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• t , i <br /> ���� City of Orono FOR I"I'P USE ONLY /, [� <br /> ���-�� � P.O.Box66 Date Received'�Q�Permit# e�0/3—C/ � / <br /> 0 ', 2750 Kelley Parlcway <br /> Crystal Bay,MN 55323 Amount �SAC Credit: <br /> I' � 1 � (952)249-4600 <br /> '� � h/ Homeowner(s)Signed: ❑Yes <br /> � ` % Resolutions(if any)Signed: �Yes ❑None Required <br /> \��k� � � Zonin Disclosure Si ned: ❑Yes ❑None R uired <br /> SH�� ' <br /> ��—`' � ��0� S <br /> CITY OF ORONO - DEMOLITION PERMIT r ��(��� �U'�Nf �,�:' V t'� <br /> (All pertnits must be approved by the Building Official and/or Zoning Department) �1�`'" _ r <br /> �Y1���1-}- veC�,lv � <br /> Job Site / Owner Information: ���'!� ��'��� <br /> Type: � Residential ❑ Commercial <br /> Site Address: � � W b �c�c'�" ��� <br /> Owner: � '� N � i�/b'� Mailing Address ��,o Gc,�xt�l�c��� <br /> City: �1�3�UU Zip: <br /> Phone: ��,� ' �H`1 ' ��� 3 Email: e�_ ��c�efs�a M � J n,L��/e� <br /> Contractor/Applicant Information: <br /> Contractor/App.: �' l�cl3��jGontact Person: ✓✓�� .�/ <br /> Address: S�.S �ov�✓I'y �o�c� �,� State License#: 6 C .���� <br /> City: ��F�e ��a�N Zip: S��s� Expiration Date: ���� <br /> Phone: �j��� - ���'S /3� Email: �o�ia.N— 5clf'C7iV.�'►/�C,or►tc�5�� �/t..'� <br /> SPECIAL CONDITIONS 8� HOLD 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 <br /> issued. <br /> Demolition by means of: � Manual Disassembly ❑ Heavy Equipment �Other �ot�•( �,�jC�� <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 <br /> structures are to be demolished. <br /> 2. Submit a survey, aerial photo or sketch showing proposed erosion control measures in <br /> accordance with Chapter 79, Construction Site Runoff Control. <br /> 3. Submit a copy of permit approval from the Minnehaha Creek Watershed District (MCWD). The <br /> City will not issue a demolition permit without a copy of the permit(s) from the MCWD or <br /> documentation stating permit(s) are not required. � � � - � �: '�' <br /> ��, �-� - 'yv_ �����u.�. <br />