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' � �� ��� �---- � � �(,- �j ; . <br /> � „ <br /> -- �, <br /> �. . <br /> , C1TY OF Ok20N0 APPLIC:AT�ON FO:R DEMOLITION PERMI2 <br /> P_O. Box 66 (2750 Kelley Parkway) <br /> Crystal gay,N�1 55323 <br /> SPECIAL CON�DITIONS &HOLD I3ARNxI-ES�AGREEMENT <br /> General�nstructious � <br /> 1, Xou zmay be required t� obtaia other permits, i.e.well abar�donmment, ctc. <br /> Z, Work must not begin wnless the permit card i::avai�able orn the j ob site. <br /> 3. p� 24 hour notice is required for all insgecti�ns. Cal.l (612)249-4600. <br /> JOB SI7E ADDRESS: a <br /> 0 S b ��a.� w oe �l iZ a �ro.� ,� <br /> Occupancy Type: _ x_Resideniia l Cornznercial ��,I �J� _ y�9 S <br /> (3��� S1� �I r�-+'� M°Phone:�, q S a- y�i- o s s 1 <br /> pW�1ER'SNAME• � � �� (t^� � ,� s sti�� <br /> Mailing Address: -7 61 c„)� : <br /> -t-. h � rll City: :.��� _I, i`- <br /> CONT�LACTOR'5NAME: c�� -I- C .�.. �.� =L��. _Bus.No.: '1c,3 - y� • �av� <br /> -a- C� � ��c/ $-s 3 7 y <br /> MailingAddress: /ya�o �;� la� - �`� � <br /> So 5.� M.,� t l�r- <br /> Demolition if plazuied by zxxeans of: �manual disass�m.bly <br /> ->C heavy equipmen� <br /> permits Issued: <br /> # ,�_Well Abandoz►ment , <br /> In xe��►for iss�an,ce of said D�molition Permit,the uudezsignecl owner hereby agrees as follows: <br /> �,. The structure(s) shall be kept enclosed an�Vor secured unti� sueh t�zzie as demolition is <br /> complete. <br /> � Demolition debris will bc�Cept off adj oinin� property and/or the public righes-of-tiway unless <br /> specific prior approval is obtained in writzn�;for temporary use thereof. <br /> 3. Foundatioas shall be completely removed fi•om the ground_ <br /> 4. All demolition dcbris sha11 be completely disposed �f off site in accordance with all <br /> applicable PCA requirements. <br /> 5, Water wells must be abandoned in accordauice with StaCe Health Depaztment z�egulations. <br /> g, Inspection required when all debris has been removed,lbefore bacl�lling. <br /> ��___-----�- _ <br /> ,�� � r��R�q+�„�q� �Wr1�lf1 af1 A I 17-woa� weD l�1U 1001-ot-n�tl <br /> Z d 9�185�L�b�9�i��'OAI/L i �8 '.LS/L Z �t3 60 ,bG '8 (I�[OY�I) �I�II .il�IddNiO� �8 .LI�A NI0133 <br />