HomeMy WebLinkAbout2001-P03872 - demo � PERMIT
GpIT`� OF ORONO
2750 K�Iley Parkway - PO Box 66 Permit Number: Po3s�2
Cry��tal Bay, Minnesota 55323 Permit Type: Demo�ition
(952) 249-4600 Date Issued: 6�a�2ooi
SITE ADDRESS: 4iot Highwood Rd
Mound,MN 55364
���: 07-117-23-44-0013
DESCRIPTION: UBC Occupancy R3
Proposed Use: lcesidentiai
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 ast be abondoned. Inspection before backfilling.
FEE SUMMARY: Permit Fee: $ 50.00
Valuation: $ 0.00
State Surcharge Fee: $ 0.50
TOTAL FEE: $ 50.50
APPLICANT: Danberry Company OWNER: Gary L Germundsen
4410 Shoreline Dr 4101 Highwood Rd
Spring Park, MN 55384 Mound MN 55364
`I'HE 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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PP A � E 1 AT E ' ISSUEDBYSIGNATURE
Copies: City,Applicant,Assessor,Finance Page 1
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4 CITY QF ORONO APPLICATION FOR DEM4LITYON PERMIT
P.O. Box 66 (2750 Kelley Parlcwa�)
Crystal Bay, MN 55323
SPECIAL CONllITIONS &HOLD f�4itNII.,E55 AGI2EENIENT
GeneralInstructions ' � � � . .
1. You may be roquired to obtain other pennits,i.e,well abandonnarnent,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 inspectior�, Cal! 12) 249-4600,
JOB SITE ADDR�SS: '�� v � �� � �v� �� ,
Occupancy Type: T�Residential Co ereial
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OWNER'S NAME: �'�''�- ' �k� �••, -,�S� � Phone: (.4��••���� " ����S
Mailing Ad'dress: \��� r��.Z , �� � City: ��< F �. \ � ,�� .��.�
CONTRACTOR'S NAME:���� ���«��e� � ~� Bus,No.: ��`-%:-��_�1 ,7/ (� �� :��'
Mailing Address; �r ti v City:�� � Q,�.��(� tv�� �,�
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Demolition if plaruied by means of manval disassembly
, heavy equipment
Permits Xssued:
# Well Abandonment '
In retum f�r issuaace of said Demolition Permit,the undersigned owner hereby agrees as follows:
1, The struoture(s) shall be kept e�,closed and/or secured uatil sueh time as demolition is
complete. �
2. Dertiolition debris will be kept off adj oining properiy,andlor the public rights-ot�way unless
specific p�ior approval is obtained in wxiting for temporary L�se thereof.
3. k'oundations shall be completely removed from the ground. � . ,
4. A11 demolition debris shall be completely disposed of o£f site in accordance with all
applicable PCA xequirements, ,
S. Water wells must be abandoned in accordance with State Health Department regulations.
6, Inspeetion requir�d when all debris has been rercioved,beforc backfilling.
0.2001 2�a0PM N0.592 P.2
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7, '�Xlithin 5 working days of superstructure removal,a final iaspecti�n shall be reque�ted. The
site shall be left clean and clear of alI debris,with any excavation filled w;th eatt�i level with
the adjacent ground elevation (except when such excar�ation is to he used as part of a new
building and such new building is actually under construction).
8, The undersigned owner shall and hereby does indemnify and hold harmless the C�ty o�
Orono, its agents, employees and assigns from and against a11 claiins, daznages, losses oz
expenses,includin.g attorney fees,againstthe City,its agents,employees and�ssigris arising
out of or resulting from the demolition described herein as pex�azmed by the property owner,
his emplo�ees, agents, subcontzactqrs or assigns.
9. Septic�yst�ms must be abandoned per Minnesota Rules Chapt�r 7080. All Se�tic tanks must
be pumped,crushed and filled with native soils, An inspection is required after the tanks are
pumped and befor�the tanks are crushed and fi11ed,
PERIVZIT TYPE AND FEE CALCULAT�ON
$50,00-Principal Sfiructure
$30A0 -Accessory Structure
1, Subtotal of above permit requested $ <�� c"C:
2, State Surcharge $ .SO
3. TOTAL PERMTT FEE(add lines 1-2 above) $ ,�; . �'"
The undersignad hereby appli�s to the City of arono for issuance of a Demolition Perznit,agrees to
do all woz1G in strict accordance with the ordinances of the Cii.y ancl the r�gulations of the State of
Minnesota, and cez�ifies that all statements made on this applieation are complete,true and coaect.
AI'PLICANT'5 SXGNAT'CJ�tE:V� V A � �— �— Date: a� ��
. OWNER'S STGNATURE: ' ,,., I�ate: �r;� v I�oc1 ( __ �
APPROVEA BX• �� Date; 5 -3� � � l
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