HomeMy WebLinkAbout1992-004656 - demo house PERMIT
! ' �,�Tl( C�F �RON� PERMIT TYPE:
1335 Brown Rd. South • P.O. Box 66 ������Lj���i=
Permit Number: t}�y��,��.
Crystal Bay, Minnesota 55323 Datelssued: �y'�/'�=��?'�:�
(612) 473-7357
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APPLICANT/PERMITEE SIGNA �� ISSUED BY:SIGNATUR -��/
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CITY OF ORONO APPLICATION FOR DSMOLITION PERMIT
P.O. Box 66 (1335 So Brown Rd)
Crystal Bay, MN 55323
� SPECIAL CONDITIONS & HOLD HARMLESS AGREEMENT
******:***t:�****�r*******�******:***�*t**********�*********�f#**�***�***�*
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*:*:*****:��*:***:*tt****#�*t:#*********�**:�*
JOB SITS ADDRESS: /a p S L,A, !(E✓�t inJ 6�v�
Occupancy Type: _�Residential Commercial
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OWNER'S NAME: � `t - ` Phone: � - — � � �
Mailing Address: � -t'� �l City: � �-
� ��� � 74 yG �
CONTRACTOR'S NAME: �j,� /c c D t�t��vr�.�r�r.0� /�✓c_ Bus. No. : cY� � - 7�i s'/
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Mailing Address: � �p� �yn�r,,q,�; ,ar/� - S� • City: ,ti ,,v,;,r.ayo�,t_ M�,�Sf'
*t*itdt**itdtdtdtdrdtitdtit�*dtdt*****atdrdtt�,t*�r*ytdt****it*t*#t*�*it*�*itdt�dttdtirit**itit***�*�** `y9
Demolition if planned by means of: ,ofnanual disassembly ✓heavy equi_r_�,ent
�burning (by fire department)
Permits Issued:
� Burning Fire Depart�nei�t
# Y�lr 11 Abandonment
In returra for issuance of said Demoli.tion �ermit, the undersigned owner
hereby agrees as fo�lowsa
1. The structure(s) shall be kept enclosed and/or secur2d until such time
as demolition is complete.
2. Demolitian debris wiil be kept off adjoining property and/or the
public rights-of-way unless specific prior approval is obtained in
writing for temporary use thereaf.
3. Foundations shall be completely removed from the ground.
4. All demolit�ian debris shall be completely disposed o� off site in
accordance with al 1 applicable FCA requirements.
5 . Water wells �nust be abandoned in accordance with State Health
Department rec�ulations.
6. Inspection reguired whe�n all debris has heen 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 sucn new building is actually under canstruction).
�/�" w ;� � BC Ti�ik�•�c- THE' p�v Bu�.✓<-o fro�� �ow� :a �-yE �-ou.vo�r�c�
Anio i?�"�,ui�� F.ro.� Ti5'g ��.v �au�=�.br��.�..
. _ _ : _ �
____ _ �
8 . The undersigned owner shall and hereby does indemnify and hold
harmless the City of Orono, its agents, employees and assigns f rom 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.
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_ ..._�.�. PERMIT_�'YP$ AND FEE CALCUI,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) S
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the u:�dersigned hereby applies to the City o� Orono for is�uance of a
Demulition Permit, agrees to do all work i.n strict a�cordance with the
ordinances of the City and the regulations of the State of Minnesota, and
certifies that all state�nents made on this application are complete, true
and correct.
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SIGNATDR33 OF APPLICAIdT: , - ,�r �- � Date:
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