACCESSORY STRUCTURE
ACTIVITY : 329-STRUCTURES OTHER THAN BUILDINGS
NOTE: DECK DEMO
APPLICANT DEMOLITION-ACCESSORY STRUCTURE 50.00
DIETZ BUILDERS LLC STATE SURCHARGE DEMO 5.00
29315 451ST AVENUE TOTAL 55.00
GAYLORD, MN 55334- Payment(s)
(507)381-8554 CREDIT CARD 0538 55.00
Minnesota State License#: BUIL-20634396
OWNER
HULBERT,JAY
3035 CASCO POINT RD
WAYZATA, MN 55391-
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 grant 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 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 ma}�be
revoked at any time for du,
Applicant Permitee ignaturc -- bate _ 7P 1ssue By ature Date
�O TO City of Orono FOit
?CT)FY JjSE ONLY �1,5-4?1,5-4?1 V P.O. Box 66 Date Received Permit# /
2750 Kelley Parkway /��� �``
Crystal Bay, MN 55323 Amount: S. S. 00 SAC Credit: /y/A
(952)249-4600
Homeowner(s)Signed: ❑Yes Cd&W
Resolutions(if any)Signed:❑Yes L2.None Required
tgkFSH��� Zoning Disclosure Signed: ❑Yes ZNonc Required
CITY OF ORONO - DEMOLITION PERMIT
(All permits must be approved by the Building Official and/or Zoning Department)
Job Site / Owner Information: i
Type: residential ❑ Commercial
Sit,z 1.juress:
Owner: Mailing Mailing Address: 30 `"' �
City: Zip:
Phone: (6I Z - Z 72 -2?3-2 Email:
Contractor/Applicant Information:
Contractor/App.: �� 2,01" lael--5 Contact Person: N► �`
Address: oS�_��,-� !f A-(2-- State License #: -631/3 96
City: Zip: X334-1 Expiration IDate: r 3 3l !S
Phone: Email: N1; � U-. ��e �c�wwr'•c�k_%-
SPECIAL CONDITIONS & HOLD HARMLESS AGREEMENT
General Instructions:
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
fff
E)( 15)IN(o DF—e- Y, 0NQ;
Permit(s) Issued. ❑ Sewer Disconnection ❑ Well Abandonment
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.
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 actuatly under construction).
12. Abandon septic systems per Minnesota Rules Chapter 7080. Ali septic tanks must be pumped,
crushed and filled with dative 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
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
F] $75.00 — Principal Structure $
$50.00 —Accessory Structure x _(how many) 5�► e
1. Subtotal of above permit requested $
2. State Surcharge 5.00
3. TOTAL PERMIT FEE (add lines 1-2 above) $ 570. S 0
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:
Owner's Signature: ( Date:
Approved By: Date: 16 ^g^
(Gluilding Official)
* Zoning Disclosure Required? ❑ YES NO
"This must be filled out by Zoning Department— For eiffer answer, a Zoning Official must sign all applications.
* Approved By: /J/A Date:
(Zoning Official)
DATE TIME
CITY OF ORONO CALLED IN
INSPECTION[JOT�CE SCHEDULED `� —�C
" PERMIT NO.G� 4 `J� � � COMPLETED
ADDRESS �J�� � C._ ��SC"` C> P`-�. �
OWNER TELEPHONE NO.�'�" 3�1-��
CONTRACTOR � I�-I Z g I�r 5
� DESCRIPTION ���L� � � � � '
lt� ❑ 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
Q ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP
_ ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ HARD COVER REMOVAL
J ❑ DEMO-SITE ❑ SEPTIC INSTALL ❑ FOUNDATION/REMOVAL
2 OWNERICONTiiACTOR TO MEET YOU:_YES_NO
WCOMMENTS: ��_: C�� � � _�Y��_�I ( G'l . 7�;��
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GW O WORK SATISFACTORY:PROCEED OJECT COMPLEfE
� ❑CORRECT WORK&PROCEED ❑ UE CERTIFICATE OF OCCUPANCY
W
O G CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. ❑ pHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (9 2� 249-46�0
OwnerlContractor on site: ! — "
Inspector.
White CopyRnspector's File � Canary CopylSite Notiee
• CITY OF ORONO PERMIT NO.: 2014-01159
`: 2750 KELLEY PARKWAY
�� '� DATE 1SSUED: 10/08/2014
ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
' ADDRESS : 3035 CASCO POINT RD PERMIT APPLICANT:
PIN : 20-117-23-34-0001 DIETZ BUILDERS LLC
LEGAL DESC : REG.LAND SURVEY NO. 0394 29315 451 ST AVENUE
: LOT 000 BLOCK 000 GAYLORD,MN 55334-
PERMIT TYPE : DEMOLITION
PROPERTY TYPE : RESIDENTIAL (507)38]-8554
CONSTRUCTION TYPE : DEMO-ACCESSORY STRUCTURE
ACTIVI7'Y : 329-STRUCTURES OTHER THAN BUII
DECK DEMO
BUILDING INSPECTION RECORD
48 HOUR NOTICE REQUIRED FOR ALL INSPECTIONS.
CALL FOR INSPECTIONS WEEKDAYS:
CONSTRUCTION HOURS: 7am-8pm Weekdays& 8am-8pm Weekends& Holidays
- INSPECTION TYPE DATE INSPECTOR DATE INSPECTOR
FINAL ,z
� INSPECTION COMMENTS:
'IN ACCORDANCE WITH CITY ORDINANCE,NEW OR SUBSTANTIALLY REMODELED BUILDINGS SHALL NOT BE UCCUPIED UNTIL ALL
WORK HAS BEEN APPROVED,AND A CERTIFICATE OF OCCUPANCY HAS BEEN ISSUED BY THE BUILDING DEPARTMENT.
THIS CARD MUST BE POSTED AND VISIBLE AT ALL TIMES UNTIL WORK IS COMPLETE.