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� 3 <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 /> 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: 6 zb j 00Jk-+W A- R-k 82o"ti,w.rJ <br /> Occupancy Type: Residential Commercial <br /> l/ <br /> OWNER'S NAME: E'(- �— VE,a Phone: 9,-1',-=), -y-71—CW-3 / <br /> Mailing Address: ' //11 City: C--.04/a- c'u- C , ,a <br /> CONTRACTOR'S NAME: UN�� CA&5To uti &LA-6j3us.No.: <br /> Mailing Address: /1,213 6141 sr�,"t3 City: ,y <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. Inspection required when all debris has been removed, before backfilling. <br />