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t <br /> CITY OF ORONO APPLICATION FOR DEMOLITION PERMIT <br /> P.O. Box 66 (2750 Kelley Parkway) <br /> Crystal Bay, MN 55323 <br /> SPECIAL CO'INTDITIONS & HOLD HARMLESS AGREEMENT <br /> General Instructions <br /> 1. You may be required to obtain other permits, i.e. burning, 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 473-7357. <br /> JOB SITE ADDRESS: /070 o Ni�� W11 <br /> Occupancy Type: Residential Commercial <br /> OWNER'S NAME: /Ili N f}GZ) 1,4�2 Phone: <br /> Mailing Address: S09 FE�D/1 �D. Al. city: <br /> CONTRACTOR'S NAME: Bus. No.: — �6 .� <br /> Mailing Address:_S09 F ��/�fl __ City: !moi¢ Z/�Ti9 <br /> 40/DM e-A 11J C . &)« �� d-o SIJ 6- 00"V v,e� <br /> Demolition if planned by means of: manual disassembly <br /> _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 hereby agrees as <br /> 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 <br /> unless 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 re,lations. <br /> 6. Inspection required when all debris has been removed, before backfilling. <br />