HomeMy WebLinkAboutDEMOLITION 07-0262
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CITY OF PRIOR LAKE
DEMOLITION PERMIT
Date Rec' d
P'ERMIT NO. ~7 -ZlP'-]
LEGAL DESCRIPTION (office use only)
l (2- \
ZONING (office use)
I LOT
OWNER
/ (Name)
BLOCK
ADDITION
pm 25 -oz->-co'j -0
1
SCorr
C ""'" r--T-l" ~l e............
(Phone) --11-b. B ~4:.-
~~'" .. B ~4 (p
(Address)
CONTRACTOR
(Company Name)
(Contact Name)
(Address) ("YO -2- 7 S
(Phone) Cj 12" Iff/.- 3 'J-(;j
(Phone) ~ 12 -/X6 - k' <50S'-
- () Lf<f-
Use ofBuiIding:
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INTERNATIONAL BUlLDING CODE
Type of Construction: I II ill IV g:? A ~
Occupancy Group: A B E F HIM <:::1C> S U
Division: 1 2 ~ 4 5
CA NOTIFICATION OF INTENT TO PERFORM A DEMOLITION
I h"'by -fy that I havo fumi"hod info,,"ation on tbi, applica.;on whkh ~ to th, b,,, of my know"d", tru, and corr,ct, I ,",0 certify that
I am th, own" 0' authoriz,d agent fo, th, abovo-montion,d pmp"", and that all 'on'truction win coufo,," to an '''''ting ~a" ond IO'a1la",
and will pm'''d m aoco.-dan" with ,"bmitt,d pia"" I am awac, that the building offi';a1 can ''''0,", tm, P'mUt fO'i"" cau,,_ FUrthmnore,
I h",by age", t at th, city official 0' a de,;gn", may "n" upon th, pmp"", to P"'ann n"d'd ""P'ctio"" "... '7
'7 ~ ~ Cf -L~ V ('
Date
n Becomes Your Demolition
it 'hen Approved
"
.-.. e.cr~~_. {Iool .eAsk- '\30
$"00.... . r;;;. J.......--v'
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Date
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Special Conditions, jf any
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24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue, Prior Lake, Minnesota 55372
Site Restoration Proposal For Demolition
Applicant:
~v<..c--
OlT'AJ~
-
\ ~4~ I F~\C-,--vv (tz-
~CoVM"1 . D...^ () 4~ ..8 !. 6 <t
Check boxes below: I . l"""""\MI)~ ~l..{)c.:.
. 'Ptb -as't-(p
r! Fill Excavation to grade
* Sod or seed all bare soils
b Erosion control (see handout). Maintain erosion control until turf is established.
r; Cap sewer below grade. * Mark location. Licensed contractor required.
:t Cap water below rade. * Mark location. Licensed contractor required.
o a City of Prior Lake Pub IC WOrks-Bep 9:. .9898 or water meter
removal.
. Cap gas line.* (By gas company)
X Disconnect electric at meter. (By electric company)
t-.ft Pump and fill cesspool/septic tanle Certified contractor required.
rJff Abandon well. Certified contractor required. Existing well
X Remove existing structure foundation and footings, materials, and debris. * *
'MAProvide dust control by following means:
1. Water mist from a water supply (i.e. neighbors, water tank)
2. Enclosure
3. Other
Address:
Comments: (provide surveyor draw site plan)
J1ldJ V ()J& ~ 8f' T~
~Jg Ol~UB~:r O{~ ~Cqr
** Final inspection and approval of restored site required. Deposit will be returned after
approved final inspection.
Signature
Date
J :\BUILDING\HANDOUTS\Demolition Restoration,doc