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(ItAI J <br /> i ► / 2kr , c, 1 717 <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: 50 S OR C KA - <br /> Occupancy Type: ,` Residential Commercial <br /> OWNER'S NAME: /FYI///•''6/E /VCW/7A/ Phone: 95-2-,ZZ (5,66q <br /> Mailing Address: g.0//v.-/- City: jA1.¢ � ni,v <br /> CONTRACTOR'S NAME: 0yy,4-i y a v fif Bus.No.: 7b3 -- itt7e) --6 77 7 <br /> Mailing Address: -75-z6.7 ,e0-01 City: ,ay!„4,14 11.4/Ai 53357 <br /> CCu (,+z. -Icy S4,Io <br /> Demolition if planned by means of: manual disassembly <br /> X heavy equipment <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 />