HomeMy WebLinkAbout2016-00039 - demo CITY OF ORONO ,
II I I'' '1 H
* 20 1 6 - 00039 *
2750 KELLEY PARKWAY DATE ISSUED: 01/26/2016
ORONO,MN 55356-
(952)249-4600 FAX: (952)249-4616
ADDRESS : 460 ORCHARD PARK RD
PIN : 32-118-23-23-0009
LEGAL DESC : ORCHARD PARK
: LOT 010 BLOCK 000
PERMIT TYPE : DEMOLITION
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : DEMO-PRINCIPAL STRUCTURE
ACTIVITY : 645-SINGLE FAMILY HOUSES(ATT&DET
NOTE: (NO NEED FOR SAC,SEPTIC AREA)
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
STATE SURCHARGE DEMO 1.00
CARLSON CONSTRUCTION TOTAL 76.00
527 8TH ST SW Payment(s)
BUFFALO,MN 55313- CHECK 4739 76.00
(612)363-1166
OWNER
MULHERAN&JON NORRIS,PATRICK
460 ORCHARD PARK RD
LONG LAKE,MN 55356-
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.
er
Applicant Permitee Signature Date Issued Btgnature Date
OW
City of Orono FOR CITY USE ONLY C
P.O.Box 66 Date Received: i - 3 110 Permit ONLY,
((C^ t
2750 Kelley Parkway �7 C�
Crystal Bay,MN 55323 i)i_ C k– Amount: $ /r3` SAC Credit: N`� �� -7" i. L
(952)249-4600 I�,�3 cl
Zr Homeowner(s)Signed: 0 Yes
.,...._ rr_=/ ma ' Resolutions(if any)Signed:❑Yes ❑None Required
Zoning Disclosure Signed: ❑Yes ❑None Required Zgi(v
upecakti ygivd
CITY OF ORONO - DEMOLITION PERMIT eJVW inwiT
(All permits must be approved by the Building Official and/or Zoning Department)
Job Site / Owner Information:
Type: g Residential ❑ Commercial
Site Address: 1 (,O Orckarc, Park road
Owner: Fpj-YjCh.Mu\InvDoi f`TphAi0rri- Mailing Address: 4118 I-faIl9rth Lk)
City: e Cc.IQ 1s I or Zip: 5533 I
Phone: (60149 -- (054+ Email: .
itU i tr1P1 fawn ilNrPOi I tow
Contractor/Applicant Information:
Contractor/App.: Ca rI S 6)1 D h s trus f 1'Vh Contact Person: Wa.CALU2diaeL11
Address: p612_15 Sf• 5 w State License#: 0
b� toZip: 553/3
City: �a Expiration Date:
Ly .
Phone: Wt.- 5L05-- ( I tido. Email: V
SPECIAL CONDITIONS & HOLD HARMLESS AGREEMENT V
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: ❑ Manual Disassembly [Heavy Equipment ❑ Other
Permit(s) Issued: ❑ Sewer Disconnection ❑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 15 —(n Zk
150784 �1/
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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
P $75.00 - Principal Structure $ 16 ."
❑ $50.00 -Accessory Structure x (how many)
1. Subtotal of above permit requested $ --i S '°a
2. State Surcharge 1.00
3. TOTAL PERMIT FEE (add lines 1-2 above) $ 1 & ' o
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.
I,:.
Applicant's Signature: If Date: fit/ it/ 1D
Owners Signature: ff/ _ Date: I f t 2..1 1 b
Approved By: emi
/ Wlqi Date:
( uilding Official)
*Zoning Disclosure Required? El YES rO 1,5 -3T10 pradv'l ivy Y", �' ,0 31a
*This must be filled out by Zoning Department-For her answer, a Zoning Official must sign all applications. 'r`4P(A
*Approved By: CSO k Date: l • ( 4 ILO
(Zoning Official)
Form Last Updated: July 2015
150784
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DATE TIME
CITY OF ORONO -'7CALLED IN -z�
INSPECTION NOTICE SCHEDULED +'"l
PERMIT NO. cS}AA/PLETTED/ / ,/ /�
ADDRESS (o O ii`IfC_. ACt../-k-� / h 1C /(
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DESCRIPTION ,f_ 1 C. eO va c
W 0 FOOTING 0 DEMO-FINAL 0 SEPTIC FINAL
Q ❑ POURED WALL 0 PLUMBING RI 0 EXCAV/GRADING/FILLING
Q ❑ FOUNDATION WATERPROOF 0 PLUMBING FINAL 0 TREE REMOVAL
❑ RADON SLAB 0 MECHANICAL RI 0 SITE INSPECTION
Q 0 FRAMING 0 MECHANICAL FINAL 0 RATED WALLS
• ❑ INSULATION 0 WOOD BURNER/FIREPLACE 0 COMPLAINT
Q 0 FINAL 0 WATER HOOK-UP 0 FOLLOW-UP
0 AS BUILT-SURVEY 0 SEWER HOOK-UP 0 FOUNDATION/REMOVAL
, ❑ DEMO-SITE 0 SEPTIC INSTAL�t 0
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OWNER/CONTRACTOR TO MEET YOU:_YES_NO
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'CZO ID CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑PHOTO TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR ❑CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (952) 249-4600
OwnerlContraor on site:
Inspector. C'`r- -1 ���-o4
White Copyllnspector's File Canary CopylSite Notice
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CITY OF ORONO 312.1CALLED IN /
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Q ❑ POURED WALL 0 PLUMBING RI 0 EXCAV/GRADING/FILLING
Q ❑ FOUNDATION WATERPROOF 0 PLUMBING FINAL 0 TREE REMOVAL
❑ RADON SLAB 0 MECHANICAL RI 0 SITE INSPECTION
Q 0 FRAMING 0 MECHANICAL FINAL 0 RATED WALLS
is ❑ INSULATION 0 WOOD BURNER/FIREPLACE 0 COMPLAINT
Q 0 FINAL 0 WATER HOOK-UP 0 FOLLOW-UP
W ❑ AS BUILT-SURVEY 0 SEWER HOOK-UP 0 FOUNDATION/REMOVAL
✓ ❑ DEMO-SITE 0 SEPTIC INSTALL
Z OWNER/CONTRACTOR TO MEET YOU:_YES NO
co COMMENTS:
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❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTO TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR ❑CITATION ISSUED
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hoou ' advance. (952) 249-4600
Owner/Contraeter
Inspector.
White Copyllnspector's File Canary Copy/Site Notice
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DATE TIME
CITY OF ORONO CALLED IN
INSPECTION NOTICE SCHEDULED 5/(p'1(p ?tel
PERMIT NO. 2-o I --tz c' 1 COMPLETED `
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OWNER TELEPHONE NO. lc I z-3k3`1 bio
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DESCRIPTION fp • • I ►'�a 1
W ❑ FOOTING 0 DEMO-FINAL - 0 S:-TIC INAL
Q ❑ POURED WALL 0 PLUMBING RI 0 : CAVA RADING/FILLING
Q ❑ FOUNDATION WATERPROOF 0 PLUMBING FINAL 0 REE R OVAL
❑ RADON SLAB 0 MECHANICAL RI • SITE INS- CTION
Q 0 FRAMING 0 MECHANICAL FINAL I) RATED WAL
1, ❑ INSULATION 0 WOOD BURNER/FIREPLACE a COMPLAINT
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0 FINAL 0 WATER HOOK-UP 0 FOLLOW-UP
41 0 AS BUILT-SURVEY 0 SEWER HOOK-UP 0 FOUNDATION/REMOVAL
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✓ BEFORE COVERING
PERMANENT
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INSPECTOR WILL RETURN
Cl CITATION ISSUED
ElSTOP ORDER POSTED.CALL INSPECTOR
❑INSPECTION REQUIRED-CALL TO ARRANGE ACCESS.
Callfor the next inspection 24 hours in advance : / ) 249-4600
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OwnerlContractor on site:
Inspector. � /
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White Copyllnspector's File Canary Copy/Site Notice