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� i <br /> �,�� CITY OF ORONO APPLICA ION FOR DEMOLITION PERMIT <br /> P.O. Box 66 (2750 Kelley Parkway) <br /> Crystal Bay, MN 55323 <br /> SPECIAL COi�1DITIONS & HOLD H LESS AGREEMENT <br /> General Instructions <br /> 1. You may be required to obtain other permits, i. . burning, well abandonmment, etc. <br /> 2. Work must not begin unless the permit card is vailable on the job site. <br /> 3. A 24 hour notice is required for all inspections. Call 473-7357. <br /> JOB SITE ADDRESS: �(U`��' r (.. �i ��J� ��'�� <br /> Occupancy Type: �_Residential Comm rcial <br /> OWNER'S NAME: `Cu'?.� '�i'�Y ��Z� C�� ' .:- � Phone: �����D�S <br /> Mailing Address: � G:' � � � � City: c'%rj)-y�D <br /> CONTRACTOR'S NAME: N�.�(�, �� Bus. No.: �-/'��7 �7��� <br /> Mailing Address: ; `) Cin'� ry'n�? - <br /> Demolition if planned by means of: _� manual disassembly�'���`�? r��'��� G�/'��� ��`�`''�- ���� <br /> heavy quipment ��� ��"'� � ���� /�� <br /> burnin (by fire department) <br /> Permits Issued: <br /> # Burning Fire Department <br /> # Well Abandonment <br /> In return for issuance of said Demolition Permit, t e undersigned owner hereby agrees as <br /> follows: <br /> 1. The structure(s) shall be kept enclosed and/o 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 <br /> unless specific prior approval is obtained in riting for temporary use thereof. <br /> 3. Foundations shall be completely removed fro the ground. <br /> 4. All demolition debris shall be completely d' posed 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 /> i <br />