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5� b-16 <br /> Ali <br /> CITY OF ORONO APPLICATION FOR DEMOLITION PERMIT <br /> P.O. Box 66 (2750 Kelley Parkway) <br /> Crystal Bay,MN 55323 <br /> SPECIAL CONDITIONS&HOLD HARMLESS AGREEMENT <br /> General Instructions <br /> I. 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: '/750 0 7onALd aiaw 4-a n C <br /> Occupancy Type: __Residential Commercial <br /> Ce(.L([vJ L) 3 60- 3 2-.0 <br /> 9 <br /> OWNER'S NAME: M,C 11 A e L A. .6r Phone: 7a 3 - 972'X707 <br /> Mailing Address: 2 3 7 p_ePtL tin d MD / City: �e ��ir1 <br /> CONTRACTOR'S NAME: (e('-9eGi S n AUiLd Bus.No.: 76 3-9 7 Z -9 70 7 <br /> Mailing Address: "3 74 AnDeLda d -2!5 City: A' &.0'LC +0441i' <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 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. Sewer and water must be disconnected at the services at the street by qualified contractors. <br /> 7. Inspection required when all debris has been removed,before backfilling. <br />