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• . �, �►�L ° � � ,/} (� �S��� <br /> CITY OF ORONO APPLICATION FOR DEMOLITION PERMIT <br /> P.O. Box 66 (2750 Kelley Parkway) <br /> Crystal Bay, MN 55323 <br /> SPECIAL CONDITIONS & HOLD HARMLESS AGREEMENT <br /> General Instructions <br /> 1. You may be required to obtain other permits, i.e. well abandonmment, etc. <br /> 2. Work must not begin unless the permit cazd is available on the job site. <br /> 3. A 24 hour notice is required for all inspections. Call (612) 249-4600. <br /> ` y ; _. <br /> JOB SITE ADDRESS: � -.�L ; ,. .,�1-.,. ��_�.. � . �; �-� � <br /> Occupancy Type: � Residential Commercia <br /> > � � � � � <br /> O�VNER'S NAME: �_�� '�� � ::����� l • �d:�,° �� , Phone: i�E,% i`.�° � - �4�-i ( <br /> Mailing Address: �,�� � �4. ��. >> . �i �'a ) City: � } �, i <br /> �-- . <br /> CONTRACTOR'S NAME: fi`��� � . 1�:� , �� , Bus.No.: l: ► �: �. ! i i` � y <br /> Mailing Address: '; �` � �,, �,�-�. '; �t�,� ` City: �v����-�, <br /> Demolition if planned by means of: manual disassembly <br /> ✓ heavy equipment <br /> Permits Issued: <br /> # Well Abandonment <br /> In return for issuance of said Demolition Permit, the undersigned o�vner hereby agrees as follo�vs: <br /> 1. The structure(s) shall be kept enclosed and/or secured until such time as demolition is <br /> complete. <br /> 2. Demo�:tion debris will be kept off adjoining property and/or the public rights-of-way unless <br /> specific prior approval is obtained in writing for temporary use thereof. <br /> 3. Foundations shall be completely removed from the ground. <br /> 4. All demolition debris shall be completely disposed of off site in accordance with all <br /> applicable PCA requirements. <br /> 5. Water �vells must be abandoned in accordance �vith State Health Department regulations. <br /> 6. Inspection required when all debris has been removed, before backfilling. <br />