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HomeMy WebLinkAboutDemolition Permit 12. 1026 IV J w O 2 z F a u� W E 2 0 W =Z WW a _ Z C 25 5 5 2 > W iv) I- 0 2WW' z Z p – – a E" 0 ------_, — WULLLLU' ---- p W 000000 (n C1 4 1 �` - w yQ ce J N O 0 p a aa ( m o 0 W 0 Q : F- Fe OOtL- - '� O N W - 2 `,\ Z IX Z_ S=Z? W C & U • W m�rt d ' (n LL .. 0 c Z to e U o = W 2 j w.¢ _j ; I W W Z X J W d J W W W W W 4. o 2 �y �' lb 1: U O O . z ❑ ❑ ❑ ❑ ❑❑ _ J o d ° t r y 0 Y W Z U O U �T 0 a LL f- 0 in Flu g P tn 0 a 0 g Z w F ° Q r 3 a ce _ �Q O ° r a z► n 10, w -. - -- W a a o. • a D 2 OO � Z LL M 0 S 0 0 U U? a o a 00000 0 -J p_ 10 \ t ;t \ § j � �� > r::\,\ �� ©�� o ,d $ ���2 E z b aaa5 \ o ■ww U) 2 $ WODU N 000000 / w / tz x - 0 \ pc e . L 2 { 0 z \ \ o d \« 7 0 7 § \ �,t, 0 2 @ o w z k o o } ' n \ -1 till I c o w m �L ■ & . Owe s 2 0 a s § ft § 0 z . w « a21 ■ . $ $ 0 X \ O O o ° g\ ;� w \ � �/ o 4( � ��` \ \ Z - a t c 2 q 00 k k 1:: § 2 j § •• -.I \ $ 0 7 B z 4 i i k §° D . z 2 A 25, � @ W o0o E u 0 \% E b k \ 0 BOO \ k \ % � \ \ LGOO U ` , P R I ��, � CITY OF PRIOR LAKE Date Rec'd DEMOLITION PERMIT r, ( . /2-- ' r N N E s O� PERMIT NO. �L y / Alt (Please type or print and sign at bottom) ADDRESS ZONING (office use) L o0 G 4ND'j OoveTR " -Prior Lae, nil LEGAL DESCRIPTION (office use only) . C I LOT l BLOCK ADDITION ,Se.z. A e . c 0 J Ur e ID A 0a71)07 0 OWNER (% I _ - 6,/A Q q (Name) ( 9 `O rt o.. E � 'Z.e- P. y` O • ) as b (Phone) Sri- i - 11 (13 (Address) j33 DDdd iI V « Lai tile Win. 4sa Li6c e yes CONTRACTOR \ � 9..67—, (Company Name) ,/l.l� i �/- • (Phone) /S e71 '14, (Contact Name) A, ,/ ���_ . LO,.i TS) vs- 00 (Ph ne) 4 ^ j J— y. 3 _,,, (Address) 95 rd / p 7 n o�f( !��'��h ,� �r� n / / Use of Building: INTERNATIONAL BUILDING CODE e `,� Type of Construction: I II III IV V A B ( .. V 1 n Occupancy Group: A B E F II I M R S U Division: 1 2 3 4 5 NJ MPCA NOTIFICATION OF INTENT TO PERFORM A DEMOLITION lj(htc(e © — fl o-f A p1J I (cedp( e_.) 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 and will proce- • .. accordance . •th submitted plans. I am aware that the building official can revoke this permit for just cause. Furthermore, I hereby ag t•' city o or a d • gnee may enter upon the property to perform needed inspections. i // I.. / w % / /i� i / • Signa e Date / METRO (MCES) SAC UNIT J _ This Application Becomes Your Demolition DETERNIINATION .. / / Perm en Approved / i YAW/2_ q � (2 /Or-CI— c D 457 51 000 .0 G O 7 Building O: cial -..."........!ate O &POS/ / Ohl E.L. G�-� ' D This is to certify that the req -st in the above application and accompanying documents is in accordance with the City Zoning Ordinance and may proceed as requested. yi anning Dire 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 o °4 ti 4646 Dakota Street SE y, Prior Lake, MN 55372 "1VNESO�A �. .e MEMORANDUM DATE: Monday, May 13, 2013 TO: Janet Ringberg FROM: Lynda Allen RE: Building Permit #12 -1026 5400 Candy Cove Trail Please refund the $5,000.00 demolition deposit on the above referenced building permit. The demolition is completed and the footings have been installed for the new home. Return deposit to: Friedges Excavating 9380 202nd Street West Lakeville, Minnesota 55044 Thank yo . 1 / Lynda S. Allen, BUitding Services Assistant Phone 952.447.9800 / Fax 952.447.4245 / www.cityofpriorlake.com 707: ° / 1: 41:7 f� . Site Restoration Proposal For Demolition V B K s [` y.f T � , N NES O . iA 16 i ti. *r D. u A,:( Ai SUA�+MTt1D Applicant: i e. A A ks a ernmenv comuncie AS t 0 '4(YT AC tvvrrn 4 ., • "t AFStit Address: Jh OD C OL)(1 & C u . -:., ' Ole 1, . 'Mwr ' ' er 1. w' ' 'V% ;w a •, +. .at► Check boxes below: IIDAdorj i.n4N , -! ,y ' ,., 41 it, if y ,,,. , ❑ Fill Excavation to grade ❑ Sod or seed all bare soils ❑ Erosion control (see handout). Maintain erosion control until turf is established. ❑ Cap sewer below grade.* Mark location. Licensed contractor required. ❑ Cap water below grade.* Mark location. Licensed contractor required. Call City of Prior Lake Public Works Department (952.447.9898) for water meter removal. 7 Cap gas line.* (By gas company) Ru --c\L# 1 ko 7 Disconnect electric at meter. (By electric company) N gt Pump and fill cesspool /septic tank.. Certified contractor required. p" Abandon well. Certified contractor required. Existing well ❑ Remove existing structure foundation and footings, materials, and debris. ** 2( Provide dust control by following means: V Water mist from a water supply (i.e. neighbors, water tank) 2. Enclosure 3. Other Comments: (provide survey or draw site plan) S l t_r U e_L\ A ti cialeg n S v) es�-oS 1- A.S c e r (3 . re_ VA. 0 v ea I "L - a_c.6e0 1q n � M! k . . . ' i "i"\' O F PRIOR ;1\''''.E C 0 3,,p p.I W �� o--k e 6 E�UiL` ANC ' PLAN HEdli: VV D NSPEcTO� / ��1► f 2 *Capping DATE 9 6/` ti P ERMIT NO. *Ca n inspected. 0 ACCEPTEDAS SUBMITT g of utilities must be i P ected. ®ACCEPTED WITH CORR E CTIONS AS NOTED ** Final inspection and approval of restoredaimtl'EmfiI OPYed after a roved final ins ection. Th ese comments are for your information- AK work shall be don PP p in full co, pliance with all applicable building & zoning code 10, 16, requirements including Hems not speciticaliy noted In thlsreview. l KEEP THIS PLAN SET ON SITE T ALL TIM Signa Date J `,BUILDING\iANDOUTS\Demolition Restoration.doc WELL OR BORING LOCATION MINNESOTA DEPARTMENT OF HEALTH Minnesota Well and Boring H 304653 • County Name WELL AND BORING SEALING RECORD Minneso a Unique Well No. ScApit Minnesota Statutes. Chapter 1031 or W- series No. p (Leave blank it not known) Township Name Township No. Range No. Section No. Fraction (sm. —fig.) Date Sealed Date Well or Boring Constructed Pr i (1 r ttl- r 115 tit as (k) .O .Su)Sg' "I) 1 I tp/ 1 t t b ANOI 1 GPS Latitude degrees_ — _ minutes_ seconds Depth Before Sealing ft. Original Depth ft. LOCATION: Longitude degrees_ minutes__ seconds t ArFER(S) STATIC WATER LEVEL Numerical Street Address or Fire Number and City of Well or Boring Location Single Aquifer ❑ Multiaquifer , ^�� S fO , G � D re 1 WE} ING M ❑ easured Estimated Date Measured x (, tc- r ,�Water -Sater-Supply Well ❑ Monit. Well Show exact location of well o • 'ring Sketch ritap of well or boring in section grid with "X." location, showing property ❑ Env. Bore Hole ❑ Other ft. low D above land surface N lines, roads, and buildings. CASING TYPE(S) `__ J [SAteel ❑ Plastic - Tile h Other ---i-----'--"--4-- ° `--- T WELLHEAD COMPLETION W E I19.( 7 Outside: ❑ Well House NiAt Grade Inside: ❑ Basement Offset h Mile 11] Pitless Adapter /Unit ❑ Buried ❑ Well Pit rs 1 ❑Buried ❑ Well Pit ❑ Other _ • I 1 Mile I ❑ Other — PRO RTY OWNER'S NAME,/,,C4IMPANY NAME CASING(S) 4 CI V t f V.V.,1 7 or Dia eter Depth Set in oversize hole? Annular space initially grouted? Property owner s mailing address if different than well location address indicated above �� in. from to 9 4 ft. ❑ Yes Li11 o ❑ Yes ❑ No ( lnknown Vo? 1a5� in. from to ft. ❑ Yes ❑ No ❑ Yes ❑ No ❑ Unknown Lo_1titoi ' lX- , * 1 1\ __ 5x044 _ in. from to_ ft. ❑ Yes ❑ No ❑ Yes ❑ No 11 Unknown WELL OWNER'S NAME /COMPANY NAME 1 SCREEN /OPEN HOLE l Well owner's mailing address if different than property owner's address indicated above Screen from t0 CD ft. Open Hole from to ft. OBSTRUCTIONS ,� L. Rods /Drop Pipe [j] Check Valve(s) 11 Debris ❑ Fill Ly No Obstruction Type of Obstructions (Describe) GEOLOGICAL MATERIAL COLOR HARDNESS OR FROM TO Obstructions removed? ❑ Yes ❑ No Describe FORMATION PUMP If not known, indicate estimated formation log from nearby well or boring. n Type IVli�u• 0 105 ❑ Removed Not Present i_j Other 7 OD USED TO SEAL ANNULAR SPACE BETWEEN 2 CASINGS, OR CASING AND BORE HOLE: Annular Space Exists ❑ Annular Space Grouted with Tremie Pipe ❑ Casing Perforation /Removal in. from to _ ft. ❑ Perforated ❑ Removed _ in. from to ft. ❑ Perforated ❑ Removed Type of Perforator [3 Other GROUTING MATERIAL(S) (One bag of cement = 94 lbs., one bag of bentonite = 50 lbs.) Grouting Material_ Q �( to_ICO ft. yards____ bags from to ft. yards _ bags from to ft. yards bags OTHER WELLS AND BORINGS REMARKS, SOURCE OF DATA, DIFFICULTIES IN SEALING Other unsealed and unused well or boring on property? ❑ Yes How many? LICENSED OR REGISTERED CONTRACTOR CERTIFICATION This well or boring was sealed in accordance with Minnesota Rules, Chapter 4725. The information contained in this report is true to the best of my knowledge. Licensee Busine ame License or Registration No. Certified Represe alive Signature Certified Rep. No. D I IMPORTANT - FILE WITH PROPERTY H 304653 1...z UL PAPERS -WELL OWNER COPY Name of Person Sealing Well or Boring HE- 01434 -12 IC# 140 -0423 9/090 Bohn Well Drilling Co. 18190 Dairy Lane, Ste 101, Jordan, MN 55352 952- 445 - 4809 /Fax: 952-445-1439/www.bohnwell.com Memo To: Gloria Belzer Dig It Drill It Date: August 10, 2012 Drain It From: Brandi Weckman Your One Stop Contractor Re: Paperwork enclosed Enclosed are the invoice for the well sealing and the sealing record for the work we completed at your home. The sealing record that is enclosed was also sent to the MN Department of Health. The yellow record should be kept; because it will be needed each time the property is sold. We also keep these records on file. If you have any additional questions please feel free to contact me directly. We appreciate your working with us and a continued customer service relationship if the need should arise. If you were happy with our installation and the entire process from beginning to end we would appreciate it if you could take a moment to write a testimonial we could post to our website page. You could email it to me or mail it along with the payment. We would really appreciate it because word of mouth is our best advertisement! Thank you again! Sincerely, Brandi (Bohn) Weckman Office Administrator brandi@bohnwell.com Bergo Environmental Services Gloria Belzer Invoice No. 5654 P.O. Box 1256 Lakeville, MN 55044 August 21, 2012 We removed the asbestos from the house located at 5400 Candy Cove Trail in Prior Lake MN Thank you for the work 6126 Olson Memorial Highway, Golden Valley, MN 55422 Office (952) 920 -8938 • Fax (952) 920 -8942 • Cell (612) 701 -7832 • IA Cell (641) 420 -4859 Bergo Environmental Services Gloria Belzer P.O. Box 1256 Lakeville, MN 55044 August 21, 2012 Re: asbestos work at 5600 Candy Cove Trail in Prior Lake, MN We accept the responsibility for disposal of the asbestos, they will be taken to be manifested to DECON a certified asbestos landfill. Jeff Bergo Environmental 6126 Olson Memorial Highway, Golden Valley, MN 55422 Office (952) 920 -8938 • Fax (952) 920 -8942 • Cell (612) 701 -7832 • IA Cell (641) 420 -4859