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City of Orono FOR CITY USE ONLY <br /> / szLok P.O. Box 66 Date Received: 3/zt/sq, Permit# 2r/tl C'C" /7 <br /> 2750 Kelley Parkway <br /> Crystal Bay,MN 55323 Amount: $ SAC Credit: <br /> (952)249-4600 <br /> >, Homeowner(s)Signed: Yes <br /> y*01E, <br /> �� Resolutions(if any)Signed:0 Yes 0 None Required <br /> Kf s H o'- Zoning Disclosure Signed: 0 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: 0 Residential ❑ Commercial <br /> Site Address: \ 11705 A)47-4:4-7-0 40A1 , <br /> Owner: 662.0: kEtc_y RCggc_ Mailing Address: 11705- 7bo,/ 'c <br /> (/pon <br /> City: iD I Zip: 555S4/ <br /> Phone: ((QIZ Z32 - 63920 Email: KEZLtj , b,--72E@M4,co vlr <br /> Contractor/Applicant Information: <br /> Contractor/App.: /JE K f'R I-I4L Contact Person: <br /> Address: 3441E 45 ,46ak State License#: <br /> City: Zip: 4. Expiration Date: <br /> K <br /> Phone: Email: <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 ❑ Heavy Equipment ❑ Other <br /> H1\ Permit(s) Issued: E 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 />