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L <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: /C7 a / k ,���+ hvh�-r-- 1'Z <br /> Occupancy Type: Residential Commercial <br /> (3�r2rt-�S <br /> OWNER'S NAME: t jar.) %Are 1--to -p 2s, 1.7t2 Phone: 6/0)r-6%' 5 C7( <br /> Mailing Address: / (!) /Hoe_ -->„4. (,o e City: (,v g y Z.r¢j hs <br /> ' r( 1, q5-- ��- 53 I�50��f LP <br /> CONTRACTOR'S NAME: 13 p� patie� Bus.No.: <br /> Mailing Address: / O /lige nj-� , NCe. `4,17--- City: <br /> Demolition if planned by means of: manual disassembly 1304-7- ht>i4-.p {'r <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. Inspection required when all debris has been removed, before backfilling. <br />