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R <br /> „// )' <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. burning, 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 473-7357. <br /> •,35" <br /> Z._ At 1=r4 y� 7L— 121' <br /> JOB SHE ADDRESS: <br /> Occupancy Type: Residential Commercial <br /> OWNER'S NA E: /� 2 (� �- I 1-�« �= Phone: c! 7 <br /> Mailing Address: cs I-4RA_�4E-STC City: <br /> I>< LS (c'? /Y 7 /L-' X 3 3 1 3 <br /> CONTRACTOR'S NAME: ti-A-124.- Cel "f' ' ' Bus. No.: '17 <br /> Mailing Address: 0640)c I City: 1.c99. <br /> ',eke <br /> Demolition if planned by means of: V,manual disassembly <br /> " heavy equipment <br /> burning (by fire department) <br /> Permits Issued: <br /> # Burning Fire Department <br /> # Well Abandonment <br /> In return for issuance of said Demolition Permit, the undersigned owner hereby agrees as <br /> 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 <br /> unless 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 />