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� 1 ����� ;:��� 1� - �7 - ��o <br /> � <br /> � .;�j'z�/G(� � lv� `�� <br /> F� �- ��� — 4-5� �— ���� � �a�s� <br /> . � <br /> CITY OF ORONO APPLICATI0�1 FOR DEMOLITION PERMIT <br /> P.O. Box 66 (2750 Kelley Parlcway) <br /> Crystal Bay, MN 55323 <br /> SPECIAL CONDITIONS & HOLD HARyILESS AGREEMENT <br /> General Instructions <br /> 1. You may be required to obtain other permits, i.e. we11 abandonment, etc. <br /> 2. Work must not begin unless the pernlit 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: � V L�� = n I�t �-�� 'J � l�; <br /> Occupancy Type: Residential Commercial pL?�bf C. � ��j��C�'� <br /> OWNER'SNAlVIE: �=�1L ��C='�' L 2 � E-f- Phone: (�'f 2—'� � �-- %���5 <br /> Mailing Address: �c�� C'�C City: — G�,C,� C.`�C•C-^ �1�(J,' <br /> �S�S;� <br /> ��I�'�'1�C'�'OR'SNAIVI�: 'C�G� � , C_�'. �n►� c�" Bus.No.: �l2 ."� 5U -�-� 3�0 <br /> Mailin;Address: ��rG� �/ SlGri �i��� n� CitY:��`i Z��f.�-�t <br /> Demolition if planned by means of: manual disassembly <br /> _�heavy equipment <br /> Pern�its Issued: <br /> # Well Abandomi�eilt <br /> In return for issuance of said Demolition Pei-�nit, the undersigned o�vner 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 lcept 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. Fo�mdations sha11.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 re�ulations. <br /> 6. Sewer and�vater must be discoiu�ected at the servic�s at the street by qualified contractflrs. <br /> 7. Inspection required when all d�bris has been removec't, before backfillina. <br />