HomeMy WebLinkAbout1997-009251 - demo , � � PERMIT
.CIT�( OF ORONO PERMIT TYPE: - � ° - �-
2750 Kelle Parkwa P.O. Box 66 ``-�=``_`�v```
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Crystal Bay, Minnesota 55323 Permit Number:
(612)473-7357 Date Issued_ _ _ _ _ _ .
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REMARKS:
FEE SUMMARY:
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APPLICANT/PERMITEE SIGNATURE ISSUED BY:SIGNATURE
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CITY OF ORONO APPLICATION FOR DEMOLITION PERiviIT
P.O. Box 66 (2750 Kelley Parkway) �
Crystal Bay, MN 5�323
SPECIAL C0�IDITIONS & I30LD HARMLESS AGREEMEN'T
General Instructions
1. You may be required to obtain other permits, i.e. burnin�, well abandonmment, etc.
2. Work must not be�in unless the permit card is available on the job site.
3. A 24 hour notice is required for all inspections. Call 473-7357.
JOB SITE t�DDRESS: I o9 o Lo�+d U•Jq �C"�e
Occupancy Type: �_Residential Commercial
OW�tER'S N��IE: Will�a►� �l, f3acK�hn Phone: �/72— y/Go
Mailin� Address: /o9U L��,, L�a A�r CitY: /�?oun�l
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CONTRACTOR'S NAME: W�ll;4,•-, �/ Boc,K»�+n.. Bus. No.:
Mailing Address: �� Ciry: `�
Demolition if planned by means of: �. manual disassembly
x heavy equipment
burnin; (by fire department)
Permits Issued:
# Burning Fire Department
# Well Abandonment
In return 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 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.
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4. All demolition debris shall be completely disposed of off site in accordance with all
� applicable PCA requirements.
5, i�Vater wells must be abandoned in accordance with State Health Department regulations.
6, Inspection required when all debris has been removed, before bacl�'�lling.
7. Within � workin� 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 ercavation is to be used as
part of a new buildin� and such new buildin; is actually under construction).
8. The undersi�ned owner shall and hereby does indemnify and hold harmless the City of
Orono, its aaents, employees and assigns from and a�ainst all claims, dama�es, losses
or expenses, includin� attorney fees, against the City, its aaents, employees and assijns
arisin� out of or resultin� from the demolition described herein as performed by the
property owner, his employees, a;ents, subcontractors or assigns.
PERtiIIT TYPE AND FEE CALCULATION
�50.00 =�Principal Structure
_� $30.00 - Accessory Structure
1. Subtotal of above permit requested $ 3 0 � oc�
2. State Surcharge $ .50
3. TOTAL PERMIT FEE (add lines 1-2 above) $ 3� � SO
The undersigned hereby applies to the Ciry of Orono for issuance of a Demolition Permit, agrees
to do all work in strict accordance with the ordinances of the Ciry and the regulations of the
State of Minnesota, and certifies that all statements made on this application are complete, true
and correct.
APPLICANT'S SIGNATURE: -� - � . �- 3 �-��
� Date.
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O`Wi ER'S SIGNATURE: G���- � - Date: � -� f ' ��
APPROVED BY: Date: � ' `� �7 7