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Home My WebLink About2012-00020 - demo CITY OF ORONO PERMIT NO.: 2012-00020 � _ � � 2750 KELLEY PARKWAY ORONO, MN 55356- �ATE ISSUED: OU10/2012 952 249-4600 FAX: 952 249-4616 ADDRESS : 3572 LIVINGSTON AVE PIN : 17-117-23-43-0150 LEGAL DESC : NAVARRE HEIGHTS : LOT 000 BLOCK 003 PERMIT TYPE : DEMOLITION PROPERTY TYPE : RESIDENTIAL � CONSTRUCTION TYPE : DEMO- PRINCIPAL STRUCTURE No�rL: L ['OUNDATIONS/ALL DEMO DEBR[S TO BE REMOVED FROM GROUND&DISPOSED OF OFF S[TE,PER PCA REGULAT[ONS. 2. WELLS MUST BE ABANDONED. 3. INSPECTIONS DONF,BEFORE BACKFILLING. NOTE: A 24-48 HOUR NOTICE IS REQUIRED FOR ALL INSPECTIONS. CALL(952)249-4600. SEWER MUS"I'I3E DISCONTINUED AT THE CITY SERVICE BY QUALIFIED CONTRACTOR BGFORE DEMO PERMIT IS ISSUED. CHECK TO MAKE SURE THIS PERMIT HAS BEEN PULLED BEFORE[SSUING THIS PERMIT. APPLICANT DEMOLITION - PRINCIPAL STRUCTURE 75.00 MIKIES LANDSCAPING STATE SURCHARGE DEMO 5.00 1 1039 COUNTY RD 16 WATERTOWN, MN 55388- TOTAL 80.00 (612)221-3657 OWNER CUFF, MARK& KAREN 3572 LIVINGSTON AVE WAYZATA, MN 55391- AGREEMENT AND SWORN STATEMENT The work for which this permit is issued shall be perfomled according to the approved plans and specifications,applicable City approvals,and the State Building Code. This permit is for only the work described and does not grant pennission for additional or related work which requires separate permits. All provisions of laws and ordinances governing this type of work shall be compied with whe[her or not specified herein.This permit wili 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. 7�he applicant is responsible for assuring all required inspections are requested in onformance with e State Buiiding Code.This permit may be revok at a , tim due e. . � / / �� / / �D/ / �— Applicant Penmtee Si ature Date Issue y Signature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. � - � • ,¢��` City of Orono C USE ONLY -1 `r P.O.Box 66 � GY� Date Received: (� rmit# l07— ��,. � 2750 Kelley Parkway � ,��'>�� h Crystal Bay,MN 55323 '�o� (952)249-4600 Amount: $ - � SAC Credit: ��04 Homeowner(s)Signed: ❑Yes Resolutions(if any)Signed:0 Yes ❑None Required Zonin Disclosure Sianed: ❑Yes ❑None Re uired CITY OF ORONO - DEMOLITION PERMIT (All permits must be approved by the Building Official and/or Zoning Department) `7ob.;,5ite/ Owner Information , ::; . Type: � Residential ❑ Commercial Site Address: �� J�-��GUQ J 1 ��'� �� jOwner: �� C + ( Mailing Address: City: ��U/v� Zip: Home Phone: Alternate Phone: �„�n`t�a+�tor/Applicant Information: y ., ; � � k� �(�= l�A/��l-�',��-c�:r1�� Contractor/App.:f�� .aL � S (�/� �p `} Contact Person: /�� Address: ,�� J �'1�/�� f,6 State License #: Cit �,t��i�z2l(��r�`��i � y: p: �J� � Expiration Date: �-- �� Phone: ��.,�-- �2�" �� S ] Alternate Phone: �) � - �"S��`��5`� �� , � ..��` .. "<SPECIAL CONDITIONS &.HOLD HARIVILESS AGREEIVIENT General Instructions: 1. You may be required to obtain other permits, i.e.: well abandonment, sewer, etc. 2. Work 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 o£ ❑ 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: l. 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 the 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 PCA requirements. 8. Abandon water wells in accordance with State Health Department regulations. 9. Ca11 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 systems per Minnesota Rules Chapter 7080. All septic tanks must be pumped, crushed and filled with native soils. An inspection is required after the 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 $ �� ❑ $50.00—Accessory Structure x (how many) 1. Subtotal of above permit requested $ 2. State Surcharge 5.00 3. TOTAL PERMIT FEE (add lines 1-2 above) $ � - '�U�� The undersigned 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 ordinances of the CiTy and the regulations of the State of Minnesota, and certifies that all sta.tements made on this application are complete,true and correct. Applicant's Signature: r� ` Date: ��O/,�- Owner's Signature: Date: � Approved By: Date: �� ( ilding Official) * Zoning Disclosure Required? ❑ YES ❑ NO ' " 1� *This must be filled out by Zoning Department—For either answer, a Zoning Official must sign all applications. * Approved By: Date: �/ � � � G v (Zoning Official) � � � A 3 �D�E TIME '� CITY OF ORONO CALLED IN INSPECTION TICE SCHEDULED 3 —L�—�S PERMITN�/a'� COMP ETED • ADDRESS 3 5 02- OWNER ' TELEP N NO.�'� CONTRACTOR L �S �; DESCRIPTION ty ❑ FOOTING �J DEMO-FINAL ❑ SEPTIC FINAL Q ❑ POURED WALL �❑�PLUMBING RI ❑ EXCAV/GRADING/FILLING Q ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ PROGRESS � ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT Q ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP W ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ HARD COVER REMOVAL J ❑ DEMO-SITE ❑ SEPTIC INSTALL ❑ FOUNDATION/REMOVAL 2 OWNERfCONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W C j n� �i � O �. � O � W � � Q � 2 W � W � j d W O WORKSATISFACTORY:PROCEED PROJECT COMPLEfE � ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY W 0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT �CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ pHOTOTAKEN INSPECTOR WtLL REfURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. (952) 249-4600 OwnerlConVactor on site: Inspector. White Copy/lnspector's File Canary CopylSite Notice