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� , ._ , I � <br /> �� <br /> �� <br /> CITY OF ORONO APPLICATION FOR DSIKOLITION PERMIT <br /> P.O. Box 66 (1335 So Brown Rd) <br /> Crystal Bay, MN 55323 <br /> � SPECIAL CONDITIONS & HOLD HARMLESS AGREEMENT <br /> ****�*�***:�*****:*�********t**************************�**�:******t******* <br /> General Instructions <br /> 1. You may be required to obtain other permits, i.e. burning, well <br /> - = abandonmment, etc. � - - <br /> 2. Work must not begin unless the permit card is available on the job <br /> site. <br /> 3. A 24 hour notice is required for all inspections. Call 473-7357. <br /> *#*t***�***��*�*�*:**:*:�*�:*t*t*:*tt::**��:** **t�:::******t**�*�***�**�r* <br /> JOB SIT$ ADDRESS: a�0' � LtJ2z�p �� <br /> Occupancy Type: �_Residential Commercia <br /> OWN$R'S NAME: ��B h��?-{L-� / v !S�� Phone: `7 � � - �a 7 <br /> Mailing Address: 0'�3 e � �-}-oi-p� t,��o ,� City: a <br /> CONTRACTOR'S NAME: }� ��' Bus. No. : <br /> Mailing Address: City: <br /> ***f*****t****:***�:**:****:**********�*�*�*:**t*�*�**�*t**:#*:*:**:t****** <br /> Demolition if planned by means of: manual disassembly heavy equipment <br /> _burning (by fire department) <br /> Permits Issued: <br /> # Burning Fire Department <br /> # Well Abandonment <br /> In return for issuance of said Demolition Permit, the undersigned owner <br /> hereby agrees as follows: <br /> 1. The structure(s) shall be kept enclosed and/or secured until such time <br /> as demolition is complete. <br /> 2. Demolition debris will be kept off adjoining property and/or the <br /> public rights-of-way unless specific prior approval is obtained in <br /> 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 <br /> accordance with al 1 app licable PCA requirements. <br /> 5 . Water wells must be abandoned in accordance with State Health <br /> Department regulations. <br /> 6. Inspection required when all debris has been removed , before <br /> backfilling. <br /> 7. Within 5 working days of superstructure removal , a final inspection <br /> shall be requested. The site shall be Ieft clean and clear of all <br /> debris, with any excavation filled with earth level with the adjacent <br /> _ ground elevation (except when such excavation is to be used as part of <br /> a new building and such new building is actually under construction). <br />