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✓�aCr�� as ��f a-E-��d <br /> Esc""o cam.: N c-T Pc"f p <br /> Q City of Orono FOR MY USE ONLY <br /> �► P.O.Box 66 Date Received: h-7 Permit# <br /> 2750 Kelley Parkway <br /> Crystal Bay,MN 55323 Amount: SZ?,J,.0—"SAC Credit <br /> (952)249-4600 , 9 7-- <br /> •► T! <br /> Homeowner(s)Signed: Yet <br /> Resolutions(if any)Signed:❑Yes ❑None Required <br /> y k E S H OSE Zoning Disclosure Signed: ❑Yes 0 None Required <br /> CITY OF ORONO - DEMOLITION PERMIT <br /> (All permits must be approved by the Building Official and/or Zoning Department) <br /> Job Site /Owner Information: <br /> Type: Residential ❑ Commercial <br /> Site Address: y U r-, cc, lnJA kd <br /> Owner: �` �� ( "�L1 ' Mailing Address: U ^ C' <br /> City: Zip: <br /> Phone: c� 1 U`� Email: t. �"� Mtn Ze 6- L GY,^ <br /> Contractor/Applicant 1, `tion: <br /> Contractor/App.: 130 ) s, @ S o� /D Contact Person: ` 1 C � �'4 <br /> Address: 0 C <br /> y State License #: <br /> City: 1 e- Zip: �� / Expiration Date: �Lp 1 <br /> Phone: '413 �3 Email: 6L rA JUn J 0 /-Aim LUQ <br /> NIMERFONS & HOLD HARMLESS , <br /> General Instructions: <br /> 1. You may be required to obtain other permits, i.e.: well abandonment, sewer, etc. <br /> 2. Work must not begin unless the permit card is available on the job site. <br /> 3. A 24-48 hour notice is required for all inspections. Call (952)249-4600. <br /> 4. Sewer must be discontinued at the City service by qualified contractor before demo permit is issued. <br /> Demolition by means of: ❑ Manual Disassembly] Heavy Equipment ❑ Other <br /> Permits Issued: r o'r der /Vc`r Vt7 <br /> ( ) ❑ Sewer Disconnection ❑Well Abandonment# <br /> In return for issuance of said Demolition Permit, the undersigned owner hereby agrees to: <br /> 1. Submit a survey, aerial photo or sketch showing all structures on the property. Note which structures are <br /> to be demolished. <br /> 2. Submit a survey, aerial photo or sketch showing proposed erosion control measures in accordance with <br /> Chapter 79, Construction Site Runoff Control. <br /> 3. Submit a copy of permit approval from the Minnehaha Creek Watershed District (MCWD). The City will <br /> not issue a demolition permit without a copy of the permit(s) from the MCWD or documentation stating <br /> {� ' <br /> permit(s)are not required. <br /> Form Last Updated: July 2015 <br /> 150784 <br />