HomeMy WebLinkAbout1998-010676-issued under old address , � _ .r
PERMIT
CI� OF ORONO PERMIT TYPE: ;;�3�_; �;x fi�t
2750 I�elley Parkway- P.O. Box 66 -
Crystal Bay, Minnesota 55323 Permit Number: :{i,i tr.:`r=
�(612)473-7357 Date Issued: t;i�,i��,.'°�;�:
SITE ADDRESS:
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APPLICANT%PERMITEE SIGNATURE ISSUED BY:SIGNATURE �
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t • APPLICATION FOR DEil�10LITION PER�tiiIT
CITY OF ORONO .
P.O. Box 66 (2750 Kelley Parkway)
Crystal Bay, MN 5�323
SPECL�.L CONDIZ'I4NS & HOLD HARiti�LESS AGREEME�'�T'
General Instructions
1. You may be required to obtain other permits, i,e. burnin�, well abandonmBlent, etc.
2. �ork must not be;in unless the permit card is available on the job site.
;. A 24 hour notice is required for all inspections. Call 473-7357.
JOB STTE ADDRESS: ��
> UC.-1� G ;5�9�L � � I� .
Occupancy Type: �_Residential Commerctal
O'4�rER'S N,4�tiIE: 1�1�.� ����se
� Phone: '� �y 3�dv
Maili�a r'lddress: �SZ�'o �D''1'�'���'''��'�'� �e' Ciry: �PPL�u�d
v L 6`���frN� _ Bus. No.: �?���s=��
COt�T�2ACTOR'S NA�.1�: �— T City: /�i�YN� N'1�
Mailing Address: i�o o -�r! a�-� D2-
Demolition if planned by means of: manual disassembly
�_ heavy equipment
burnin; (by fire department)
Permits Issued:
# BurninJ Fire Department
# Well Abandonment xfo C�<< a�1 S�Sc,�,-� .
In retum 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 tune as demolition is
complete.
2. Demolition debris will be kept off adjoinin� property andlor the public rights-of-way
unless specific prior approval is obtained in writin� 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
appiicable PCA requirements.
5, Water wells must be abandoned in accordance wich State Health Department regulations.
6, Inspection required when all debris has been removed, before bac�'�ilin�.
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. 7• Within 5 worki.n� days of superstructure removal, a final i.nspection shall be requested. T
The site shall be left clean and clear of all debris, with any excavation filled with earth
level cvith the adjacent Qround elevation (except when such excavation is to be used as
part of a new buildin� and such new buildin� is actually under construction).
8. The undersigned owner shall and hereby does indemnify and hold hartnless the Ciry of
� Orono, its aQents, employees and assi�ns from and a�ainst all claims, dama�es, losses
or expenses,Vincludin� attorney fees, a�ainst the Ciry, iu a�ents, employees and assi�ns
arisin� out of or resultin� from the demolition described herein as performed by the �
properry o�vner, his employees, a�en[s, subcontractors or assi�ns.
PERtiIIT TYPE AND FEE CALCULATION
$50.00 ='Principal Structure
� $30.00 - Accessory Structure
1. Subtotal of above perniit 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, aarees
to do aIl work in strict accordance with the ordinances of the Ciry and the regulations of the .
State of Minnesota, and certifies that all statements ma n ' application are complete, true
and correct.
APPLICANT'S SIGNATURE; ��/ �.� ��
Date:
OtiWi ER'S SIGYATURE: Date:
A.PPROVED BY: Date: �d- 2� -�C$
_ :,
CITY OF ORONO CALLED IN ATl�� TrM��
INSPECTION NOTICE �=� lU SCHEDULED %/v-9.Y .' o a
PERMIT NO. �� COMPLETED
ADDRES �✓�
OWNER G��✓ �����Q'��� ONTR.
TELEPHONE N0. J�� �� �.,-=
� DESCRIPTION
l� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
� 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
�
O 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q 05 FINAL 14 SEWER HOOK-UP 06 PROGRESS
� 07 DE - 27 SEPTIC MAINT. 21 COMPLAINT
J 7 DEMO-FINAL_�� 15 SEPTIC INSTALL. 22 FOLLOW-UP
= 23 SEPTIC FINAL 35 HARD COVER REMOVAL
J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
Q OWNER/CONTRACTOR TO MEET YOU:_YES_NO
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� WORKSATISFACTORY:PROCEED PROJECTCOMPLETE
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� ❑ CORRECT WORK R PROCEED 0 ISSUE CERTIFICATE OF OCCUPANCY
W
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN
INSPECTOR WILL REfURN
❑STOP ORDER POSTED.CALL INSPECTOR ❑ CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the ne t inspection 24 hours in advance.473-7357
Owner/Contra r on e:
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Inspector.
White Copyllnspector's File � Canary CopylSite Notice