HomeMy WebLinkAboutDemolition Permit 04-1153
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CITY OF PRIOR LAKE
DEMOLITION PERMIT
Date Rec' d
/1./().()4--'
(Please type or print and sign at bottom)
IAD;rJrc H~ ~~ ()j-
! PERMIT NO.~ tl--//5 $
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID 26. 901-. () II. 0
OWNER
(Name)
(Phone)
(Address)
CONTRACTOR
(Company Name)
(Contact Name)
(Address) 1/ 6 4- 0
~hone) ~. 6f;t 2 b
(Phone) 6IZ-~... 380>1
I
!
Use of Building:
H~'ib~
INTE&~ATIONAL BUILDING CODE
Type of Construction: I II ill IV t!) A 6D
Occupancy Group: A B E F HIM & S U
Division: 1 2 3 4 5
MPCA 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 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 proceed in accordance with submitted plans. I am aware that the building official can revoke this permit for just cause. Furthermore,
I hereb ee that the city offici~e may enter upon the property to perform needed inspections.
~ Ii, CJ -- (J 4-
. Sign re Date
This Application Becomes Your Demolition
Ufl)tnA~V~~ loLOL
B"Hdi"Offidol '-._. ~ .
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I :METRO (MCES) SAC UNIT
DETERMINATION
ISrs Gy.J~TIA/b
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T]11S IS to cemfy that the request m the above apphcatlOn and accompanvmg documents IS m accordance with the City lomng Ordmance and may proceed as requested
~,!!:-4- J?1 ...~ Ie) 1>
Planmng Director - SpeCial ConditIOns If anv
:24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue, Prior Lake, Minnesota 55372
FRO~I : DON STODOLAt.JELL DRLG CO. J INC. FAX NO. : 9524469670
Aug. 15 2006 09:06AM P2
WilLi. OR OOnlNG 1.0011'110"
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Mum. OEPT OF IlEJ\LTIl Copy
H 250653
Nlliiiiiorp9riOll~-w~iIP
HOUSE MOVING IN PRIOR LAKE
.:. A Demolition permit is required.
.:. $5,000.00 Non-revocable Letter of Credit is required.
.:. Site restoration plan is required, or an approved building permit application for a new house.
.:. Damaged sidewalks, street or curb shall be repaired in an approved manor with all costs to be paid
by the permit holder.
.:. The structure to be removed shall not be stored on the street or other public property.
.:. The permit holder shall control erosion on the property.
.:. Open foundations or other hazards shall be protected with an approved safety fence.
.:. The permit holder shall comply with the Tree Preservation Ordinance. All work shall be done
outside the drip line of all protected trees.
COMPLETE THE FOLLOWING
1) Proposed house move date (24-hour Poli~e notice required)
2) Scott County Highway Permits ~ Yes _ No (For County Roads)
3) Site Restoration Plan Yes No
4) Utilities shut off notification:
Electric
Water
Natural Gas
Telephone Company
5) Tree removal or cutting
6) Proposed route diagram
() .-tir'"0-
Z:I
City, State, Zip UM-- ""
Contact Person 134.~ . ~--
State House Mover's License No. ~/3 Cftf6' 0
Property Owner Name
Property Address (House to be moved) 2. 9 16"
Signature of Applicant: g~
V Yes
Yes
Yes
----v-- Yes
Yes
Yes
No
No
No
No
No
_ No (Locate on City map)
Phone Number 2-
Date of Expiration ~
Phone Number
l/~~
~ Date !f-~ - 6'4
16200 Eagle Creek Ave. S.E., Prior Lake, Minnesota 55372-1714 / Ph. (952) 447-4230 / Fax (952) 447-4245
AN EQUAL OPPORTUNITY EMPLOYER
Site Restoration Proposal for Demolition
Applicant:
L-4/ Ifilv q 'flu/I. Se fJ1() UCV5
/
Address:
Check boxes below:
~Fill Excavation to grade
p/' Sod or seed all bare soi Is
~ Erosion control (see handout). Maintain erosion comrol until turf is established.
o ~p sewer below grade. * Mark location. Licensed contractor required.
o ~ap water below grade. * Tv1ark location. Licensed contractor required.
o C~ City of Prior Lake Public Works Department for water meter removal.
g/ Cap gas line. * (By gas company)
if".J)isconnect electric at meter. (By electric company)
~ Pump and fill cesspool/septic tank. Certified contractor required.
V / Abandon well. Certified contractor required. Existing well
~Remove existing structure foundation and footings, materials, and debris. * *
o Provide dust control by following means:
1. vVater mist from a water supply (i.e. neighbors, water tank)
2. Enclosure
3. Other
Comments: (provide surveyor draw site plan)
*Capping of utilities must be inspected.
* * Final inspection and approval of restored site required. Deposit will be returned after
approved final inspection.
/7nV-- 1/-1{).~4
Date
J:\BUILDING\HANDOUTS\Demo Site Restor.doc