HomeMy WebLinkAbout2017-01496 - demo CITY OF ORONO I*I z I I �7 I� 1,1131113611111
2750 KELLEY PARKWAY DATE ISSUED: 12/12/2017
ORONO,MN 55356-
(952)249-4600 FAX: (952)249-4616
ADDRESS : 2665 CASCO POINT RD
PIN : 20-117-23-23-0021
LEGAL DESC : SPRING PARK
: LOT 136 BLOCK 000
PERMIT TYPE : DEMOLITION
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : DEMO-PRINCIPAL STRUCTURE
NOTE:
1. FOUNDATIONS/ALL DEMO DEBRIS TO BE REMOVED FROM GROUND&DISPOSED OF OFF SITE,PER PCA REGULATIONS.
2. WELLS MUST BE ABANDONED.
3. INSPECTIONS DONE BEFORE BACKFILLING.
NOTE: A 24-48 HOUR NOTICE IS REQUIRED FOR ALL INSPECTIONS. CALL(952)249-4600.
SEWER MUST BE DISCONTINUED AT THE CITY SERVICE BY QUALIFIED CONTRACTOR BEFORE DEMO PERMIT IS ISSUED. CHECK
TO MAKE SURE THIS PERMIT HAS BEEN PULLED BEFORE ISSUING THIS PERMIT.
APPLICANT DEMOLITION-PRINCIPAL STRUCTURE 75.00
GORDON JAMES CONSTRUCTION STATE SURCHARGE DEMO 1.00
5159 MAIN STREET E DEMOLITION-ACCESSORY STRUCTURE 50.00
P.O.BOX 306 TOTAL 126.00
MAPLE PLAIN,MN 55359- Payment(s)
(763)479-3117 CHECK 14061 126.00
Minnesota State License#:BUIL-20531961
OWNER
GUTERMUTH,DAVID&LYNN
2665 CASCO POINT RD
WAYZATA,MN 55391-
AGREEMENT AND SWORN STATEMENT
The work for which this permit is issued shall be performed according to
the approved plans and specifications,applicable City approvals,and the
State Building Code. This permit is for only the work 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 specified 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.
( /Mil/d)
Applicant Permitee Signature Date Issued B�gnature Date
City of Orono FOR TY SE ONLY
W
Date Received:!// � Pernvt# 60J2750 Kelley ParkwayCrystal Bay,MN 55323 Amount: $/ SAC Credit:
(952)249-4600Homeowner(s)Signed: ❑Yes
C ,i Resolutions(if any)Signed:❑Yes ❑None Required
H oVP Oh'^A t Zoning Disclosure Signed: 0 Yes 0 None Required
tV
CITY OF ORONO - DEMOLITION PERMIT
(All permits must be approved by the Building Official and/or Zoning Department)
Job Site/ Owner Information:
Type: RResidential ❑ Commercial
e
Site Address: 7.4)6 C Civ-Sc-0 Cd ;NA- `;-. •
Owner: `i.:)0-�& 9 Li Mailing Address: S`t'd
•
y l'��
Cit ` /Oco.�a Zip: /';'
Phone: CA S2- ' 5`l`l - l") t`f Email: o v�_-( M 1,c \L frk Sn .
Contractor/Applicant Information f
Contractor/App.: ��0, 8 o--, --... 0,...,0s Contact Person: ,......\61,\,-. vu-,,.�
Address: St S l ),Ac-L-,.), ¶k . State License#: ' CS-A\`l.c,1
City: )k a rS Zip: SS-39) Expiration Date: 3("/3% /‘
Phone: °'152 - --1–( 1 - 563 Email: ,iV\•'1,\ J P 90 r- - rdk-e-
'_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: 0 Manual Disassembly a-kleavy Equipment 0 Other
Permit(s)Issued: 0 Sewer Disconnection 0 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, Construction Site Runoff Control.
3. Submit a copy of permit approval from the Minnehaha Creek Watershed District (MCWD). The City will
not issue a demolition permit without a copy of the permit(s) from the MCWD or documentation stating
permit(s)are not required.
Form Last Updated: July 2015 1 'to
150784 JJJ
4. Submit a$2,500 escrow and an escrow agreement signed by the property owner(copy attached).
5. Keep all structure(s)enclosed and/or secured until such time as demolition is complete.
6. 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.
7. Completely remove foundation(s)from the ground.
8. Completely dispose of all demolition debris off site in accordance with all applicable PCA requirements.
9. Abandon water wells in accordance with State Health Department regulations.
10. Call for an inspection when all debris has been removed, before backfilling.
11. 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).
12. 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.
13. 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
(31)p, $50.00-Accessory Structure x (how many) SZ)
(5;
1. Subtotal of above permit requested $ ``
2. State Surcharge 1.00
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.
�/ ►k • t3•
Applicants Signature: �"/'�� Date:
Owner's Signature: i�
g -� - - - � �— Date:
Approved By: ` i Date: )/ /l
G / 17� ildin Official)
*Zoning Disclosure Required? ❑ YES cNO TVO1 � 4t 2011 -6144'
*This must be filled out by Zoning Department-For eIt15er answer,a ZOO ng Official must sign all applications.
*Approved By: 0 /4Li Date: It' 2-747
(Zoning Official) ' `r M 4t 17-3 Q
Form Last Updated: July 2015
150784
ORONO COPY
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