HomeMy WebLinkAbout1997-009101 - demo , + � PERMIT
CITY OF QRONO PERMIT TYPE: :: �:. -�
2750 Kelh�y Parkway- P.O. Box 66 '"-'�—=� `-'�"`�
Permit Number: �:li:,`�;�t�s;,
Crystal Bay, Minnesota 55323 _ _
(612) 473-7357 Date Issued: �=';':i��.>'�;
SITE ADDRESS:
=,; � c fv;�,:;:£ :� _,;E��`:�. _�, .
.�:=�
- W_. . . . . . _ -1w� _.= _._ _ _ � _
DESCRIPTION:
;_�S tt_7 �i�� =�•1'(iE;�. �'{F:�ra i.;_ -�_ii�.tL��ny�.y:-`i;l
t.�l.�: 1 fR�.S'`j �aii tj'�:. ���'� �t�.�'i�!"_�.'��.Y I�`�C�l I'��=.
REMARKS:
FEE SUMMARY:
_.�,.T::. - �_: . - _ . _ .
=:,�1�}��t���,��:_ _____.__ `_ -
���F�..a� t._,T �*�;;{j��,t._1
CONTRACTOR: -� =, , = ��,���#. — OWNER:
- �-��� �"�'"�i.� f'.:".'';"F':i 1�'�j��j,_; �,:.L�,�.S-�:-�,tiS,) . .. . _.
--;:y;..._� _.: .._... _ :v _ _ .. ,_ __ _., .._
:11 ,�1,��. ..�;, I!'*,!(i_� {-�E'3 =�i .1��•. {`,:i�ih # i� :��F-j{»il-;:�:. !);;
c:r r.,_:__=:.�.i�:�;° r.�..; r�--:� ;-��=;M�r,;;w� r:r,; �:�,:_,_=��
. _ _. . .... �. _
� :.. � . .: . :, : ,, �:
. , ._.,��r•t.c,.:�` ''
;; _. : �
, � , ,. . :_, : ...;. : , , :;_'..;
•_,!.�•_ . . . _ _ _
-� .�_ :-,_.:—,�_.,.�._,:- :..f;�i:;:�=�-,�:�' __.,`; _ _._3n� ;;� ;1 ' , � : 4 ._ ��3"°we
. ,7' _ :,—
i i'� �il'v�1r il•+!��#�i=�J i t:y.f .t�_. S`� ��i�.,` ' _
_;: ._ _ I�:C f'�t�.�: n� t�= � „ _..... .. .. . . ... . _ _ _ _. _.� . _ . .
Y. __
r=�
. �
. -.
—'F-,f;�I� ) ,: 3 �f-ii-._�_. . '•_ �,. : a � . i i`,i —� i �—:`:L.. r �.iWifri�'f Tr . � t_f�
.." _ �-,_—, � .
1 / .i .�i . :.�., . �� �'^F'A, i�t t
� � 1 i �- � . ' . - �_ . ._.-�F_.f I� ���:i i...�3 i tV;� ��_i.�� . .
_ .�
� ,_�, .�_f a_� s_���G I t��P�;_'r� �. .� .. _ ,__e . _ . .. .
L _I
�n��� �
APPLICANT/PERMITEE SIGNATURE ISSUED BY:SIGNATURE
..�`. , _ . � /
.
�/�
CITY OF ORONO APPLICATION FOR DEMOLITION PER�IIT
P.O. Box 66 (2750 Kelley Parkway)
Crystal Bay, i�1N 5�323
SPECL�iL COtiTDITIO�iS & HOLD HAR��iI.ESS AGREE�IENT
General Instructions
l. You may be required to obtain other permits, i.e. burnin�, well abandonmment, etc.
2. `�Iork 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 473-73�7.
JOB SITE ADDRESS. ��• �r � � �l�v i C� ���
Occupancy Type: Residential Commercial
, �, , _ . . . � `.'� . .. ,
O�VNER'S NQu�1E: - � '' ����c • "_" � r'� Phone: ;�' /��' . �
Nlailin� Address: � � � � /v � •',,: .., �� � Ciry: ��' f � �',�� <
0
� � 6 '�,,�' �: �ret� Bus. No.:�i�—��� ����
CONTRACTOR S NAl1�: �
Mailing Address: �/ z� �J�"-�-- City:��/ce�-�-4s-� , 1�-�-�'
Demolition if planned by means of: manual disassembly
� heavy equipment
bumin� (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.
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 bacl�"�lling.
�
_ _ �
�
7. Wichin � 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 eYcavation is to be used as
part of a new building 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 a�ents, employees and assigns from and aaainst all claims, dama�es, losses
or e�penses, including attorney fees, against the City, its aaents, employees and assiQns
arisin� out of or resultin� from the demolition described herein as performed by the
property owner, his employees, ajents, subcontractors or assiQns.
PER�IIT TYPE A�'VD FEE CALCULATION
_� �50.00 =�Principal Structure
$30.00 - Accessory Structure
1. Subtotal of above permit requested $ ���✓
2. State Surcharae $ .50
3. TOTAL PER�l�1IT FEE (add lines 1-2 above) $ ��_�
The undersi�ned hereby applies to the Ciry of Orono for issuance of a Demolition Permit, agrees
to do all �vork in strict accordance with the ordinances of the City and the rewlations of the
State of Minnesota, and certifies that all statements made on this application are complete, true
and correct. �
��,(, �i^J �4�C''��¢ ��
�� ��cce e� � y�-e(�"�,
APPLICAivT'S SIGNATURE: '�. � • � Date: ; � ' ,�` ' ~~'�
,
c^.
O`VN�R'S SIGNATTJRE: / `- . - Date: • � -' '��
APPROVED BY: Cy�%ln�-- � Date: � " l 3 � � �
DATE TIME
CITY OF ORONO CALLED IN
INSPECTION NOTICE 09�b � SCHEDULED = �
PERMIT NO. � COMPLE D T_ h
ADDRESS�,3��� � ��IA�e �T
OWNER CONTR.
TELEPHONE NO.
� DESCRIPTION P� S C.� N���
� 01 FOOTINO 11 MECHANICAL RI 18 EXCAV/dRADINO/FIWN�
� 02 FRAMINO 13 MECHANICAL FINAL 19 LAI�SHOREJWETLANDS
Q 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 O6 PROGRESS
~ 07 DEM�SITE 27 SEPTIC M/UNT. 21 COMPLAINT
J
� 07 DEM�FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
= 09 PLUMBING RI 23 SEPTiC FINAL 35 HARD COVER REMOVAL
+r t0 PLUMBINd FINAL 28 CEDAR SHINGLES 36 FOUNDATION REMOVAL
Z OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
�
W
a
�
�
O
�
�
O
�
W
� �
Q
z . � ��ro� a �.
W
�
W
�
�
d ❑WORK SATISFACTORY:PROCEED - PROJECT COMPLETE
W
� ❑CORRECT WORK 8 PROCEED C ISSUE CERTIFICATE OF OCCUPANCY
W
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
0 BEFORECOYERING PERMANENT
OCORRECTUNSAFECONDITIONWITHIN HOURS. L PHOTOTAKEN
INSPECTOR WILL REfURN
❑STOP ORDER POSTED.CALL INSPECTOR '= CITATION ISSUED
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call fo�the ne t inspection 24 hours in advance.473-7357
OwnedCont n 'te:
Inspector.
White Copyllnspector' File Canary Copy/Site Notice