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- - 1 <br /> �O� City of Orono FO�R��C�TY, USE ONLY Ir � � ` l� <br /> P.O. Box 66 Date Received: 1�' �;���G� Permit�t � � <br /> � 2750 Kelley Parkway �r,T <br /> Crystal Bay,MN 55323 Amount: $ SAC Credrt:� <br /> (952)249-4600 � <br /> � ,�- Homeowner(s)Signed: ❑Yes <br /> y<^ � � Resolutions(if any)Signed:❑Yes ❑None Required <br /> G <br /> lqkES H�4� Zonin Disclosure Si ned: ❑Yes ❑None Re uired <br /> �\���� . <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: G- ��-�� ��'�Lti''� � ���rr"�-- <br /> Owner: �./�_�^� l�C�.�-d►`� Mailing Address: Z I`��i ��C�v�� � Y'�'- <br /> c�ty: 1, �,M2.���- z�p: �S 3� j <br /> Phone:I��I Z � � 7C� "-L�2 �>�' Email: � C'� � ^`1.,�� � � I, �,�YX�-C.-u1M <br /> Contractor/Applicant Information: <br /> Contractor/App.: ,l� � � Contact Person: <br /> Address: State License#: <br /> City: Zip: Expiration Date: <br /> Phone: Email: <br /> SPECIAL CONDITIONS & HOLD HARMLESS AGREEMENT <br /> General I nstructions: <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 contr ctor before demo permit is issued. <br /> 1�c��Cti��IC..�� l—L�i� �-�— <br /> Demolition by means of: ❑ Manual Disassembly eavy Equipment U fher <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 structures are <br /> to be demolished. <br /> 2. Submit a survey, aerial photo or sketch showing proposed erosion control measures in accordance with <br /> Chapter 79, Construction Site Runoff Control. <br /> 3. Submit a copy of permit approval from the Minnehaha Creek Watershed District (MCWD). The City will <br /> not issue a demolition permit without a copy of the permit(s) from the MCWD or documentation stating <br /> permit(s) are not required. �A . � ��� <br /> Form Last Updated: July 2015 <br /> 150784 <br />