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e <br /> Pi 0- t�0601-EseccW✓ <br /> yCity of Orono Fc R rry t SE o�i.Y�/ <br /> W <br /> PO.Box 66 Datc Rce ed: �] )�_. �2750 Kelley Parkway <br /> Crystal Bay.MN 55323 Ymounr SAC Creel c(952)249600 IHomm nerts)Signed: 0 Yes <br /> Resolutions(f any)Signed:0 Yes 0 None Required <br /> Zoning Disclosure Signed. 0 Yes 0 None Required <br /> CITY OF ORONO - DEMOLITION PERMIT <br /> (All permits must be approved by the Building Official andlor Zoning Department) <br /> Job Site/Owner Information: <br /> Type: X Residential ❑ Commercial <br /> Site Addre s: F 70 <br /> (>C1'. lei (e -,-7,, .�-c <br /> VPrucr'' -re 4.1)emit/.rWCoQpooaz'Pp <br /> Owner. -tv,utr Ljsk-oK y 6R1I L :wing Address: 30JD a>btiCS LAMS <br /> City W rt413 _ _ Zip: KN 5534! <br /> • <br /> Phone. `la qs4- (Art Email: 77; C) /7? it ;.Z 6.-ne ` (-0n' <br /> Contractor/Applicant Information: /�j <br /> //-...-, <br /> i//. <--- <br /> Contractor/App.. n Contact Person: <`�', /� f , <br /> Address: .01/0/ :.-,,,,a--- 1. 0 3 State License#: <br /> J <br /> City: /1-4„7/t rii Zip: j:13(/.3 Expiration Date: <br /> Phone: (7_5.2 - 1-35-- <br /> .. (//33 Email: .1_, �//,fi n,,,/-i -.73 %7%S:c.1, ;,-" <br /> SPECIAL CONDITIONS & HOLD HARMLESS AGREEMENT <br /> General Instructions: <br /> 1. You may be required to obtain other permits, i.e.: well abandonment, sewer, etc. <br /> 2. Work must not begin unless the permit card is available on the job site. <br /> 3. A 24-48 hour notice is required for all inspections. Call (952)249-4600. <br /> 4. Sewer must be discontinued at the City service by qualified contractor before demo permit is <br /> issued. <br /> Demolition by means of: ❑ Manual Disassembly jleavy Equipment ❑ Other <br /> Permit(s) Issued: ❑ Sewer Disconnection ❑ Well Abandonment# <br /> In return for issuance of said Demolition Permit,the undersigned owner hereby agrees to: <br /> 1. Submit a survey, aerial photo or sketch showing all structures on the property. Note which <br /> structures are to be demolished. <br /> 2. Submit a survey, aerial photo or sketch showing proposed erosion control measures in <br /> accordance with Chapter 79. Construction Site Runoff Control. <br /> Submit a copy of permit approval from the Minnehaha Creek Watershed District (MCWD). The <br /> City will not issue a demolition permit without a copy of the permit(s) from the MCWD or <br /> Øc <br /> documentation stating permit(s)are not required. <br />