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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: 02 L V d— U—) <br /> Occupancy Type: Residential Commercial 6 A l� <br /> OWNER'S NAME: '�K�ELM i t S , 1— C� Phone6 6,:�) 3 8'3— '1 LI-1 I <br /> Mailing Address: 557X7I e r"sc�y� �s L�E-�c City:_\.P_ (MU <br /> CONTRACTOR'S NAME: N C K..k apL— us.No.: <br /> Mailing Address: t'h iPNe_ b�j City: lJ 11L leiy .T 1N111U`�S a O <br /> Demolition if planned by means of. manual disassembly <br /> heavy equipment <br /> Permits Issued: <br /> # //,M03Well Abandonment <br /> ��9/53 • <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 />