HomeMy WebLinkAbout2004-P08318 - demo PERMIT
C�T�� �O F O RO N O Permit Number:
2750 Kelley Parkway - PO Box 66 Pog31g
Crystal Bay, Minnesota 55323 Permit Type: Demol�tion
(952) 249-4600 Date Issued: izi2�i2oo4
SITE ADDRESS: 2545 North Shore Dr
Wayzata,MN 55391
P I D: 09-117-23-41-0003
DESCRIPTION:
Proposed Use: Residential
Buildin Census Code 645
Pernut Class: g
Permit Sub-type(s): Demo-Principal Sriucture
Permit Type: Demolition Demo-Accessory Structure
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
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m�st be abondoned. Insnection before backfillin�.
FEE SUAIIMARY: Permit Fee: $ 80.00 Valuation: $ 0.00
State Surcharge Fee: $ 0.50
TOTAL FEE: $ 80.50
APPLICANT: Bradley&Cheryl Jones OWNER: Bradley&Cheryl Jones
2545 North Shore Dr 2545 North Shore Dr
Wayzata,MN 55391 Wayzata,MN 55391
THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED
AND AGREES TO DO ALL WORK IN SI'RICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF
MINNESOTA BUILDING CODE REQUIREMENTS.
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APPLICAN PERMITEES[G A �URE ISSUEDBYSIGNATURE
Copies: 1-File(SiQnitures Requ7fed), 1-Applicant, 1-Monthlv Reports, 1-Assessine, 1-Finance Page 1
CITY OF ORONO APPLICATION FOR DEMO I RMIT
P.O. Box 66 (2750 Kelley Parkway)
Crystal Bay, MN 55323
SPECIAL CONDITIONS & HOLD HARMLESS AGREEMENT
General Instructions
1. You may be required to obtain other pennits, i.e. well abandonmment, etc.
2. Work must not begin unless the permit card is available on the job site.
3. A 24 hour notice is required for all inspections. Call (612) 249-4600.
JOB SITE ADDRESS:��S �J N�/�r� S� �r� �r�v-�.�r
Occupancy Type: _ 1�� Residential Cormnercial ��D/vU, f'j1N S S 3�'�
(f�)9SL—Y7G—d419
OWNER'SNAME:(�/^�je�/�` e�er'yL- ��NGS Phone�0)(olZ-�i/7-5�/ 1�v
MailingAddress: /a-�LrJo od�!-,��l/ �v City: �,Q ONo , /'r�i✓ S S�j�/
� CONTRACTOR'S NAME: Bus.No.:
Mailing Address: City:
Derrfolition if plaiined by means of: manual disassembly
heavy equipnlent
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Permits Issued: /V �-
# Well Abandonment
In return for issuance of said Deinolition Permit,the undersigned owner hereby agrees as follows:
1. The structure(s) shall be kept enclosed and/or secured until such time as deinolition 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 backf'illing.
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 ilew
building and such new building is actually under construction).
S. The undersigned owner shall aiid hereby does indemnify and hold hannless the City of
Orono, its agents, einployees and assigns from aiid against all clainls, damages, losses or
expenses,includiiig 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 systeins must be abandoned per Minnesota Rules Chapter 708Q. All septic tanlcs must
be puinped,crushed and filled with native soils. An inspection is required after the taiilcs are
ptunped and before the tanks are crushed and filled.
PERMIT TYPE AND FEE CALCULATION
� $50.00 -Priiicipal Structure
✓ $30.00 -Accessory Structure �5��j�o�- �� S�'
1. Subtotal of above permit requested $ O � � ��
2. State Surcharge $ .50
3. TOTAL PERMIT FEE(add lines 1-2 above) $ �� . S v
The undersigned hereby applies to the City of Orono for issuance of a Deinolition 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 inade on this application are complete,true and correct.
APPLICANT'S SIGNATURE ( � ate: ��"' �' ��
OWNER'S SIGNATURE � ` Date: �` 2 D�
APPROVED BY: Date: �L- Z7 `�'`'�
��� �
��— DATE TIME �
CITY OF ORONO CALLED IN � �S
INSPECTION NOTICE c,�2 `Q scHE�u�Eo �:� � �-�
PERMIT NO. P(�% U J( U COMPLETED
ADDRESS .�5�'S ,� 1 - .S�1or� �/�
OWNER CONTR. ���JCslxt,-/'�r�-f�_
TELEPHONE NO. L� ��� � �a� ��3�
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� DESCRIPTION � ����,1
l� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
� 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
�
O 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q 05 FINAL 14 SEWER HOOK-UP 06 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
� 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
= 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
J 10 PLUMBING FINAL ' 36 FOUNDATION/REMOVAL
Z OWNER/CONTRACTOR TO MEET YOU:�YES_NO
� COMMENTS:
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W ORKSATISFACTORY:PROCEED PROJECTCOMPLEfE
� ❑CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
W
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONW�THIN HOURS. ❑ pHOTOTAKEN
INSPECTOR WILL RETURN ❑ CITATION ISSUED
❑STOP ORDER POSTED.CAIL iNSPECTOR
C INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the next spection 24 hours in advance. (g52) 249-4600
OwnerlContr 't :
Inspector. �
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