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HomeMy WebLinkAbout2000-P02636 - demo � �. PERMIT � C I TY O F O RO N O Permit Number: 2750 Kelley Parkway - PO Box 66 P02636 Crystal Bay, Minnesota 55323 Permit Type: Demo�ition (612) 249-4600 Date Issued: �i�ioo SITE ADDRESS: 3436 Livingston Ave WAYZATA,MN 55391 P ID: 17-117-23-43-0021 DESCRIPTION: Proposed Use: Permit Class: Building Permit Type: Demolition Permit Sub-type(s): Demo-Accessory Structure DETAILS: Approved per resolution#: Separate permits required: NOTICES/REMARKS: ��:�'.:.^.�:::Q.^.��;;:'��^:O'��ti`:.�.���;�.^,:�Y��1��r, .. a R. .ia�,,..�0.7..F�ff�:��..o�Dv A r ,l�t;..,,� �7U�11� .�..'.'.."I...,.. 1....,....... 1.... ..'.b:.,..�....,.,. m xst be abondoned. Inspection before backfilling. FEE SUMMARY: Permit Fee: $ 30.00 Valuation: $ 0.00 State Surcharge Fee: $ 0.50 TOTAL FEE: $30.50 APPLICANT: ROXANN BEISCH OWNER: ROXANN M BEISCH 3436 LIVINGSTON AVE 3436 LIVINGSTON AVE WAYZATA,MN 55391 WAYZATA MN 55391 THE UNDERSIGNID HEREBY REQUESTS PERNIISSION TO MAKE TI�REAL IMPROVEMENTS SPECIFIED AND AGREES TO DO ALL WORK IN STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCFS AND STATE OF MINNESOTA BUII.,DING CODE REQUIREMENTS. , ` L/ ISSUED BY SIGNATURE Copies:City,Applicant,Assessor,Finance Page 1 e � CITY OF ORONO APPLICATION FOR DEMOLITION PERMIT P.O. Box 66 (2750 Kelley Parkway) Crystal Ba�, MN 55323 SPECIAL CONDITIONS & HOLD HARMLESS AGREEMENT General Instructions l. You may be required to obtain other permits, i.e. well abandonmrnent, etc. 2. Work must not begin unless the permit cazd is available on the job site. 3. A 24 hour notice is required for all inspections. Call (612)249-4600. JOB SITE ADDRESS: �J�I �J �—i v� � I�'t�V�2_ W Z JIII N Occupancy Type: � Residential ommercial OW�ER'S NAME: �O�or.��..��\ S� l� Phone:�,Sa��l 7�-�U s�� Mailing Address:�,V 3Lo L�v��c-�nti. �re Crty��.1�zo.�, J1/� (V CONTRACTOR'S NAME: S�`-� Bus.No.: Mailing Address: City: Demolition if planned by means of: X manual disassembly heavy equipment Permits Issued: # Well Abandonment In return for issuance of said Demolition Permit,the undersigned owner hereby agrees as follows: l. The structure(s) shall be kept enclosed and/or secured until such time as demolition is complete. 2. Demolition debris will be kept off adjoining property and/or the public rights-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 regulations. 6. Inspection required when all debris has been 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 such new buildinQ is actually under construction). 8. 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. 9. Septic systems must be abandoned per Minnesota Rules Chapter 7080. All septic tanks must be pumped,crushed and filled«ith native soils. An inspection is required after the tanks are pumped and before the tanks are crushed and filled. PERMIT TYPE AND FEE CALCULATION $50.00 -Principal Structure � $30.00 -Accessory Structure 1. Subtotal of above permit requested $ 3� � �� 2. State Surcharge $ .50 3. TOTAL PERMIT FEE (add lines 1-2 above) $ �J� ► �J� 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 aze complete,true and correct. APPLICANT'S SIGNATURE: \ Date: � � d OWNER'S SIGNATURE: c Date:�T'� � � APPROVED BY: Date: