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. . � � �� A������� �� <br /> J � � �� �� <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 abandonment, etc. <br /> 2. Work must not begin unless the pernut card is available on the job site. <br /> 3. A 24 hour notice is required for all inspections. Call (952)249-4600. <br /> JOB SITE ADDRESS: 13 (o �C,1 U lr �C,�,�''� l�G <br /> Occupancy Type: Residential Commercial <br /> OWNER'S NAME: �0.�►O���- i✓�„S 6 n Phone:� c1S��-- �1� '' � �"f'�� <br /> Mailing Address: �jc�.►.,�-�, City: O r 0 V�O <br /> CONTRACTOR'S NAME: �.--�4�-I+e I�l i^ 6 Vl`J�' Bus.No.: Co � a-" �� t`3�7 Z7 <br /> MailingAddress:�/�D [1-I'�+-'1'� Wd� Gr City: (r'rdeh Z+/o <br /> Demolition if planned by means of: manual disassembly <br /> _�heavy equipmen; <br /> Permits Issued: <br /> # Well Abandonment <br /> In return for issuance of said Demolition Permit,the undersigned owner hereby agrees as follows: <br /> l. The structure(s) sha11 be kept enclosed and/or secured until such time as demolition is <br /> complete. <br /> 2. Demolition debris will be kept offadjoining property and/orthe 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 /> 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. Sewer and water must be disconnected at the services at the street by qualified contractors. <br /> 7. Inspection required when all debris has been removed,before backfilling. <br />