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, �ITY OF ORONO APPLICATION FOR DEMOLITION PERMIT <br /> P.O. Box 66 (2750 Kelley Parkway) <br /> Crystal Bay, MN 55323 <br /> SPECIAL CONDITIONS & HOLD HARMLESS AGREENIENT <br /> General Instructions <br /> 1. You may be required to obtain other permits, i.e. well abandonmment, etc. <br /> 2. Work must not begin unless the permit card is available on the job site. <br /> 3. A 24 hour notice is required for all inspections. Call (612) 249-4600. <br /> JOB SITE ADDRESS• � � 7 r� S � `` �-�' /�.' ` �� �� <� � <br /> Occupancy Type: �_Residential Commercial �.,,t� ��, r�, N <br /> OWNER'SNAME: C�` f-.� �> � G�,-.� .t G Phone: `� �"�_ � `/ Y_ y� � � <br /> Mailing Address: City: <br /> CONTRACTOR'S NAME: K'� "�; t f Fx c `` ``� �'n�`" Bus.No.: ��e 3 - j—v s-- � s-i- 7 <br /> Mailing Address: �� 's f�' h���-� <�4 ^ � °- �"�- �''� City: C�--�f � -� I <br /> Demolition if planned by means of: manual disassembly <br /> � heavy equipment <br /> Permits Issued: <br /> # 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 /> ?. Demolition debris will be kept off adjoining property and/or the public rights-of-way unless <br /> specific prior approval is obtained in 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 accordance with all <br /> applicable PCA requirements. <br /> 5. Water �vells must be abandoned in accordance with State Health Departrnent regulations. <br /> 6. Inspection required�vhen all debris has been removed, before backfilling. <br />