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�.� ����/C� <br /> � 6� � ��, <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 abandoninment, etc. <br /> 2. Work must not begin unless the permit cazd is available on the job site. <br /> 3. A 24 hour notice is required for all inspections. Call (612) 249-4600. <br /> � <br /> JOB SITE ADDRESS: � ���C� 13�y S:� ��� ��'��� <br /> Occupancy Type: ��Residential Commercial <br /> OWNER'S NAIVIE: • �- "'v � Phone: �Sd— �j�/t"" c���� <br /> Mailing Address: << City:��'o,�/c� <br /> CONTRACTOR'S NAME: /�9�fr':� C:c�/1�('cz c�;�j 11 c, Bus.No.: y�j — �C 7c.y' <br /> Mailing Address: CitY� C1_��z- ,�'/.�n <br /> Demolition if planned by means of: manual disassembly <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 /> l. 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 adjoining 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 />