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, <br /> 'ITY OF ORONO APPLICATION FOR DEMOLITION PERMIT <br /> P.O. Box 66 <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. burning, well. <br /> abandonmment, etc. <br /> 2. Work must not begin unless the permit card is available on the job <br /> site. <br /> 3. A 24 hour notice is required for all inspections. Call 473-7357. <br /> JOB SITE ADDRESS: 11-1-7Z3 21 Goo <br /> Occupancy Type: Residential Commercial <br /> OWNER'S NAME: Phone: 7 /- c7 (.4 <br /> Mailing Address: City: 0 <br /> CONTRACTOR'S NAME: F.a . 0 -_� --� ��r c Bus. No. : <br /> Mailing Address: City: ,M , <br /> Demolition if planned by means of: _manual disassembly _heavy equipment <br /> burning (by fire department) <br /> Permits Issued: <br /> # Burning Fire Department <br /> # Well Abandonment <br /> In return for issuance of said Demolition Permit, the undersigned owner <br /> hereby agrees as follows: <br /> 1. The structure(s) shall be kept enclosed and/or secured until such time <br /> as demolition is complete. <br /> 2. Demolition debris will be kept off adjoining property and/or the <br /> public rights-of-way unless specific prior approval is obtained in <br /> 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 <br /> accordance with all applicable PCA requirements. <br /> 5 . Water wells must be abandoned in accordance with State Health <br /> Department regulations. <br /> 6. Inspection required when all debris has been removed , before <br /> backfilling. <br /> 7 . Within 5 working days of superstructure removal , a final inspection <br /> shall be requested. The site shall be left clean and clear of all <br /> debris, with any excavation filled with earth level with the adjacent <br /> ground elevation (except when such excavation is to be used as part of <br /> a new building and such new building is actually under construction). <br />