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� <br /> ' f�4:0``�� City of Orono FO CI SE ONLY n(�Q <br /> �� P.O.Box 66 Date Received: Pennit# �� 7 / V <br /> �����r;,., ���� 2750 Kelley Parkwa}� ' �� � <br /> � ��' �- � Crystal Bay,MN 55323 Amount: $ � ✓ SAC Credit: <br /> ��A � {�o�% (952)249-4600 <br /> �'rraso8.. <br /> Homeowner(s)Signed: ❑Yes <br /> Resolutions(ifany)Signed:❑Yes ❑None Required <br /> 7onin Disclosure Si ned: ❑Yes ❑None Re uired <br /> CITY OF ORONO - DEMOLITION PERMIT <br /> (All permits must be approved by the 13uilding Official and/or Zoning Department) <br /> Job Site/Owner lnformation; <br /> Type: ��Residential � Commercial <br /> Site Address: � � 3-� ����'�� �L''�/V/ ��� <br /> Owner: �IJl1 ��'Qi�{�� I�S Mailing Address: ��3� ��.�b�1S �1�J'�_ <br /> City: ��6�Y� Zip: ��3� j <br /> Home Phone: �7Cr3- �Iv2�{- (�� Alternate Phone: N{�i <br /> Contractor/Applicant Informatton.''' <br /> Contractor/App.: 1��C,�4�� � 'AT�1A�-i �/�-'(s Contact Person: �; (^/� �L�f"�F/r'� ) � <br /> Address: �� IaS ��C�I`: Ct���•f�/��.- State License #: <br /> City: �I•�YY�IC.e�(2L Zip: S�3"1� Expiration Date: <br /> Phone: ��7(�;a3� ��k'�S� Alternate Phone: �������"�;�`��I�C` �� <br /> SPECIAL CONDITIONS & HOLD HARMLESS AGREEM�NT <br /> General Instructions: <br /> l. 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 as follows: <br /> 1. The structure(s) shall be kept enclosed and/or secured until such time as demolition is <br /> complete. <br />