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dFt <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 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: 30'�L) way Pr'— /et t) KO <br /> Occupancy Type: __>,C Residential Commercial <br /> OWNER'S NAME: 1 + be��i R*-e,Jc k,04;-5 Phone: <br /> Mailing Address: City: <br /> CONTRACTOR'S NAME: Sf6A) k +k o 0 � II,w&,U Bus. No.: q'"7 3 _5 93S <br /> Mailing Address: 16 3 y&) M;A4V r o�v u_ ,�lv l City: N2 P,o <br /> Demolition if planned by means of: manual disassembly <br /> X heavy equipment -1-�KR•v �� �� k� <br /> Fine �Q�uR�•�► ��/� <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 />