HomeMy WebLinkAbout2011-00082 - demo Z
' CITY OF ORONO PERMIT NO.: 20��-000s2
" 2750 KELLEY PARKWAY
ORONO,MN 55356- DATE ISSUED: 02/04/2011
952 249-4600 FAX: 952 249-4616
ADDRESS : 4415 NORTH SHORE DR
PIN : 07-117-23-43-0017
LEGAL DESC : SAGA HILL REVISED
: LOT 000 BLOCK 018
� 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 2448 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 T'HIS PERMIT.
APPLICANT DEMOLITION-PRINCIPAL STRUCTURE 75.00
SMUCKLER CUSTOM BUILDERS,INC. STATE SURCHARGE DEMO 5.00
7509 WASHINGTON AVE. S.
EDINA,MN 55439- MISC FEE 0.00
(952)828-1908 TOTAL 80.00
Minnesota State License#:20384253
OWNER
TWOMEY,DAREA&CHRIS
150 2ND STREET NE
MINNEAPOLIS,MN 55413-
AGREEMENT AND SWORN STATEMENT
T'he 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 1 SO 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 aze
requested in conform with the State Building Code.This permit may be
�, revo t any tim or due cause.
1 , � , � � , ,
. Applican ermitee Signature Date Issue By S' ture Dat —
f SEPARATE PERMITS REQUIRED FOR WORK OTHER N DESCRIBED ABO .
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,�p�, City of Orono ; � �y �i /� +p�
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o � P.O.Box 66 �eRc�y�•� ��"'�Per�i�# �--�_,
2750 Kelley Pazkway "
� �� Crystal Bay,MN 55323 � `�` � ��
(952)2'49-4600 ��t* r� � �� ` t `�AC�� �
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CITY OF ORONO-DEMOLITION PERMIT
(All pernvts must be approved by the Build'mg Official and/or Zoning Department)
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Type: Residential ❑ Commercial
Site Address: �q I '� �� � ���ry� ..� lfZ./
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City: Zip:
Home Phone: Alternate Phone:
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Contractor/App.:c��'jZU��� ��rt� �dl��.v�ontact Person:
Address: ��`�1 Cl//C��►s�9. �1'' �'Ue �' State License#:
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City: �-����- Zip: Sr� �� Expiration Date:
Phone: � s2 � Z.�'.�J " / � �ti Alternate Phone:
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General Instructions:
1. You may be required to obtain other pernuts, 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: ❑ Manua.l Disassembly �Heavy Equipment ❑ Other
Pernut(s) Issued.:��ewer Disconnection �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.
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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 Departrnent regulations.
6. Inspection required when all debris has been removed,before backfilling.
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 paxt of a new
building and such new building is actually under construction).
8. Septic systems must be abandoned 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 ta,nks are crushed and filled.
9. The undersigned owner shall and hereby does indemnify and hold harmless the City of
Orono, its agents, employees and assigns from and against all cla,ims, damages, losses or
expenses, including attomey 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
$50.00—Accessory Structure (how many) (what)
1. Subtotal of above permit requested $ � ��
2. Sta.te Surcharge $ 5.00
3. TOTAL PERNIIT FEE (add lines 1-2 above) $ CJ� •��
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.
Applicant's Signatu e: Date:
Owner's Signature: Date:
Approved By: � Date: �}-- `t - �1 (
B ' g Official)
* Zoning Disclosure Required? ❑ YES �NO �(',
*This must be filled out by Zoning Department—For either answer,a Zoning Official must sign all applications.
* Approved By: Date:
(Zoning Official)
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2. bemolat�on debris will be ke,�t of£adjoiwiag groperCy aud/oz t}a.�public r�ght�-o way untess
specific pxa,or a�roval.is ob�aaned in wwri�ti�ug�or t�emporary use f�arao£
� 3. Faua,daCi.ons shall be comp�etely�removed from the ground. � .
4. ' A11 c�,molition'debris sha1�be aompletely dispos�of o£f site in accorda�,ae with a11
. �lacab�.e PCA re�quirements. '
5. Watex walls�anust b�abandoned in acca�rda�nae wiYh.Skate Heal�tb�Depa�fimcnt reg�ilataons. .
. 6. �Zspection reqaired when a���,ebris ha�beea.removed,before bacl�6ial�i�ag, .
7. W�itk�in 5 v�o�days of an�ershiictur�re�moval,a�na1 inspeciion.sha,�b z�sted.. The
� site sb,a1�be le#t c�ea�a and cl�a.r of all debtxs,wi�'h any excavation,fi11ed wi earth 1eve1 with
the ad.jacen.t ground e�evation(except when suc�e�oavation is to be vsed as�art a£a new �
' buildiz�g and such nerw builditig is aotually under coz��ta�ttction). . .
8. S�ptic systtema must be abandoned pex XV�['inaosota Ru.les Chapter 7080. A�1 tic taalcs . �
xnust tie pumpe�cl;cruehat and fi11ed wi4k�rnakive soils. .An ' on is re��d after the .
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� ta�ks ate gvmped and b�foze tha tanl�s are crushed a�otd fi ed, ' .
9. .The undezs�igmal.own�r sba11 aad�ereby does indemn�i£y aa,d ho d has�nless tb�,e City of � �
C�rono,i�agenfs,employe��d assigae�rv�m and agai.nst ail c�me,damages,loese�or ,
. e�enses,including a�tam.ey�ees,ag�inst�e Cify,its agents, �loy�ae aad a�signss azi,sing . .
oizt o�o�xesu�t�g�roni the damolit�om desen"bed 3�erein as pex�orai�d b the properiy ownaz,
• hiS�nn�Ioye,ea, agez,tts,suboon�ractors or as�ig�,s. � �
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PE�T TYPE AND��C `�O�T �
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• � $75.00—F,�ncipal Stzuctur� . .
$50.00—Accessory Structuxe (how n�emy) (�) �
1, Subtdl�l o�abovepermit requ�ted $ � S • � :
2. State Surchatge , $ 5.0�
3, TOTAL PER1V�[',��+E(add lines �-2 a.buve) $ �d•�"" ' , .
� The undersig�aed Jaerby applies to t$e City of Omno foz zs�uauce of a Demo t�c�Pe�uit,a °
, to do a1t the woz���striet accurda�ce wi���he ordinances o�the City�d e z�egulxttons o
t�e State of Mirmssota, aud ce�fes f�at aU s�texnenYs m�de oz�tki�is applic 'on ate vomplete
trlle�[�00�70Ct.• . � . , .
,A,pglic,�nt's Sig�ua : Date•
Orwner's aiguature: �( �Date• �. �
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' ��Prnved�Y� Dste• �-�' ' ► t
O£�cial) � .
��mn t t�elosure Req�ixec�3❑ YES �O t�,,,('', .
�1ed otu by Zoniag D�e�t ��r�that s�swax,a Zoni�g Offiicia.l m e:�a I appl�cat�ions. �
*.A,pProved�y: T�ate: �
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