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HomeMy WebLinkAboutDemolition 13.1170 0 Q a IQ z - 2 ' 1- P J OS 1% re -. 0 M \' U' zW CL G t °u.0 C.).. z W td i. N ,M O❑❑❑❑❑ z o g 0 X 2Z z am < m z tl z _ w _ _ tg Z ==zZ V d c g 0 0 w N Q 6 d . z • V d 2 3 co C '2 ' W W W W k r-- 000000 ik _ J a a� I W > Z J LL' XW ° < �+- z z - o zZ p z v to • N o '��,I OV W i H ?��J g g Q A a p p V V o? 4 0 d ❑❑❑❑ 0 ❑ 0 � M 1 _ z ;; i i 4 P R 4 ) 4,,, AE, 9 CITY OF PRIOR LAKE Date Rec'd t77 DEMOLITION PERMIT NNB SO i; - i Z$D 1 PERMIT NO. 13 , / /76 I (Please type or print and sign at bottom) ADDRESS \& 7— U\— ejr S ZONIN5 (office use) LEGAL DESCRIPTION (office use only) • LOT BLOCK ADDITION PID 25 q3o. 051.0 OWNER ( \--\,-, Z rS I.. � C1n'1( \ ) ( 4 - 2. ko l ho,..C. (Name) r4 C � (Phone) . Z- si1Ceiy (Address) 1: 4 (p (J1nr`141(1 k .0% s & r'C \ - CONTRACTOR __ (Company Name) _ Ak DOC t r- N%S. G 1-i-L (Phone)CM2 ` l -f S) (Contact Name) "--- 3 - C-V{ . . .S1 1 ) Co 0- - 3421 - G0 0 n (Address) p, 6 , ls. Q k(Zy Use l off Building: ( INTERNATIONAL BUILDING CODE Or-5 J A4 te∎AN. 1 Type of Construction: I II III IV V A B Occupancy Group: A B E F H I M R S U ,__,,// Division: 1 2 3 4 5 Lid'N1PCA NOTIFICATION OF INTENT TO PERFORM A DEMOLITION , 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 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 tha and will proceed in accordance with 4 bmitted plans. I am aware that the building official can revoke this permit for just cause. Furthermore, I hereby agree that the city official • a designee may enter upon the property to perform needed inspections. • Signature Date This Application Becomes Your Demolition ftle i' ` ®t,.. k ! l t` ' i ermit Wizen Approved K 7 i.l 7666 S ' 0 od C,F'Z 71c Ae- i4 k ' i/ t Buil , g Official Date 10 ZZ ao D zc zz) /d. L/,/ This is to certify that the request in the a ve application and accompanying documents is in accordance with the City Zoning Ordinance and may proceed as requested. /0 — al - /3 annin ire r 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 • 0 1 .1341° {y Site Restoration Proposal For Demolition u',,,, j__ ,, I N s i c cfo . ant: J • � . Q- .,"\e--c Applia �p � � 4-- � I Address: - 0 .'1, O-y- \025K jr k?f \.c \,,,,,, ON-OA S:5 Check boxes below: k Fill Excavation to grade -a-- Sad- or_seed allar-e -seils X Erosion control (see handout). Maintain erosion control until turf is established. f ) Cap sewer below grade.* Mark location. Licensed contractor required. Cap water below grade.* Mark location. Licensee . ontractor required. X Call City of ' .t• . ',...lic Works De.. m: t '952.447.9898 for water meter removal. 1K ovv6- >`i5 "- Cap gas line. 0 . : - e •. . ;, Disconnect electric at meter. (By electric company) • . ess.. sep is e - . -. ---:: - - :=. • . - _ 1 1. , = ' " ' " " - - - es con. ac o . • 1 .: --_ . ' �- 7 Remove existing structure foundation and footings, materials, and debris. ** ' by S Provid ) ust control b following means: 1 Water mist from a water supply (i.e. neighbors, water tank) . 2. Enclosure 3. Other CITY OP.PRiOR LAKE • B ILDI • ' Mjt PLAN REVIEW Comments: (provide survey or drag s ,rg _ . PATE 10 AW PERMI ' •. ��� 0 CI .ACCEPTE 1 A SUBMITTED _� O ACCEPTED WITH CORRECTIONS AS NOTED 0 NOT ACCEPTED - CORRECT & RESUBMIT These comments are for your information. All work shall be done inl uN compliance with all applicable building & zoning code requirements including items not speci*callynoted in this review. KEEP THIS PLAN SET ON SITE AT ALL TIMES *Capping of utilities must be inspected. * * Final inspection and approval of restored site required. Deposit will be returned after approved fi .1 • s • - ction. I(A2A\\3 Signature Date J:`,BUILD t 4 \HANDOUTS\Demolition Restoration.doc o PRIG* u Memo SO Date: Thursday, December 12, 2013 To Janet Ringberg From Lynda Allen Subject Demolition Permit #13 -1170 14372 Rutgers Street . The demolition permit has been closed on the above referenced project. Please return the $5,000.00 demolition deposit to J.B. Woodfitter & Associates Post Office Box 1028 Prior Lake, Minnesota 55372 Thank you 1 i __1 N - c L da S. Allen Poppler Building Services Assistant City Engineer Phone 952.447,9800 / Fax 952.447.4245 / www.cityofpriorlake.com AKE DEPARTMENT OF I L BUILDING AND INSPECTION INSPECTION RECORD SITE ADDRESS 1,43 b StzS TYPE OF WORK 1: t ^� USE OF BUILDING • F. rZ PERMIT NO. 13-/170 DATE ISSUED 1© 2z- r 3 BUILDER -- $ s tA PHONE # 6(i-36 • S� NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW THE PERMIT IS BY SEPARATE DOCUMENT su �..,J ) r e INSPECTOR DATE 1 S6cc i_"fi 4iv1e.. 1 PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED . I I FINAL 1 1 FOR ALL INSPECTIONS (952) 447 -9850 • STATE OF MINNESOTA DEPARTMENT OF HEALTH ABANDONED WELL RECORD . l.• LOCATION OF WELL I • MINNESOTA UNIQUE WELL NO. I ./ Q CQsy County Nava Scott I (leave blank If net known) [ f / ' Township Name Township Number Range Number Section No. Fraction ' 4. YELL DEPTH (completed) Date sealed N E Is is of k Prio Lake T115N s R21W r 30 NE NW NE .94 fee February 27, 1991 , Numerical Street Address and City of Will Location or Distance from Road S. DRILLING METN00 (11 known) Intersection 1® Cable tool q3 Havers. 7❑ Driven lt❑ Dug ' 23 Hollow Rod 4 Atr to florid 110 • Show exact location o1 well • 3❑ Rotary . 6❑ Jetted (Power Auger • • -(in section grid with •X•) Sketch map Of well location `im 6. OflSTMICTIOIIS 11 . \ We11 obstructed Cafes ❑ No • . :::t r moved o Yes ❑ Ne If obstruettna cahewt . e . remor.d. Conact IOM w _ r _ i v 7. i sealing. _ . ....I - - • - E . , I . • _ - y ed. I ®.Doamstic 43 Nonitorleg 6O (lest Ledo 4, • 4] Irrigation S❑ Public co Industry • � ( 10 Test /tell 60 Nunidpal MOD Commercial • ,i ^ �lr \ �� , L 7❑ Air Conditioning 110 2. PROPERTY OWNER'S NAME • Mailing Address if different than 6. CASING(S) • property address indicated 1)$) Slack 421 Tkrudad 70 HOUTS, Geraldine 14372 Rutgers Street NE 20 Ulu. ti Welded Prior Lake, Minnesota 55372 I❑ Plaftlo t❑ Stainless Steel • HARDNESS of 4 1n. to 90 Tt. I. FORMATION LOG COLOR FORMATION FROM TO If not known. indicate formation tog from new well or nearby wall. ie. to ft. • 9. SCREEN el screened well from 90 ft. to 94 ft. (if known) ❑Open Note from ft. to ft. . 10. STATIC WATER LEVEL 54 re. ® below ❑ above 2/27/91 land surface Oat. Measured • 11. WELLHEAD COMPLETION • • I❑ Pitl.as Adapter Craved Dvrt.d • • mg Basement offset 10 3[J Well Pit 16. REMARKS. ELEVATION. SOURCE OF DATA - CASINGS REMOVED. CASINGS PERFORATED. ETC. 12. GROUTING INFORMATION 1(J4 Neat Commit 2❑ D.ntonite 43 Grout material CE U11Tltyrom 0 to94 ft. cu. , 13. NEAREST SOURCES OR CONTAMINATION _ _ feet - -- d None , type We11 disinfected before sealing) ® Yes • 14. PUMP ® Removed ❑ Not Present • Type: l® Submersible 4] L.S. Turbine 60 Reciprocating . 4:34,i C Cutrtfugal 43 1S. EXISTING WELLS (Please sketch locations of abandoned and active wells in remarks section or on back.) ,. • Other unused wills) ea property? [ ® )Tas No � � ,'�' Abandoned: ® Permanent ❑ Temporary ❑ Not staled 6 !l � g e �7 17 WATER WELL CONTRACTORS CERTIFiCATION ' to r This well was sealed under my jurisdiction and this report M RFC.Er4 :"' Is true to the but of my knowledge and belief. • ' 1 • ' . f ' ASSOCIATED W ) E De6 11 WELL (1a D m RII�S, INC. 27259 f , lte :n I I tt)U 310er yeses, No. • mono, D. ; ' i a i t r, • _ - .ta 55347 , .�, -. i �',, 2 28 91 ' h = .�-!,' rTi'*V at. 2 27 91 FFiC1Al MAROONED WELL RECORO (May be used for Property Transfer) Name of il.r IJOYORTHIrt nut wz,i WED Dale Gast /Randy Alt 1 1n r 1i1 • lommrr.l mp minor Irimmnimmiu F ' lllnr7Emirilr * - E 1 1 II T11 ITT it TIFF I' ) I I: I