HomeMy WebLinkAbout1995-007324 - demo 2 houses PERMIT
,.: G'�TY OF ORONO PERMIT TYPE:
2750 Kelley Parkway- P.O. Box 66 ��.-:��.-,F==.`�t:�
Permit Number: `;:-;-�_�-:;i
Crystal Bay, Minnesota 55323 - - • -�-�
(612) 473-7357 Date Issued: __ :��-.�:c,
SITE ADDRESS:
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APPLICANT/PERMITEE SIGNATURE ISSUED BY:SIGNATURE
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� 08i31i95 10:0? Tlf CITY OF ORONO 612-473-7357 002
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CITY OF ORONO A�'PLiCAT�ON FOR DEMOi,iTInN PERMIT
P.O. Box 66 (2750 Kelley Parkway)
Crystal Bay, MN 55323 �
SPECIAL COND�'I'iONS & HOLD HARMLESS AGREEMENT
General instructions
1. You may be ttiquired to ubtain other perriilts, i.e. burning, well abandonmment, etc.
Z, Wock must not begin unless the permit card is available on the job site.
3. A 24 hour notice is requirrd for all inspections. Cai] 473-7357.
JOB S1TE ADDRFSS: � 3`F Z-- �O�-� �''t'� I��''"� -
Occupancy Type: _,_.��Residential �Commercial
OWNER'S NAME:�_ Phone: 29'?�v�i'�l
Mailutg�Address:� l,o -��+ C1ty: mn 5S iblo �
COTV'!'RACTOR'S N�+iN�: �� t�� � Bus. No.: 42�2?�/�--
MaiJing; Address: )�,oau �l�vr' �1.r� _ , City:0?.,,��.,c . t-w►-. �3�`1�
, Demoli�on if planned by mr.a��s of: manual disassembly
� _ heavy cquipment
� � burning (by firc department)
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Permits I Issued:
' � Burning Fin Aepartment .
� wcu Abenaonmenc
I In retucip for issuance of said Deraolition Pcrmit, the undersigned owncr hereby agrees as
� foltowsi
1, The swcture(s) shall be kept enclosed and/or securod until such time as demoGtion is
� ¢omplete.
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2. Demolition debris will be kept off adjoining property and/or thc public rights-of-way
� . 1�nless specific prior approval is obtained 'w writing for temporary use thcreof.
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3. Foeu�datiuns sliall be complctcly removed from the �round.
; q, pll demolition debris shatl be eompletely disposed of off site 'vn accordamce with all
applicable PCA requircm�nts.
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' S, Water wells must tx abandoned in aeeordance wi[h State Health Depgrtment regulations.
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' 6. lnspeciion required whcn al1 debris has been rcmoved. before backfiiling. i
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� � �31 i95 10:07 THE C I TY OF OfZ01J0 612-473-'i 57 603
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7. Withiz� 5 working days of supersttucture re�►ova�+ a fi�al inspection shail be requested.
The sitC shall be left clean and cicar aJ'all d�bris, with any excavation tilled with eazth
level with the adjacent ground elevatfon (cxcept whcn such excavation �s to be used as
part of a new building at�d such new building is actually under construction).
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g, Th� undersigned owner shall and hereby does indemnify and hold harmless the City of
Orono, its agez�ts, employees and assi�ns from and against all claim�s, damages, losses
or expenses. including attorney fees, against the City, its agents, cmploxees and assigt�s
arising out of or resulting from the demolition described herein as performed by the
properry owner, his employees, agents, subcontractors or assigns.
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pE�tIT TypE AND FEE CALCULATION
$50,00 - Prir�cipal Structure '
1
$3Q.00 - Accessory St�'ucture �
f. Subtotal of above permit requested $
$ I
2. State Surcharge
3. TOTAL PEItMIT FEE (add linas 1-2 above)
$ I
The undetsigned hereby applies to the C�ry of Orono for issuancx:of a Demoiitio Pcrmit, agrces ;
to do all wock in suict accordance with thc ordinances of the Giry and tho regnlations of the
State of Minnesota, and certi�es that aIl statcments made on this applicadon are complete, true ; .
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and correct.
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APPLICANT'S 3IGNA • 1'- Dat,e: 9S
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pW1YER'S SIGNATURE:
Aate:_ �
APPROVED BY: Date:
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