HomeMy WebLinkAbout1997-008721 - partical demo/1 room .. PERMIT
CI'�Y OF ORONO PERMIT TYPE:
2750 Kelley Parkway- P.O. Box 66 ��;=7� �����Ita
Permit Number: ,•;��;.;$•~��
Crystal Bay, Minnesota 55323 Date Issued: ;�� �^:,.�t;:�_�.,.
(612) 473-7357
SITE ADDRESS:
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REMARKS:
FEE SUMMARY:
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PPLICANT/PERMITEE SIGNATURE ISSUED BY SIGNATURE
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CITY OF ORONO APPLICATION FOR DEMOLITION PER��IIT
P.O. Box 66 (2750 Kelley Parkway)
Crystal Bay, i�1N 5�323
SPECIAL CONDITIO�IS & HOLD HARiti1I.ESS AGREEMENT'
General Instructions
1. You may be required to obtain other permits, i.e. burninQ, well abandonmment, e�c.
2. Work 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: �1, � No 2-�`� �c-y-o� p(Z
Occupancy Type: Residential Commercial
O`�'ER'S NQt�ti1E: �/bFi�1 ��- S r�A ;;-�^��;�r� .� Phone: ��/–Do to C�
Mailin� �ddress: � , -.:' ',, �' -�_.� Ciry:_�siAC., 'l3��! —
CONT'RACTOR'S NAlI�: �P� �/�/ov�� C� Bus. No.: �`t�` �`� `� �
Mailing Address: ��•`,� C�.�_ p.i���_ r�`� .:��,. City: �'7_ t,..e,� c.�r i W j�
Demolition if planned by means of: _� manual disassembly — PA2�-c� ���Y�n..c�
heavy equipment
bumin� (by fire department)
Permits Issued:
## Burnin� Fire Department
# Well Abandonment
In return for issuance of said Demolition Permit, the undersi�ned owner hereby agrees as
follows:
1. The structure(s) shall be kept enclosed and/or secured until such time as demolition is
comple[e.
2. Demolition debris will be kept off adjoinin; 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 re�ulations.
6, Inspection required when all debris has been removed, before backfillin�.
. �
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 �vith the adjacent around elevation (except when such excavation is to be used as
part of a new building and such new building 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 aQainst all claims, damages, losses
or expenses, including attorney fees, against the Ciry, its ajents, employees and assians
arisin� out of or resultin� from the demolition described herein as performed by the
property owner, his employees, aQents, subcontractors or assiQns.
PERti1IT TYPE A�'VD FEE CALCULATION
�50.00 ��Principal Structure
�30.00 - Accessory Structure
1. Subtotal of above permit requested $
2. State Surcharge $ .50
3. TOTAL PERII�IIT FEE (add lines 1-2 above) $
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.
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APPLICANT'S SIGNA �� Date:
OW��R'S SIG� TURE• � Date:
APPROVED BY: Date: I - Z 8 ��'�