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� . <br /> , CITY OF ORONO APPLICATION FOR DEMOLITION PERMIT <br /> � P.O. Box 66 (2750 Kelley Parkwayj <br /> Crystal Bay, MN 55323 <br /> SPECIAL CONDITIONS & HOLD HARMLESS AGREEMENT <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: `/`r�� `���� � �,;�. � ;��� C����U <br /> Occupancy Type: �Residential Commercial <br /> A ` '�'� T <br /> OWNER'S NAME: � `�/ �._ ��J�"��'i'� � ��Phone: ��- �' �� <br /> Mailing Address:�.��% !,��,� r_3ia ���. ,�l ,,����� ?��'�City: G.-� �� `� � <br /> 6!�- � �� <br /> � � ,��., ��`�/� <br /> CONTRACTOR'SNAME:�G;--, �j 1,�� �r�4 �us.No.: '`��--��� �— '-� � <br /> Mailing Address:;�;:�� �.�� -;<:; ���+�� i�`�°�� �< �-•<�,'�� City: ;.�.�::v�. ��, <br /> ��:> �� <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 /> 2. Demolition debris will be kept off adj oining 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 wells must be abandoned in accordance with State Health Department regulations. <br /> 6. Inspection required when all debris has been removed, before backfilling. <br />