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Home My WebLink AboutDemolition Permit 02-0032 OOV ~, ~U 't' ,-oJ CITY OF PRIOR LAKE DEMOLITION PERMIT 1. White - File 2. Blue - City 3. Yellow - Applicant Permit No. 02-0032- DIRECTIONS 1. DATE BUILDING INFORMATION 7. SIZE OF STRUCTURE SPACES NUMBERED 1 THRU 10 MUST BE FILLED IN BEFORE PERMIT ISSUED (Please print ortype and sign at bottom). II-S:-o f 8. NO. OF STORIES /~ 9. TYPE OF CONSTRUCTION ~oc>L:J 10. COMPLETION DATE 2. SITE ADDRESS /.5 S- ~O /)~,f-eg 3. LEGAL DESCRIPTION LOT Set-T .54- BLOCK AtI~ AlW PID ,.Jf9/ ~4t/o/f ADDITION /,J - $ / - 0 I 4. OWNER (Name) (?R~~~'- g,A. y 5. AR9HITECT (Name) / (Address) ~':-""- ""'A:"JU -r '-. L, C / (Address) C#.A(""k'"A- /)110/' , (1 el. No.) ~ -7#7- 4/54- (Tel. No.) 6. CO TRACTOR (Name) (Address) (Tel. No.) ?k.. tJi;"tI~r L. /.C CHAgA AtAI ~,J - 747- 47..r4 I her by certi I h e furnished Ilfor.mil.tion which is to the best of my knowledge true and correct. I also certify that I am the owner or a oriz agent for the a 0 mentioned property and that all construction will conform to all existing state and local laws rndill p cee in accordance W~SUb It.ted plans. I am aware that the bUildin.g official ca. n revoke this permit for just cause. Fu er ore hereby, agree th the . y official or a designee may enter upon the ~p~ to perform needed inspections. '. /11-/4('/ . . ///vk/ 'J./t/J ~ -, /s~re / - , {. Date .v FOR ADMINISTRATIVE USE a&'P tAJC/ NO 4-51 ~ ~ MATERIAL FILED WITH APPLICATION - 11 ,f 4 (J o Site Restoration Plan h'1f)~ y ,/ o Utility Abandonment Plan ./1 r _ ~ r I.., o Sewer Abandonment () . 01/ I ' 1>~1 / o Water Abandonment METRO SAC UNIT DETERMINATION o WQ.\\~ Se.~c.. USE OF BUILDING S{='O SITE RESTORATION PLAN Accepted by Rejected by o Electrical Abandonment o Other Occupancy Group A B E H R V M CREDITS Park Oed. Credit ................................................ $ SAC Credit ......................................................... $ Sewer & Water Connec. Fee Credit .................. $ Water Tower Fee Credit .....................................$ TYPE OF CONSTRUCTION: II III IV Division 2 3 4 tliS Iication becomes your de oljontf.err:tf(n ~ U ~~ Date_I'2-C;-O {Issuedby. Date This is to certify that the request in the above and accompanying documents is in accordance with the City Zoning Ordinance and ma~.j?JQceed jlsr\equ. e_sted. ~-X~~-R~----- 1/7/IO'L C;:.~~:-.j~f~"4-L- Cn1 Planner' Date ~on Itions if any Other .................................................................. $ TOTAL CREDITS ....,................... $ -P . . - . f- ,., Site Restoration Proposal for Demolition Address: 6<< ~7A-C. / /.s5'~ 6'~ / tJ~G"c.04Atf:'Vr / /JL&:'#' AV~ ~L~ Applicant: hid Check boxes below: ~ll excavation to grade o 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 Cap water below grade, * Mark location. Licensed contractor required. ~ap gas line. * (By gas company) rg/'Disconnect electric at meter. (By electric company) liYP"ump and fill cesspool/septic tank. Certified contractor required. ~~don well. Certified contractor required. 0 Existing well ~ Kemove existing structure foundation and footings, materials, and debris. * * Comments: (provide surveyor draw site plan) *Capping of utilities must be inspected. * * Final ins . n and approval of restored site required. Deposit will be returned liP ::U~& //~k Ur:t~cv - Date DEMO.DOC ~ - -- Minnesota Pollution Control Agency Notification of Intent to Perform a Demolition Type of Notification I I Original I I Amended I) Project Cancellation Buildini! Owner: Name: (?~"'L Address: Ruildinp Information: 5/97 Building N~me: ~(!r" ~ ~trr,..(!('s Address/Location: /.5~4b /)'Art:;lIr-~ A/4J City, State, Zip: ~1I'..c.. ~ -"'/U..:n;g 'JJ County: ~I'O"- Phone Number(s): Age of Bldg. (years): B Size of Bldg. (sq. ft.): Number of Floors Including Basement Levei(s): ,d). ~;r- Present Use of Bldg.: ~""~"".4 L. Demolition Contractor: Name: Address: City, State, Zip: Contact Person: Phone Number(s): ~ / ~U7A1"'''''T Lee Prior Use of Bldg.: ~"._r/.A-c..... City, State, Zip:~f~~ #1# Dates when demolition or intentional burning will Begin -I/-/tf -0 t.. & End /.,) - 3/ ~o/" Phone Number(s): 4eAlAJr ibid - ~..~~ Notification must be postmarked or received ten (10) working days before demolition begins. .See item #5 for emergency demolitions. Both Beginning and Ending dates should be amended in writing as necessary to reflect current project dates. Contact person: 7~7 - ~7~ If there is >260 linear feet or> 160 square feet of Regulated Asbestos-Containing Material (RACM) in the building to be demolished, it n:ust be removed by a licensed asbestos contractor pdor to demolition. The State ofMN- Notice orIntent to Perform an Asbestos Abatement Project must be used to notify for the asbestos removal. Is nonfriable ACM present in the structure to be demolished? If YES complete items 1-9. If NO complete items 3-9. I I YES Xl NO 1. If ACM will be left in place for the demolition indicate the amount of Category I and/or Category II nonfriable ACM left in place. Categ. I Linear Feet Categ. 11 Linear Feet Square Feet Cubic Feet Square Feet Cubic Feet ~orv I non friable ACM means asbestos-containing packings, gaskets, resilient floor covering, and asphalt roofing products containing more than one percent asbestos. .Category I nonfriable ACM is not allowed to remain in place for demolition if it is in poor condition. ~orv II nonfriahle ~means any material, excluding Category I non friable ACM, containing more than one percent asbestos that, when dry, cannot be crumbled, pulverized, or reduced to a powder by hand pressure. .Category II nonfriable ACM is not allowed to remain in place for demolition if it has a high probability of becoming crumbled, pulverized, or reduced to a powder during demolition, transport, or disposal. (ex transite, cement, slate roofing) 2. Description & Location of ACM remaining in place (including floor # and room #): TOO (for hearing and speech impaired only): (612)282-5332 Printed on recycled paper containing at least JO%fibersfrom paper recycled by consumers The ("enler of the Lakt Counlry White - Building Canary - Engineering Pink - Planning BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST NAME OF APPLICANT 0:JsU' (;''0 ~l?~ APPLICATION RECEIVED Ii... 5 -0 ( The Building, Engineering, and Planning Departments have reviewed the building permit application for construction activity which is proposed at: /55'-/0 1)r-~ lJu..e-. Accepted Accepted With Corrections Y Denied Reviewed BY(("J) ~~~ I Date: 12 - (q-- c> { Comments: l. ~l1i&... \,j.Q.tl o.\oCl,^~ 0Qjti .(:'1CQ..'tl'~/\..., 2 . M ~~'" \.o..l II\.. ().os tav\ (]c1Vlh~ \ 3. Ptok~\-. 0.1\ gtJ'^ o't,cc..-k -f~s. ~ ~C'., --y ~. Th,'b V\60SL i'5 V10 \- {-o ~ \M.o\1"'~. 5:. Th~ ~()C;~ ts +e lolL J~ol~~_ "The issuance or granting of a permit or approval of plans, specifications and computations shall not be construed to be a permit for, or an approval of, any violation of any of the provisions of this code or of any other ordinance of the jurisdiction. Permits presuming to give authority to violate or cancel the provisions of this code or other ordinances of the jurisdiction shall not be valid." White - Building Canary - Engineering Pink - Planning The Ctnler of 1he Lakt Counlr)' BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST NAME OF APPLICANT APPLICATION RECEIVED I i / \ '- / \\ / I It . l ! I The Building, Engineering, and Planning Departments have reviewed the building permit application for construction activity which is proposed at: ./ I !; '..- Accepted V Accepted With Corrections Denied Reviewed By: ~~- ComMents: ,~~v ~~V; J L\J_ Date: 1/7 /07- ~ ~r;:WJLl/'l ~_l!/ ~ I "\~ ~..'"S . ,I. I ' ( ;, If .. <9w_,S\0 d6Y1l~i)'{~~:{~ ~ ~ {\ 1-i.t9 T '1 (0 b.o_/~ I~ '1' P p t~~~~ "The issuance or granting of a permit or approval of plans, specifications and computations shall not be construed to be a permit for, or an approval of, any violation of any of the provisions of this code or of any other ordinance of the jurisdiction. Permits presuming to give authority to violate or cancel the provisions of this code or other ordinances of the jurisdiction shall not be valid."