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Home My WebLink About2013-00025 - demo CITY OF ORONO * Z 0 1 3 - 0 0 0 2 5 * ' � +' �` '` 2750 KELLEY PARKWAY DATE ISSUED: OU1U2013 ORONO, MN 55356- (952) 249-4600 FAX: (952) 249-4616 ADDRESS : 4156 HIGHWOOD RD PIN : 07-117-23-44-0019 LEGAL DESC : HIGHWOOD LAKE MTKA : LOT 023 BLOCK 000 PERMIT TYPE : DEMOLITION PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : DEMO- PRINCIPAL STRUCTURE NOTG: l. FOUNDATIONS/ALL DEMO DEBRIS TO BG REMOVF.D FROM GROG\D&D[SPOSGD OF OH'F SI"CE, PGR PCA RGGULATIONS. 2. WELLS MUST BE ABANDONED. 3. INSPECTIONS DONE BEFORE BACKFILLING. NOTE: A 24-48 HOUR NOTICE IS REQUIRED FOR ALL INSPECTIONS. CALL(9�2)2d9-4600. SEWER MUST BE DISCONTINUED AT THE CITY SERVICE BY QUALIFIED CONTRACTOR BEFORL:DEMO PI?RM[T IS ISSUED. CHECK TO MAKE SURE T[IIS PERMIT HAS BEEN PULLF.D BEFORG ISSU[NG Tk IIS PF,RMIT. APPLICANT DEMOLITION - PRINCIPAL STRUCTURE 75.00 DENALI CUSTOM HOMES STATE SURCHARGE DEMO 5.00 18352 MINNETONKA BLVD. DEEPHAVEN, MN 55391- TOTAL 80.00 (952)476-2679 Minnesota State License#:20175394 OWNER MUSGJERD, SCOTT& MELISSA 4156 HIGHWOOD RD MOUND, MN 55364- AGREEMENT AND SWORN STATEMENT The work for which this permit is issucd shall be periormed according to the approved plans and specifications,applicable City approvals,and thc State E3uilding Code. This permit is for only the work describcd and does not grant permission for additional or related work which requires separate permits. All provisions of laws and ordinances govcrning 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 may be revoked at any time for due cause. / / / / // / /_3 Applicant Permitee Signature Date Issue y Signature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. � - � � � �� City of Orono FOR CITY USE ONLY O O P.O-Box 66 Date Received: l-/l-I� Permit# /3 -DD � C� �;,.,.,__ 2750 Kelley Parkway ��'� ��'� = � Crystal Bay,MN 55323 Amou�t $ SAC Crcdit: � °i��r��ti o - (952)249-4600 z��8�„ �_� Homeowner(s)Signed: �Yes Resolutions(if any)Signcd:❑Yes ❑Nonc Rcquircd Zoning Disclosure Signed: ❑Yes �None Required CITY OF ORONO- DEMOLITION PERMIT (All permits must be approved by the Building Official and/or Zoning Department) Job Site/Owner Information: Type: � Residential ❑ Commercial Sitc Address: �I I�S(- �1nLi,1'��'Y'� -�� Owner: �c7�-{- 7'1�1,i.S��, �� Mailing Address: ��5 ��- ��t�1 '�'r5 � �r � City: )�'lI�1VI��r.5� Zip: �3� ��} Home Phone: GJ�� -17.�=�%4 7.3 Alternate Phone: Contractor/Applicant Information: Contractor/App.: I�-,�,�I �c.L�fi�'i)I ��1'It�'� Contact Person: aj�(�' ��✓�(�iti�) Address: �� r�'��'C� �� State License#: •�''� �S�%'� b ,Ql�ti�� 3 City: �`� Zip: -%j�� Expiration Date: � '� � " Z�� Phone: q� � `f 7� `� `7�/ Alternate Phone: 1�-?-`%7 �.G_>� SPECiAL CONDiTIONS & HOLD HARMLESS AGREEMENT General Instructions: 1. You may be required to obtain other permits, i.e.: well abandonment, sewer, etc. 2. Wark 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 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 $2,000 escrow and an escrow agreement signed by the property owner. 4. Keep all structure(s) enclosed and/or secured until such time as demolition is complete. � = ,� . 5. Keep all demolition debris off adjoining property and/or thc public rights-of way unless specific prior approval is obtained in writing for temporary use thereof. 6. Completely remove foundation(s) from the ground. 7. Completely dispose of all demolition debris off site in accordance with all applicable PCf1 requirements. S. Abandon water wells in accordance with State Health Department regulations. 9. Call for an inspection when all debris has been removed,before backfilling. 10. 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). 11. Abandon septic systerns per Minnesota Rules Chapter 7080. All septic tanks must be pumped, crushed and filled with native soils. An inspection is required after thc tanks are pumped and before the tanks are crushed and filled. 12. 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. PERMIT TYPE AND FEE CALCULATION �$75.00—Principal Structure $ 75 ❑ $50.00—Accessory Structure x (how many) �� l. Subtotal of above permit requested $ 7� 2. State Surcharge 5.00 3. TOTAL PERNIIT FEE (add lines 1-2 above) $ �(1 The widersigned 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 ordinance� c�f the City and the regulations of lhe State c�f Minnesota,and certifies that all statements madc on this application are complete,true and correct. Applicant's Signature: � �r�i� Dat�� Z ,� � � , _ . Owner's Signature: % �� . � if � Date: '� �^ / '" d. I J / Approved By: +� ��M c+�--- Date: � - 1� ' i � (B ding Officialj * Zoning Disclosure Required:' ❑ YI:S �;�0 ��1(,�71�.-� �L-�jj7j *This must be filled out by Zoning Deparnnent For either ans�ti�er,a Zonmg Official t�:s:sign all applications. :Pl�r�ecd �i:: __..�N� Y�1�,� I)atc: - �' ��_--- ,,.._:.._. <,.,;....:,.