HomeMy WebLinkAbout1998-010702 - demo PERMIT
'IT:� OF ORONO PERMIT TYPE:
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_:50 Kelley Parkway- P.O. Box 66 .� _
Permit Number: i_;: ;.�::t_��_
Crystal Bay, Minnesota 55323 _ _ ._ _
�612)473-7357 Date Issued: ;,;-;.;:f;; :==t;;
SITE ADDRESS:
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DESCRIPTION:
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REMARKS:
FEE SUMMARY:
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APPLICANT PERMITEE SIGNATURE ISSUED BY:SIGNATUR
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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 �round 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 undersigned owner shall and hereby does indemnify and hold harmless the City of
Orono, its aaents, employees and assi�ns from and against all clauns, damages, losses
or erpenses, including attorney fees, against the Ciry, its agents, employees and assijns
arisin� out of or resulti.n� from the demolition described herein as performed by the
property owner, his employees, a?ents, subcontractors or assigns.
PER�IIT TYPE AND FEE CALCULATION
$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 conect.
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A]PPLICANT'S SIGNAT'URE:_ .,� ���.aZ Date: ,�� .J�' ��
OWiYER'S SIGNAT'[JRE: �.���.� ..��_ Date: �� 3�`' c1 �'
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APPROVED BY: Date: `�'' 3� �5�
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CITY OF ORONO A.PPLICATIOtiT FOR DEMOLITION PERI�IIT
P.O. Box 66 (2750 Kelley Parkway)
Crystal Bay, �SN 5�323 �
SPECL4L CO�tDITIO�S & HOLD HAR'�1LESS AGREE�\'T �
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General Instructions
1. You may be required to obtain other permits, i.e. burnin;, well abandonmment, etc.
2. `Vork must not be�in 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 ADDRESS: yrU7,H, a-�����,� �.� /`t�f��� �'�' �S!3� `i
Occupancy Type: �Residential Commercial
O`�rER'S NQu�IE:���'lv�+'-,lj�"V S/� u � Phone: `'/'�.,'Z� �7�i �
Nlailin� Address:YI'v�fffi�yt�o�,� �� Ciry: �7� •�r. �v�,/
COti'TRACTOR'S NAlI�: G� �N S�/�"�t�/Z Bus. No.: Y?� —.�� � �
l�Iailin� Address: City:
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Demolition if planned by means of: manual disassembly �
_ L heavy equipment {
burnin� (by fire department) i
Permits Issued: �'�
# Burning Fire Department �
## Well Abandonment
In return for issuance of said Demolition Permit, the undersigned owner hereby agrees as I'I
follows:
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1. The structure(s) shall be kept enclosed and/or secured until such time as demolition is il
complete.
2. Demolition debris will be kept off adjoining property and/or the public ri�hts-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 backf'�lling.