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���/Z�ll��3 <br /> �o��3y <br /> r�:ITY O:F ORONO APPLICATI:ON FOR DEMOLITION PERMIT <br /> P.J. Box 66 (2750 Kelley Park��ay) <br /> • Crystal Bay, MN 55323 <br /> SPECIAL CONDITIONS & HOLD HARA�LESS AGREEMENT <br /> Genet•al Instructions <br /> 1. You �nay be required to obtain other permits, i.e. �vel( abandonment, etc. <br /> 2. V1/ork must not begin uilless the permit card is available on the job site. <br /> 3. A 24 hour notice is required for all inspections. Call (952) 249-4600. <br /> JOB SITE ADDI2ESS: 0��'1.�,,0 �'X ��('��" <br /> Occupancy Type: �_Residential Commerciai <br /> OWNER'S NAME:_ ��.. e.� ��,�p�i�,��zel�S�C^ Phone:_(�lZ. -�tZ�--�itf$ <br /> Mailing Address: ��3� "�tJ�Q,� �y.� 5, City:___��S 5-�cf(a <br /> CONTRACTOR'S NAME: ' a��c��-� I3us.No.:�I,SZ-��-(o-S�l`�7 <br /> NlailingAddress: ��3Zy �n(`�-a �\�� City: (�.e��, � em� ��� <br /> Demolition if planned by means o£ manua( disassembly <br /> _�heavy ec�uipment <br /> Permits lssued: <br /> # Well Abandonn�ent <br /> In return for issuance of said Demolition Per�nit, the undersigned owner hereby agrees as follows: <br /> 1. The structure(s) shall be kept enclosed and/or secured until such time as demolition is <br /> complete. <br /> 2. Demolition debris will be kept off adjoinin�property and/or the public rights-ot=way Luzless <br /> specitic �rior approval is obtained in writing for temporary use thereof. <br /> 3. Foundations shall be completely removed from the�n•ound. <br /> 4. All demolition debris shall be completely disposed of off site in accordance with all <br /> applicable PCA rec�uirements. <br /> 5. Vl/atei-wells must be abandoned in accordance with State Health .Department i•egulations. <br /> 6. Inspection required when all debris has been removed, before backtilling. <br />