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02/03/03 MON 11:57 FAX 6129340901 INGRAM EXCAVATING 2001 <br /> Feb-03-2003 10:04am From-CITY OF ORONO +9522494616 T-865 P.001/010 F-232 <br /> • 1--) (e-4 (( ( • , CL` �. <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:.. 3 C5- <br /> Occupancy <br /> Occupancy Type: JX'. Residential Commercial <br /> OWNER'S NAME: /It*a t Phone: 651-- Y?o <br /> Mailing Address:_ 5 -e ra.vi 07;4. City: fa dehl 4 / <br /> CONTRACTOR'S NAME: �n �a.►► ��a vim •�� Bus_No.: .2 -9.7 Y—(25;77 <br /> Mailing Address:_/Z700 P'a. a e,— T,-. City: bilert 4-0. <br /> Demolition if planned by means of: manual disassembly <br /> X 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 /> • <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 /> t <br />