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�U� PC) G7&!? <br /> �v <br /> q�q <br /> CITY OF ORONO APPLICATION FOR DEMOLITION PERMIT <br /> P.O. Box 66 (2750 Kelley Parkway) i�ql� �rnc C is _ rse <br /> .� Crystal Bay, MN 55323 <br /> 1 <br /> SPECIAL CONDITIONS&HOLD HARMLESS AGREEMENT <br /> General Instructions <br /> 1. You may be required to obtain other permits, i.e. well abandonment, 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 (952) 249/-4600`. <br /> JOB SITE ADDRESS: I D(c�j <br /> Occupancy Type: _Residential Commercial <br /> OWNER'S NAME: cy-)aj--J.s l in L Phone: a q a <br /> Mailing Address: U-�;DCity: <br /> CONTRACTOR'S NAME: < VV1� ? S� I" us.No.: -J C) <br /> Mailing Address: Sc 11- City: S 1/1 <br /> Demolition if planned by means of- manual disassembly <br /> heavy equipment � � ��-�Z�L-�t U►•� <br /> Permits Issued: ` — v Woo-" <br /> C S <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 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 wells must be abandoned in accordance with State Health Department regulations. <br /> 6. Inspection required when all debris has been removed, before backfilling. <br />