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4 , <br /> City of Orono 7 CT�'Y USE ONLY y� 3/ <br /> -$.04/0W <br /> PO. Box 66 Date Received:J� Z //3 Permit#�rV�3 —O�� <br /> 2750 Kelley Parkway ITT) <br /> Crystal Bay,MN 55323 Amount: $ S3 SAC Credit: <br /> (952)249-4600 <br /> h Homeowner(s)Signed: 0 Yes <br /> Resolutions(if any)Signed:❑Yes ❑None Required <br /> Zoning Disclosure Signed: 0 Yes 0 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: [' esidential ❑ Commercial <br /> Site Address: C> 6 <br /> -C O w'P_t)b-p V /74/ ti S <br /> Owner: o- Soyr A rid-er.SG h Mailing Address: <br /> City: 0 VY)h (9 Zip: <br /> Phone: Email: <br /> Contractor/Applicant Information: <br /> Contractor/App.:A- I V'41/1.51 Contact Person: & 4- <br /> Address: -<-7-7 90 Piokit.e.,,, f7t State License#: <br /> City: Zip: c. Expiration Date: <br /> Phone(' 7Z 2 ) ; A Email: <br /> SPECIAL CONDITIONS 8g 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 DisassemblyHeavy 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 />