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� <br /> , � <br /> � City of Orono FOR CITY USE ONLY � <br /> �¢ �� P.O.Box 66 Date Received: Permit# ��(��C <br /> 2750 Kelley Parkway <br /> y ;y'°� R Crystal Bay,MN 55323 Amount: $_ ��•�AC Credit: <br /> + �� :�� r.c?�:� (952)249�600 <br /> ��0��' Homeowner(s)Signed: ❑Yes <br /> Resolutions(if any)Signed:❑Yes ❑None Required <br /> Zonin Disclosure Si ed: 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: � � �" � ti u �`�� `�`' " "� ��� <br /> Owner: �J«/!�✓ .rc'1••� // Mailing Address: .�3��� �+� �/�h�� Q�,��J'i�, <br /> City: 1'v, //� � � Zip. ��E �? �' � <br /> Home Phone: Alternate Phone: c'r�/� �?�' �� "' � r9 9 <br /> Contractor/Applicant Information: <br /> Contractor/App.: l���� f� fx��r�u �f y� Contact Person: � �'� � f �' r�"` 4 <br /> Address: ��3 j ��'"�y �L'<� " ' `� State License#: .�//-� <br /> �� � <br /> City: �r�I f� � Zip: rf `�� � Expiratian Date: y/-� <br /> ' 6 �_ .�vr-- 3 s���-7 c r �i� E;• �- ��s= 3��� �� <br /> Phone: 7 A�ernnte Phone: <br /> SPECIAL CONDITIONS & HOLD HARMLESS AGREEMENT <br /> General Instructions: <br /> 1. You may be required to obtain other pertnits, 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 a11 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 <br /> Permit(s) Issued: ❑ Sewer Disconnection ❑Well Abandonment# <br /> In return for issuance of said Demolition Permit,the undersigned owner hereby agrees as follows: <br /> 1. The structure(s) shall be kept enclosed and/or secured until such time as demolition is <br /> complete. <br />