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.' � � ��'' <br /> . ' ; (� (,�"� <br /> � �� <br /> City of Orono � ,( R CITY USE ONLY //__ � <br /> �O�O P.O.Box 66 ��/v�" Date Received: —�/�� Permit# �� <br /> 2750 Kelley Parkway <br /> Crystal Bay,MN 55323 Amount: $ �� SAC Credit: <br /> (952)249-4600 <br /> '� ,� Homeowner(s)Signed: ❑Yes <br /> yF' �,� Resolutior�(if any)Signed:�Yes ❑None Required <br /> �qKFSH�R� Zonin Disclosure Si d: ❑Yes ❑None Re uired <br /> CITY OF ORONO -DEMOLITION PERMIT <br /> (All permits must be approved by the Building Official and/or Zoning Department) <br /> Job Site/Owner Information: <br /> Type: ❑ Residential �Commercial <br /> Site Address: o�$�b0 S�o,�:.���. ��;,, <br /> Owner: U�e�re.�s $09$ L.�� Mailing Address: � I O II �' ►4v�. .�, <br /> City: ��n�c i ns z�P: 5�343 <br /> Phone: �o Ia�3�3 - 33 a 1 Email: ���x �• r►���1.1a,,�.�1 cs , c��, <br /> Contractor/Applicant Information: <br /> ContractoNApp.: -Sc.-M� Contact Person: <br /> Address: State License#: <br /> City: Zip: Expiration Date: <br /> Phone: Email: <br /> SPECIAL CONDITIONS & H LD HARMLESS AGREEMENT <br /> General Instructions: <br /> 1. You may be required to obtain other permits,i.e.:well abandonment,sewer,etc. <br /> 2. Work must not begin unless the permit card is available on the job site. <br /> 3. A 24-48 hour notice is required for all inspections. Call(952)249-4600. <br /> 4. Sewer must be discontinued at the City service by qualified contractor before demo permit is issued. <br /> Demolition by means of: [�Manual Disassembly ❑ Heavy Equipment ❑ Other =n�rn�.\ d�o <br /> Permit(s) Issued: ❑Sewer Disconnection ❑Well Abandonment# <br /> In return for issuance of said Demolition Permit,the undersigned owner hereby agrees to: <br /> 1. Submit a survey, aerial photo or sketch showing all structures on the property. Note which structures are <br /> to be demolished. <br /> 2. Submit a survey, aerial photo or sketch showing proposed erosion control measures in accordance with <br /> Chapfer 79, Construc6on Site Runoff Control. <br /> 3. Submit a copy of permit approval from the Minnehaha Creek Watershed District (MCWD). The City will <br /> not issue a demolition permit without a copy of the permit(s) from the MCWD or documentation stating <br /> permit(s)are not required. <br /> Form Last Updated: July 2015 ' <br /> 150784 <br /> I <br /> I <br />