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4105W <br /> 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 abandonment,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 (952) 249-4600. <br /> JOB SITE ADDRESS: ,?,-7 Oq 6J i°� 7ECS FbEr L <br /> Occupancy Type: Residential Commercial <br /> OWNER'SNAME: 13IUL l2-fNKC L Phone: <br /> Mailing Address: 1k 35S 7�& /H AIS City: fz ywra nt S SyYfo <br /> CONTRACTOR'S NAME: vn�J uL ICF Ho16:2 - Bus.No.: <br /> Mailing Address: 1;t 1�19 i 0 i 0 L. 1-D City: O(Lo'j 0 <br /> tee•-.�i:+.�� :fr1-2nnmA h.,means of: X manual disassembly <br /> heavy equipment <br /> Y <br /> �andonment <br /> ;aid Demolition Permit.the undersigned owner hereby agrees as follows: <br /> shall be kept enclosed and/or secured until such time as demolition is <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. Sewer and water must be discommected at the services at the street by qualified contractors. <br /> 7. Inspection required when all debris has been removed,before backfilling_ <br />