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O Clty Of O�Of10 . FOR CITY USE ONLY <br /> , P.O. Box 66 Date Received: Permit# <br /> � 0 2750 Kelley Parkway <br /> Crystal Bay, MN 55323 Amount: $ SAC Gedit: <br /> (952)249-4600 <br /> '� �- Homeowner(s)Signed: ❑Yes <br /> � <br /> F �,� Resolutions(if any)Signed:�Yes ❑None Required <br /> t�XESH��� Zoning Disclosure Signed: ❑Yes ❑None Re uired <br /> CITY OF ORONO - DEMOLITION PERMIT <br /> (All permits must be approved by the Building Official andlor Zoning Department) <br /> Job Site / Owner Information: <br /> Type: � Residential ❑ Commercial <br /> Site Address: �� ��,,s�"?.e-.-- I��-�- <br /> •� --� <br /> Owner: �r`2�� GA��-�--� Mailing Address: �G►�vc-.� <br /> City: /`'`��,•t v Zip: .553�Z. <br /> Phone: (=�/ 2 - � r � - �-! �"�'� Email: G'�Ars-�r� �.I��ti,�y�� �dt� <br /> Contractor/Applicant Information: <br /> Contractor/App.: Contact Person: <br /> Address: State License #: <br /> City: Zip: Expiration Date: <br /> Phone: Email: <br /> SPECIAL CONDITIONS � HOLD HARMLESS AGREEMENT <br /> General Instructions: <br /> 1. 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 to: <br /> 1. Submit a survey, aerial photo or sketch showing afl structures on the property. Note which <br /> structures are to be demolished. <br /> 2. Submit a survey, aerial photo or sketch showing proposed erosion control measures in <br /> accordance with Chapter 79, Construction Site Runoff Control. <br /> 3. Submit a copy of permit approval from the Minnehaha Creek Watershed District (MCWD). The <br /> City will not issue a demolition permit without a copy of the permit(s) from the MCWD or <br /> documentation stating permit(s) are not required. <br />