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APPLICATION FOR DEMOLITION PERMITCITY OF OROMO <br />P.0, Box 66 (1335 So Brown Rd) <br />Crystal Bay, MN 55323 <br />SPECIAL CONDITIONS & HOLD HARMLESS AGREEMENT <br />General Instmctlons <br />1. You may be required to obtain other permits, i.e. burning, well <br />- -abandonirunent, etc. • - - - --- - - . <br />2. Work must not begin unless the permit card is available on the job <br />site. <br />3. A 24 hour notice is required for all inspections. Call 473-7357 <br />JOB SITE ADDRESS: <br />Occupancy Type:Residential Commercial <br />OWNER'S MAMS:Phone : <br />Mailing Address:City: <br />CONTRACTOR'S NAME:Bus. No.: <br />Mailing Address:_______________________________________ City:_________________**************** ********** A ************** ♦ <br />Demolition if planned by means of:manual disassembly heavy equipment <br />burning (by fire department) <br />Permits Issued: <br />#_ _ _ _ Burning Fire Department <br />i Well Abandonment <br />In return for issuance of said Demolition Permit, the undersigned owner <br />hereby agrees as follows: <br />1.The structure(s) shall be kept enclosed and/or secured until such time <br />as demolition is complete. <br />2.Demolition debris will be kept off adjoining property and/or the <br />public rights-of-way unless specific prior approval is obtained in <br />writing for temporary use thereof. <br />3. <br />4. <br />Foundations shall be completely removed from the ground. <br />All demolition debris shall be completely disposed of off site in <br />accordance with all applicable PCA requirements. <br />5.Water wells must be abandoned in accordance with State Health <br />Department regulations. <br />6.Inspection required when all debris has been removed, before <br />backfilling. <br />Within 5 working days of superstructure removal, a final inspection <br />shall be requested. The site shall be left clean and clear of all <br />debris, with any excavation filled with earth level with the adjacent <br />ground elevation (except when such excavation is to be used as part of <br />a new building and such new building is actually under construction).