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. tt �(�e�(.;'�=� <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 p�rmits, i.e. well abandonment, etc. <br /> 2. Work must not begin unless the pernlit 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: �' Sc a �,� `� <br /> Occupancy Type: Residential Commercial <br /> OWNER'SNAME: �� -� Phone: <br /> Mailing Address: � I J City: ���y l <br /> �'L'1�I�'RACTOR'S NAMF.: �7AJI '"�rn�,�-� ��a�r�5 Bus.No.:� (Z- Z�'o—��/G2� <br /> MailingAddress: 6 D C ���D� City: `'�' y<t SS.�I <br /> Demolition if planned by means of: manual disassembly <br /> __�heavy equipment <br /> Permits Issued: <br /> # � Well Abandonment <br /> In return for issuance of said Demolition Pennit, the undersigned owner hereby agrees as follows: <br /> 1. The structure(s) shall be kept enclosed avd/or secured until such time as demolition is <br /> complete. <br /> 2. Demolition debris will be lcept�ff adjoining property and/or the public rights-of.-way unless <br /> specific prior approval is obtained in writing for temporary use thereof. <br /> 3. Fotmdations 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 disconnected at the services at the street by qualified contractors. <br /> 7. Inspection required when all debris has been removed, before backfilling. <br />