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HomeMy WebLinkAboutDemolition Permit 05-0138 CITY OF PRIOR LAKE DEMOLITION PERMIT Date Rec'd I Z 1 c 4- rl",e IAI/ os: 0/3 7 I PE&.\1IT NO. OS- C' /3F I (Please type or print and sign at bottom) I ADDRESS I / (P330 PI1/ZK- /lv&/Vu6 ZONING (office use) ..It: /~O I LEGAL DESCRIPTION (office use only) I LOT ~ BLOCK ADDITION LAtf -:;1 U( A'el PID 25. tJ9?~()o4-. 0 - . I (Phonel b~ I) ~I - ~b b :s I ~/?ID '\ C'o.' . , - t' ~ r1 --( <. ~ l; " eN !...J"l:'~ *E \.::;~ ~ : . ~=~J~b"),.J.. ~D LD~f Qy~ (Address)L....( loB (21. 0.,../ C D!.JC"T CONTRACTOR \'.... r (CornpanyNarne) UArlL<; ,,-rr~"S-'(. (Contact Narne) M~ K- DA-NlS (Address) It 0\) (5,,\ ~+" LN., Jct'DA,J (Phone) (<1$ 2 -'J '-f<:tl-- ~t /)~ (Phone) (c::'12 ') '-Ie; D - ~ D f.c;z. -L, Use of Building: ~/S J) , INTER...~ATIONAL BUILDING CODE Type of Construction: I IT ill IV Occupancy Group: A B E F H I Division: 1 2 3 V A B M R S U 4 5 o MPCA NOTIFICATION OF INTENT TO PERFORM A DEMOLITION l.f<.. .C. 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 thatl 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 proceed in accordance with submitted plans. I am aware that the building official can revoke this permit for just cause. Furthermore, I hereby agre that the ci ial or a designee may enter upon the property to perform needed inspections_ ~ \ (2- b-b~ . Signature Date This Application Becomes Your Demolition Permit When Approved ~.~ Building Official I METRO (MCES) SAC UNIT DETERMINATION r . ...-//r/J'~L 1. . . -{...c . Ii 5~ c (, C' (: (7 / l t:/t..~ /c. "' . j / . ,-) . . - -/:-J...C ~~a-..t' J/u.cYL.- (~4....... t, .{1..1.l,V ~-nt---ftZa~~ Itto tt-</~, t ,;{ / Z. I' t 4- certify thai the request in the above applicanon and accompanymg documents IS in accordance wnh the City Zomng~' inance and may proceed as requested. ",.~~~ /'/ ?:?:/05 ~D . A<--/;;:,J:e~f.JTs 100ft r Date ' :24 hour notice for all inspections (95:2) 44i-9850, fax (95:2) 44i-4245 16200 Eagle Creek Avenue, Prior Lake, Minnesota 55372 Site Restoration Proposal for Demolition Address: 2~ 7 i) '6ei D~-t \J I t:vJ e yA?J C~+ t1 L'I-l D1 -,- )~ ~t bI-I -c S Applicant: K- bJl/~ AN. \) Lee- ( Check boxes below: :J Fill Excavation to grade o Sod or seed ali bare soils J.11L. Erosion control (see handout), Maintain erosion control until turf is established. ~ Cap sewer below grade. * Mark location, Licensed contractor required. Oil Cap water below grade, * Mark location. Licensed contractor required, ~ Call City of Prior Lake Public Works Department for water meter removal. "fi( Cap gas line. * (By gas company) Diil:.. Disconnect electric at meter. (By electric company) o Pump and fill cesspool/septic tank. Certified contractor required, ^,-" St:.pi-tL o Abandon well. Certified contractor required. Existing well No w..1 I !8.. Remove existing structure foundation and footings, materials, and debris. * * jit Provide dust control by following means: (Y Water mist from a water supply (i.e. neighbors, water tank) 2. Enclosure 3, Other Comments: (provide surveyor draw site plan) / . ~ i~~~~~~~ ' 1. ~ ~.....-1J ~~. ~ ~ ~'O /'I~~~ ~~ . ~ . ~ . ~ ~ f'tI-+O ~~ ~apPing ofuUities must e inspected. ~ 1-> r.i'~()"o.oo ~ ~ ** Final inspection and approval of restored site required, Deposit will be returned after approved final inspection. rJ~~ ( Signature , z - <0 --c(--! Date J:\BUILDING\HA0iDOUTS\Demo Site Restor.doc