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, ' ��� �g� <br /> . �� Sv <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 abandonmment, etc. <br /> 2. Work must not begin unless the permit card is available on the job site. <br /> 3. A 24 hour notice is required for all inspections. Call (612) 249-4600. <br /> JOBSITEADDRESS: �3qZ QAIa`1'r ��'IG �0°�� <br /> Occupancy Type: ���Residential Commercial <br /> OWNER'SNAME: ��� �' RO�A"""e �°�"1e Phone: atS2•a1�19• CLN6 <br /> Mailing Address:g$s� ��e�W 'E�. �"�.�1"� t + I'�N City: <br /> c.�1a� <br /> CONTRACTOR'S NAME: SO�r► �Cwew� �S°"`S Bus.No.: �►S t—�13 S-�1 t 00 <br /> Mailing Address: *�a►0� L�r►C0��r• �tti� City: C��;,�.0. . MF� <br /> Demolition if planned by means of: manual disassembly <br /> SS y3 ` <br /> �heavy equipment <br /> Permits Issued: <br /> # 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 /> 2. Demolition debris will be kept off adj oining property and/or the 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. Inspection required when all debris has been removed, before backfilling. <br />