HomeMy WebLinkAbout1991-003628 - demo PERMIT
� !� OF ORONO PERMIT TYPE: T. �, r _.
' rown Rd. South • P.O. Box 66 �'��-�-`_�''��'
Permit Number: �,!_=.;i_�.;=;
�rystal Bay, Minnesota 55323 ' Date Issued: �y,�j;�.�;,j���
(612) 473-7357
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AP L.ICANT ER ITEE SIGNATURE ISSUED BY SIGNATURE
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CITY OF ORONO APPLICATION FOR DEIKOLITION PSR1rIIT
P.O. Box 66 (1335 So Brown Rd)
Crystal Bay, MN 55323
SPECIAL CONDITIONS & HOLD HARMLESS AGREEMENT
*****�*:***t**�**�*******:*******��*�**�*��*��**#*:**:***:�***��**:***�**�
General Instructions
1. You may be required to obtain other permits, i.e. burning, well
abandonmment, etc.
2. Work 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.
�***�***�:*:*:****t****:�**:*��t�:*�*�:****:********:t��:*�#t*:::*:********
JOB SITB ADDRESS: ��6� ���K?��J�.EvI (..-��.1£
Occupancy Type: �_Residential Commercia
OWNER'S NAME: �0�,2 r� c�sc�p Phone: �t-1z-•�728
Mailing Address: S(� TN�.A,�/�vJ (�E City:
CONTRACTOR'S NAI�D?:�'�:EC--��Z�E {-�� -�--r.icr Bus. No. : �15• I 84�
Mailing Address: 3zs ��cc�,� �� o�-T� City: i,���po�-�� S�4p
*�:***:��#***:**t*t****�**t:t******:*�:�t**�**�:****�*********�*#* *****::* �
Demolition if planned by means of: manual disassembly �heavy equipment
burning (by fire department)
Permits Issued:
# Burning Fire Department
# Well Abandonment
In return for issuance of said Demolition 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 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).
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8. 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.
�*�*�*�*******:***:*#******�*�:***:*****�:**�::***:**�*�*t*��*�t*:*�:******
PERIrIIT TYPE AND F$E CALCDI.ATION
$50. 00 Principal Structure
$30.00 Accessory Structure
1. Subtotal of above permit requested $
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.
SIGNATIIRE OF APPLICANT: - Date: ' � '
DATE �/ TIME
CITY OF ORONO CALLED IN
iNSPECTION NOTICE SCHEDULED " �-9� � k --�
PERMIT NO. -�� '' '� COMPLETED l( N
ADDRESS �`[:���%' ' /�t.�G�c1(-�v C Cfv--�
OWNER��r �,�C�_ CONTR.
TELEPHONE NO. _ ���d'�/�r�
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� DESCRIPTION �--��'� `- ��'-�1�_'✓ ��S C`c.���
� 01 FOOTING 11 MECHANICAL RI 16 WELLTEST PUMP
Q 02 FRAMING 11 MECHANICAL FINAL 18 EXCAVIGRADINGIFILLING
y 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 19 LAKESHOREIWETLANDS
� 04 WALL BD. 12 WATER HOOK-UP 34 TREE REMOVAL
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Q �INAL 13 METER SET/TURN ON 17 SITE INSPECTION
� 07 DEMO—SITE 14 SEWER HOOK-UP O6 PROGRESS
� 07 DEMO—FINAL 27 SEPTIC MAINT. 21 COMPLAINT
? 09 PLUMBING RI 15 SEPTIC INSTALL. 22 FOLLOW-UP
J 10 PLUMBING FINAL 23 SEPTIC FINAL
� OWNERICONTRACTOR TO NJ�ET YOU:_YES_NO
� COMMENTS: �-� '�-��l"1� � �'�� �� c?�a �Z c
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� �WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE
W ❑ CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
O C CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING pERMANENT
�CORRECT UNSAFE CONDITION WITHIN HOURS. r� pHOTO TAKEN
�NSPECTOR WILL REfURN
❑STOP ORDER POSTED.CALL INSPECTOR �. CITATION ISSUED
G INSPECTIONREQUIRED.CALLTOARRANGEACCESS.
Call for the next inspection 24 hours in advance.473-73�J7
OwnerlContra tor n site:
Inspector.
White Copy/lnspec or's File Canary CopylSite Notice