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CITY OF ORONO APPLICATION FOR DEMOLITION PERMIT <br /> P.O. Box 66 (2750 Kelley Parkway) <br /> Crystal Bay, MN 55323 r <br /> - SPECIAL CONDITIONS& HOLD HARMLESS AGREEMENT <br /> General Instructions <br /> I. 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(612) 249-4600. <br /> JOB SITE ADDRESS: 10y <br /> Occupancy Type: Residential Commercial <br /> OWNER'S NAME: Phone:-20-/5-yr---a aas- <br /> Mailing Address:_J()C) U gkL Aog- S• City: 4( J ZZ ten U-0 //P�S '4-/QC <br /> CONTRACTOR'S NAME: Bus.No.: ?G7>/<1:2 <br /> Mailing Address: l OD F->rt',ka e As.2 e City:-De "kir-, SS3�g <br /> Demolition if planned by means of: manual disassembly <br /> heavy equipment eC� 6 q7 81 <br /> Permits Issued: <br /> # Well Abandonment <br /> In return for issuance of said Demolition Permit,the undersigned 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. <br />