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< v <br /> /�j City of Orono FOR CITY USE ONLY <br /> P.O. Box 66 Date Received:7 Permit# 615-4005F eD <br /> V 2750 Kelley Parkway <br /> Crystal Bay,MN 55323 Amount: $s SAC Credit: <br /> (952)249-4600 &K <br /> es <br /> Signed: &Yes <br /> �� * Resolutions(if any)Signed:❑Yes [9-< e Required <br /> �RkESHO Zoning Disclosure Signed: ❑Yes one 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: 1070 Tnk&w.) RoaJ <br /> Owner: FaY W a 11 arol¢✓ Mailing Address: /°3o �v, fl ow View Dy. <br /> City: Orono t MAJ Zip: <br /> Phone: 452- 345- 6?2'7 Email: <br /> Contractor/Applicant Information: <br /> Contractor/App.: C�4✓(e-oEdd NNOVo. Contact Person: C1u L���ive <br /> Address: /Soso 23r`A" KA State License#: SC (P 35-245- <br /> City: ��4�,M1VZip: r (IV 7 Expiration Date: 313 t ' 2 0 l7 <br /> Phone: 12 - 39- 1739 Email: Cha V(-S Cvoi6. <br /> SPECIAL CONDITIONS & HOLD HARMLESS AGREEMENT <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 /> Permit(s) Issued: ❑ Sewer Disconnection ❑ Well Abandonment# <br /> NI* k/It <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 /> permit(s) are not required. <br /> Form Last Updated: July 2015 <br /> 150784 <br />