HomeMy WebLinkAbout2013-00106 - demo � `1
CITY OF ORONO * 2 0 1 3 - 0 0 1 0 6 *
2750 KELLEY PARKWAY DATE ISSUED: 02/12/2013
ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 1545 MAPLE PL
PIN : 08-117-23-33-0029
LEGAL DESC : CRYSTAL BAY VIEW
: LOT 007 BLOCK 006
PERMIT TYPE : DEMOLITION
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : DEMO- PR[NCIPAL STRUCTURE
ACTNITY : 645-SINGLE FAMILY HOUSES(ATT& DET
NOTF.:
l. FOUNDATIONS/ALL DEMO DEBRIS TO BG REMOVED FROM GROUND& DISPOSED O�OPF SI"I'E,PER PCA REGULATIONS.
2. WELLS MUST BE ABANDONED.
3. INSPECTIONS DONE BEFORE BACKF[LLING.
NOTE: A 24-48 HOUR NOTICG IS REQUIREU FOR ALL INSPECTIONS. CALL(952)249-4600.
SEWER MUST C3E DISCONTINUGD A'i'THE CITY SERVICE[3Y QUAL[FIED CONTRACTOR 13EFOR1;DEMO PGRMI"1'IS ISSUED.
CHECK TO MAKE SURG THIS PERMIT HAS BI:EN PULLED QGFORE [SSUING THIS PERM[T.
APPLICANT DEMOLITION - PRINCIPAL STRUCTURE 75.00
Maple Place LLC STATE SURCHARGE DEMO 5.00
550 25TH AVE N
ST. CLOUD, MN 56303- TOTAL 80.00
OWNER
Maple Pface LLC
550 25TH AVE N
ST. CLOUD, MN 56303-
AGREEMENT AND SWORN STATEMENT
The work for which this permit is issued shail be performed according to
the approved plans and specifications,applicable City approvals,and the
State Building Code. "fhis pennit is for only the�i�ork described and does
not grant permission for additional or related work which requires separate
permits. All provisions of laws and ordinances governing this type of work
shall be compied with whether or not specitied herein.This permit will
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.
The applicant is responsible for assuring all required inspections are
requested in conformance with the State Building Code.This permit may be
revoked at any time for due cause.
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Applicant Permitee Signature Date ssue Signaturc Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
O City of Orono TY USE ONLY �
P.O.Box 66 Date Received: � Permit# D/ - �
� � 2750 Kelley Parkway
Crystal Bay, MN 55323 Amount: $� SAC Credit:
(952)249-4600
a .�. Homeowner(s)Signed: ❑Yes
S'�n �� Resolutions(if any)Signed:�Yes ❑None Required
`��f S H�F� Zoning Disclosure Si ed: ❑Yes ❑None Required
CITY OF ORONO - DEMOLITION PERMIT
(All permits must be approved by the Building Official and/or Zoning Department)
Job Site / Owner Information:
Type: �.] Residential ❑ Commercial
Site Address �5�� ��P�`� � `���--
Owner. 1" Y,l P!L �l u c�2.. �1—C— Mailing Address: ��—� �� ��'� �
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City: �-- �v�t Zip:
Home Phone: l.t�l � o��� ���� Alternate Phone:
Contractor/Applicant Information:
Contractor/App.:�� � Contact Person: �-V�ct �, � �`'��5��'`-�
Address: State License #:
City: Zip: Expiration Date:
Phone: Alternate Phone:
SPECIAL CONDITIONS � HOLD HARMLESS AGREEMENT
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 of: ❑ 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:
1. 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, Consfruction Site Runoff Control.
3. Submit a $2,500 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. Call 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) $
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 statements made on this application are complete, true and correct.
Applicant's Signature: Date:
f
Owner's Signature: �-- Date:
� t -
Approved By: �1 �� Date: — I � -- � 3
(Building O icia )
* Zoning Disclosure Required? ❑ YES �10
"`This must be filled out by Zoning Department— For either answer, a Zoning Official must sign all applications.
* Approved By: Date: `� �
(Zoning icial)
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DATE TIME
CITY OF ORONO CALLED IN
INSPECTION NOTICE,,,�� SCHEDULED
PERMIT NO. �Z(Y�3�C� COMPLETED a _�;c�
ADDRESS 1.J��..5� /�'�Cc'r�� �,�..,
OWNER TELEPHONE NO.
CONTRACTOR �� � �d��-Sa•-t �,�a�s"-<c
� DESCRIPTION �E'��
tV ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL
Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING
v3 ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL
Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION
Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ PROGRESS
� ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT
� FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP
_ ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ HARD COVER REMOVAL
v ❑ DEMO-SITE ❑ SEPTIC INSTALL ❑ FOUNDATION/REMOVAL
2 �IIINERlCONTNACTOR TO MEET YOU:_YES_NO
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� ❑WORK SATISFACTORY:PROCEED �dECT COMPLETE
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� ❑CORRECTNfORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE COA/ERING PERMANENT
❑CORRECT UNSAFE CONOITION WITHIN HOURS. ❑pH0T0 TAKEN
INSPECTOR WILL RETURN
❑STOP OROER POSTED.CALL INSPECTOR �CITATION ISSUED
O INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call forthe next inspection 24 hours in advance. (952) 249-46�0
OwnerlCorrtra or on site:
Inspector: �--�
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�J� DATE TIME ✓
CITY OF ORONO CALLED W 3-1 I
INSPECTION NOTICE SCHEDULED �3^1 Z-l3 �
PERMIT NO. ��13-�� l��' COMPLETED
ADDRESS �S�S /�� ��
OWNER TELEPHONE NO. ��Z- �✓2 3/��
CONTRACTOR ���`'� 4���� ���
�; DESCRIPTION ����-a ��
� ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING
Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS
y ❑ FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL
Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION
Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS
� ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT
� ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP
_ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL
� ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL
Q OWNER/CONTRACTOR TO MEET YOU:_YES_NO
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W ❑WORKSATISFACTORY:PROCEED �RROJECTCOMPLETE
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W
O ❑CORRECT WORK,CALL FOR REINSPECTIOtJ TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN
INSPECTOR WILL RETURN ❑ CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑ INSPECTIONREQUIRED.CALLTOARRANGEACCESS.
Cail for the next inspection 24 hours in advance. �95Z� Z49-46��
OwnerlContractor on site:
Inspector.
White Copylinspector's File Canary CopylSite Notice