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O City of Orono FO CIT SE ONLY <br /> P.O.Box 66 Date Received Permit# �1 'Q �Qp <br /> 2750 Kelley Parkway <br /> Crystal Bay,MN 55323 Amount: S G SAC Credit: d J/cZ <br /> (952)249-4600 <br /> folia <br /> Homeowner(s)Signed: , Yes <br /> / o00 <br /> Resolutions(if any)Signed:❑Yes.B None Required <br /> (qkf S H Opti Zoning Disclosure Signed: ❑Yes e"None Required <br /> CITY OF ORONO - DEMOLITION PERMIT <br /> (All permits must be approved by the Building Official and/or Zoning Department) <br /> Job Site / Owner Information: <br /> Type: ] Residential / �❑ Commercial <br /> Site Address: �ZS t✓�' �����✓ ,���1�'� JCT�✓ �� <br /> Owner: c 1A/ ril A-e //02- 6 t <br /> Mailing Address: <br /> City: �:� PA- Zip: ��yz <br /> Phone: 6_1/z_ �Z� 7 Q O Email �64e 110 Act), (o,�, <br /> Contractor/Applicant Information: <br /> Contractor/App. L !n/ --Contact Person: <br /> Address: -Pio , 6�� g- l State License#: <br /> City: WJ417 Zip: �1( Expiration Date: <br /> Phone: �IZ�7Y]- 5-7-573 Email- be V 6 Sl"S tAgd �aa>r. 601-- <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 Heavy 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 /> 3. 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 /> documentation stating permit(s) are not required. <br />