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,SID%Vag <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 abandonment, 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 (952) 249-4600. <br /> JOB SITE ADDRESS: 3g lf/cS rxSET "0,110 <br /> Occupancy Type: Pc Residential Commercial <br /> OWNER'S NAME: /�6( p, ,�/Gi .5e)i Phone: &c ) -- <br /> Mailing Address:bp Tern s ,e. _ £)/ , d6sY City: /.f/4,J'zap- /9/t/ 5:5',Tr <br /> CONTRACTOR'S NAME: /G tr- so/Vs /4/c Bus.No.(?5 2) '73 s'— Y/33 <br /> Mailing Address: i(i/o/ (p 2,b 3 City: Horkm/s Am/ s15—sr? <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 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. 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 />