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. _-_�__�_ <br /> /--��A r� Cit of Orono <br /> Y F�rz c>/>���I;sH:o�vT.�� / (�,� <br /> . , {Y/� P.Q. Box 66 Dat�Receiv�d 1.��'.�'1"I�Pe,rrtnit i! .. ��.._L�f r`� I�� I <br /> V ° 2750 Keiley Parkway <br /> 3'��� Crystai Bay, MN 55323 Amount: �,� SAC Credit: SAn C-'�f�� <br /> � � (952j 249-460Q �� <br /> �E ry � � }lomec�ltinert�l Signed: ❑l es � ���� � ����� <br /> ��"� �. ' � Resolu[ions(it�ny)Si�necl:❑ �es ❑None Reqiiired <br /> �`��k���.���lt�,.� Zoniii�I�iseln�ure Sia��ed: ❑Yes ❑None Re uired <br /> �_._.__ - l�l�� <br /> CITY OF ORONO - DE OLITIC�N PERMIT <br /> (Ali permits must be approved by the Building Official and/or Zoning Department) <br /> ; Job Site i Owner informatic�n: <br /> � <br /> Type: �Residential ❑ Gommercia! <br /> Site Address: �0� � �CT�"� � . <br /> Qwner: ��S 'd"5��� �'C/C G T1 Mailing Address: �DJ� �,t>/ (�6-c-v �/�'Lv ,QI�' <br /> City: LO�_�� Zip: � �J��J�� <br /> pnon�: �/Z — �7p � 7��� �m���: �� � �r �1 , c�a.v� <br /> C�ntractor l Applicant lnformation: <br /> Contractor/App.: ��/e�� ��1� Cl.{5 rD�a.c Cantact Person: /'�/ � `Ll�S ��/'L� <br /> %�{��r�v c 5 /'L <br /> Address: IS�-3-��O�T/�f �L /I,' State License#: g� 'tj�l� l �] �- <br /> City: /(l1 J4��f�..� Zip: J'v��� Expiration Date: /��' � ��17 <br /> Phane: 7�3`-��3 L'�Z � Emaii:�l ����-��1�1 lC� 3"�f�1et ���'��. <br /> � � <br /> S�Ec��� or� trloNs s� HOLD �AR LEss A __� NT —� <br /> General [nstructions: <br /> 1. You may be required ta obtain other perrnits, i.e.: well abandonment, sewer, etc. <br /> 2. Work must not begin unless the permit card is avaifabie 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 qua{ified contractor before demo permit is issued. <br /> Demolition by means of: ❑ Manual Disassembly �,Heavy Equipment ❑ Other <br /> Permit(s) Issued: ❑ Sewer Disconnection ❑ Well Abandonment#��- <br /> `�``Q�y t,�,'�l� ���j�l -�.,,� <br /> In retur'n for issuan�e of said Demolitior� 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 ar� <br /> ta be demolished. <br /> 2. Submit a survey, aerial photo or sketch showing proposed erosion controi measures in accordance with <br /> Chapter 79, Constructron Site Runoff Cot�trol. <br /> 3. Submit a copy of permit approval from the Mir�nehaha Cr�ek Watersf�ed District {MCWD). The Gity will <br /> not issue a demolition permit witho�t a copy of the permit(s) from the MCWQ or documentation stating <br /> permit{s) are not required. <br /> Form Lasf Updated: July 2015 j f n .�`�1 I <br /> l�iii3•i �V' <br />