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City of Orono F C1"Y USE ONLY ;{ <br /> l V P.O.Box 66 Date Received: Permit#aoLy— o ✓ <br /> 2750 Kelley Parkway <br /> Crystal Bay, MN 55323 . Amount: $ bV SAC Credit: <br /> (952)249-4600 <br /> Homeowner(s)Signed: ❑Yes <br /> ytn <br /> Resolutions(if any)Signed:El Yes El None Required <br /> xBSHD�� �I,�l l� Zoning Disclosure Signed: ❑Yes ❑None 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: L4 Ll loc,4 r �" <br /> Owner: C.� 'C rgoPEf rY Mailing Address: TO I3o x <br /> City: L if I7Lt+1-'' Zip: SS 3S' <br /> Phone: Email i e' L L' err JC.— <br /> Contractor/ <br /> .KContractor/Applicant Information: - <br /> Contractor/App.: �� �'`�r'^E S Contact Person: �_� o�{"� ���sw� """� <br /> Address: T'� ��C-' State License#: <br /> City: IM14fL Zip: 5`1S.3s"� Expiration Date: <br /> Phone: �`I C ,)H 711 3 i i '-IEmail c <br /> —�-- . - <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 <br /> issued. <br /> Demolition by means of: ❑ Manual Disassembly OHeavy Equipment ❑ Other <br /> Permit(s) Issued: ❑ Sewer Disconnection ❑ Well Abandonment# <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 <br /> structures are to be demolished. <br /> 2. Submit a survey, aerial photo or sketch showing proposed erosion control measures in <br /> accordance with Chapter 79, Construction Site Runoff Control. <br /> 3. Submit a copy of permit approval from the Minnehaha Creek Watershed District (MCWD). The <br /> City will not issue a demolition permit without a copy of the permit(s) from the MCWD or <br /> documentation stating permit(s) are not required. <br />