HomeMy WebLinkAboutDemolition Permit 08-0977
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CITY OF PRIOR LAKE
DEMOLITION PERMIT
Date Rec' d
II 2&,.08
I PERMIT NO.08_~\ 17
ADDRESS /A~7,3 0 .J-hl
/~, / (V WrlIU;.)
ZONING (office use)
LrI kA5 /8'0
^
LEGAL DESCRIPTION (office use only) .
ADDITION ::;Cc--/ 3 3-+ ~L-/2-itJ rr cuu
LOT
BLOCK
PID zc; --13 3'~ a:> :5 -0
x
OWNER
(Name)
S~YV\ 'SL
330
(Phone) (; I ~ - '7 ~ '1 . (., C; '6<f
I
(Address)
s\ (;v'v'1-- -\.-v,~, \.
K
CONTRACTOR
(Company Name)
(Contact Name)
(Address)
'S-e \ t=-
(Phone)
(Phone)
Use of Building:
~(NC:::7L6 ~J111
Ji,U5C
INTERNATIONAL BUILDING CODE
Type of Construction: I IT ill IV
Occupancy Group: A B E F H I
Division: 1 2 3
,tj)A$
M R S U
4 5
:MPCA NOTIFICATION OF INTENT TO PERFORM A DEMOLITION
'f
I hereby certify that I have furnished information on this application which is to the best of my knowledge true and correct, I also certify that
I am the owner or authorized agent for the above-mentioned property and that all construction will conform to all existing state and local laws
n 'proceed in accordance with submitted plans, I am aware that the building official can revoke this permit for just cause. Furthermore,
hereby gree that the ~"eSignee may enter upon the property to perform needed inspecn,'ons. , ",. /'
L !1/~~--o6
. Signature Date
ecomes Your Demolition
'he Approved
/1 2",/08
N~
o
This is to certify that the request in the above application and accompanying docnments is in accordance with the City Zoning Ordinance and may proceed as requested.
1/- ~-OB
Date
Special Conditions, if any
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:
o~ uXJ
Address:
15 -; "30
;i,.~~ ~~ A?..:J
Check boxes below:
1i Fill Excavation to grade
~ Sod or seed all bare soils
o Erosion control (see handout). Maintain erosion control until turf is established.
o . Cap sewer below grade. * Mark location. Licensed contractor required.
o Ettp '.T.'~ter below grade. * Mark location. Licensed contractor required.
o Call {;i.ty of Prior Lake Public Works Department (Call 952.447.9843 or
952.447.9844) for water meter removal.
)f Cap gas line.* (By gas company)
)( qt.~co.!lnect '.atm~!~E,(ay~lectric company)
)t'~u~plan~gll cess~~~.!ts~lc tan~Jcertified contractor required.
'XJ Abandon well. ~rtified contrador-iequT~7 Existing well
X Remove existing structure foundation and footings, materials, and debris. **
o Provide dust control by following means:
1. Water mist from a water supply (i.e. neighbors, water tank)
2. Enclosure
3. Other
Comments: (provide surveyor draw site plan)
F/~ t:=. tDG,dTS B u/LA.Ic:Ez) ;7bu 5 6-
El A~/,/ f2.6tPcJ i12-65 A j:.Lc;not- {Ii u..-v ~ lr
*Capping of utilities must be inspected.
** Final inspection and approval of restored site required. Deposit will be returned after
roved final inspection.
['.~
Signature
I/~d&-O~
Date
J :\HANDOUTS\Demolition Restoration.doc
P RIO R LA K E ~~r~'::~r::D ~=SPECTION
INSPECTION
RECORD
SITE ADDRESS /5730 ~~ iA.cL6 t2zJ
TYPE OF WORK PbnOI." IrrON
USE OF BUILDING A6-no I.
PERMIT NO. 013-177 DATE ISSUED 1/ /"L~/o~
,
BUILDER S/YlSG PHONE # ~z- -7'~4 ~r!34
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR
DATE
r;iQ:~iI14i S~n~ ~/L RU- I I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
~A~MIIJ~ iVtEi-1-- CAJO A--~ I
I FINAL I I
FOR ALL INSPECTIONS (952) 447-9850
Shakopee Mdewakanton
Sioux Community
FAX COVER SHEET
OFFICERS
Stanley R. Crooks
Cltairntan
Glynn A. Crooks
Vic~ Cltairman
Keith B. Andersoo
Secretaryf/'reallU'fT
2330 SIOUX TRAIL NW. PRIOR LAKE, MINNESOTA
TRmAL OFfICE: 9S2-44S-8900. FAX: 952-445-8906
To:
Paul Baumg~rtn.r
Agency/Company: Building Inspector - City of Prior Lake
FAX#:
952.447.42"
From: Christina Fuechtmann
FAX#:
i52.445.0038
Program/Department: Public Works Administrative Assistant
Date: 12/4108
Time~
10:30a.m.
Total Pages Sent:
2 including cover
Comments:
........................................................................................................
Originals to follow:D
Originals will not follow:D
1 a~ed
BEOOStoto2SS
S~~OM ~IIBnd ~SWS W~2E:Ol B002 toO oaa
SCOTT COUNTY, MINNESOTA Permit # 2 4 U U 7
INDIVIDUAL SEWAGE TREATMENT SYSTEM (ISTS) PUMPING PERMIT
Owner", ,\ ,,' - ",Address 15130 flv~ Uz Lfl
Pumper h;'" No. of Tanks Pumped Total Gallon. Pumped
Check all that apply: Residential 0 Commercial DRental
~CPtiC 0 Holding 0 Pump Chamber 0 Cesspool ~bandoned 0 Other:
Condition of Barnes (baffles must be im''}lecteu) 0 Acceptable 0 Unacceptable 0 Replaced Baffles
Depth of sludae layer inches
Disposal Location (be specific) E-;.' -( {(. ~. (,
Did you observe a surface discharge? D Yell 0 No
Pum~d From: 0 Maintenanoo Hole 0 Removed Tank l.id (stave. for <:xamplc:) 0 Inspection Pipe (see below)
I have ~c:n informed about the correct tank cleaning procedures and understand that I risk having my system fail prematurely
if the tank is nQt pumplX1 through the Maintc;:uaocc Hole I Tank Lid to enable the removal of Rolids.
Signature of Owner I Owner's Agent Reason for not pwnping through the Maintenance Hole I Tank Lid
Comments ilBAl..)O(),~,~ }',
1'>. I 1i f' J, r,' , I ~ (, I 0
Pumper I Inspector Signature ;' ~t"NI' !' n v,t.tf Dd~ (:<. I ~ ~"
Only one permit is needed per ISIS. IftJ1l~e is nlore tll' one ISTS on a property. submit a sepaute pennit for each ISTS.
Submit a permit whenever a tank is pumped fOT abandonment. Pumping the tank does not (}onstitute a compliance inspection.
While - County
, " Canary - I1omeowner
4,. .
. .,,;......;'tu.
Pink - Pumper
Form 111:
......J._._~..,~___.._.. .....
a a~ecl
8EOOStotoass
S~~OM JI10nd JSWS W8aE:Ol 800a toO ~aa
I I
Shakopee Mdewakanton
Sioux Community
FAX COVER SHEET
OFFICERS
Stanley R.. Croaks
Chairman
Glynn A, Crooks
Yiee ClttJll'Mm1
Keith B. Anderson
SecretarylTreQ3"'"
2330 sroux TRAn. NW. PRIOR LAKE. MINNESOTA
TRIBAL OFFlCB.: 952-445-8900 . FAX: 952-"145--1906
To:
Paul Baumgartner
Agency/Company; Building Inspector - City of Prior lake
FAX#:
962.447.4246
From: Christina Fuechtmann
FAX#:
ProgramlDepartment: Public Works Administrative Assistant
962.445.0038
Date: 12/4108
Time:
10:10 a.m. ,Total Pages Sent:
2 Ineludlna Cover
Comments:
........................................................................................................
. Originals to follow:D
Originals will not foil ow: 0
1 a:iJecl
8EOOS~~2SS
S~~O~ ~IIHnd ~SWS W~21:01 8002 ~O oaa
Dec.03.2008 11:25 AM Mineral Service Plus 3202380198 PAGE. 11 2
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