HomeMy WebLinkAbout1998-010761 - demo PERMIT
;� '�LITY OF ORONO PERMIT TYPE: -
2750 Kelley Parkway - P.O. Box 66 ="-'�=_f'��v`=�
Crystal Bay, Minnesota 55323 PermitNumber: :_;f;:;;:-,�
(612) 473-7357 Date Issued: ;-;��;•; �,;���;;;
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REMARKS:
FEE SUMMARY:
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APPLICANTPERMITEE SIGNATURE ISSUED BY:SIGNATURE �
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CITY OF ORONO APPLICATION FOR DEl�10LITION PER��IIT
P.O. Box 66 (2750 Kelley Parkway)
Crystal Bay, i��N 5�323 �
SPECIAL CO��ITIONS & HOLD HARiI�TI.ESS AGREEME\TT'
General Instructions
1. You may be required to obtain other permits, i.e. burn.inQ, well abandonmment, etc.
2. ti�'ork must not begin unless the permit card is available on the job site.
3. A 24 hour notice is required for all inspections. Call 473-7357.
JOB SITE r�iDDRESS: .3`7�'(j(�� FC�X �t�cG-t'
Occupancy Type: �_Residential Commercial
O`Y�'ER'S N��IE:�n N Y�.-L p Cs--- � QC.�.�� LJ Phone: CQ(Z.- � SZO-�S�/C�
Mailin� Address: 2[�, S � S h.o f�(� n� ��_ Ciry: W��, ���f-a S �3��
CONTRACTOR'S NA.iVIE: �m��-o.�c� '����r���.� Bus. No.: 3�i - c��3i
Nlailing Address: F�r���ca•..:�r tC��d, �� c'nQY�,��� City: ('f��„r,e���',5
Demolition if planned by means of: manual disassembly
heavy equipment
�_ burnin� (by fire department)
Permits Issued:
� Burning Fire Department
� Well Abandonment
In return for issuance of said Demolition Permit, the undersi�ned 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 reb lations.
6, Inspection required when all debris has been removed, before backfillizbg.
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7. Within � workin� 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 Qround elevation (except when such excavation is to be used as
part of a new buildin� and such new building is actually under construction).
8. The undersi�ned owner shall and hereby does indemnify and hold harmless the City of
Orono, its aaents, employees and assigns from and against all claims, damages, losses
or expenses, including attorney fees, against the City, its ajents, employees and assijns
arising out of or resultin� from the demolition described herein as performed by the
property owner, his employees, a�ents, subcontractors or assigns.
PERI�IIT TYPE AND FEE CALCULATION
DL $50.00 =�Principal Structure
$30.00 - Accessory S[ructure
1. Subtotal of above permit requested $
2. State Surcharje $ .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 Ciry and the regulations of the
State of Minnesota, and certifies that all statements made on this application are complete, true
and correct.
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APPLICANT'S SIGNA Date:
O`VNER'S SIGNATLTRE: Date: '�J � �
APPROVED BY: �. ���- Date: 4 '�S` ��
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