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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 (,6112) 249-4600. <br /> JOB SITE ADDRESS: !4 <br /> Occupancy Type: —7Z—_Residential Commercial P4 c� �_ 7-) <br /> LJ f6- d-qQl <br /> OWNER'S NAME: Com} - l l K�� )Phone: <br /> Mailing Address: C city:- <br /> CONTRACTOR''Z <br /> ity:CONTRACTOR'S NAME: Bus.No.: <br /> Mailing Address: City: <br /> Q <br /> (1 Demolition if planned by means of: manual disassembly �jt� � I <br /> 1 heavy equipment <br /> Permits Issued: <br /> # Well Abandonments <br /> CA/V// <br /> In return for issuance of said Demolition Permit,the undi. geed 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. So, <br /> C) P <br /> (wAu � � <br /> �IJ <br />