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� �.� � � <br /> r � � <br /> � . f 'L•Y , s t ,�S'Z,.wz`'z'4 � r,.-'? .J � f'T <br /> •'3 . C��'�`3 <br /> CITY OF ORONO APPLICATION FOR D$HOLITION P$RMIT <br /> P.O. Box 66 (1335 So Brown Rd) <br /> Crystal Bay, MN 55323 <br /> � SPECIAL CONDITIONS & HOLD HARMLESS AGREEMENT <br /> *****�*:*�t*****************t*********#***�**�t***********#***�r*f********** <br /> General Instructions <br /> 1. You may be required to obtain other permits, i.e. burning, well <br /> _- ---•- _• abandonmment, etc. -- - _ .._,._ . _ _.. _._.__ . .,__.. .,_. .._s _ - _ - -- - - . _-- _ <br /> 2. Work must not begin unless the permit card is available on the job <br /> site. <br /> 3. A 24 hour notice is required for all inspections. Call 473-7357. <br /> *t*�******:t**�******:***�*t*t*ft*:t*:t*******t�*******t**t**t�:**tt****t�* <br /> JOB SITS ADDRESS: 1287 Brown Road S . <br /> Occupancy Type: Residential Commercia <br /> OWNSR'S NAME: City of Orono Phone: 4��-��5� <br /> Mailing Address: Box 66 , Crvstal Bay, MN 55�2'� City: <br /> CONTRACTOR'S NAME: Citv of Orono Bus. No. : <br /> Mailing Address:Box 66 , Crvstal Bav. MN 55323 City: <br /> ******t****:�****�*:*******:*:********:****t*************�*:�************** <br /> Demolition if planned by means of: manual disassembly �heavy equipment <br /> burning (by fire department) <br /> Permits Issued: <br /> � Burning Fire Department <br /> # Well Abandonment <br /> In return for issuance of said Demolition Permit, the undersigned owner <br /> hereby agrees as follows: <br /> 1. The structure(s) shall be kept enclosed and/or secured until such time <br /> as demolition is complete. <br /> 2. Demolition debris will be kept off adjoining property and/or the <br /> public rights-of-way unless specific prior approval is obtained in <br /> 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 <br /> accordance with al 1 app licable PCA requirements. <br /> 5 . Water wells must be abandoned in accordance with State Health <br /> Department regulations. <br /> 6. Inspection required when all debris has been removed , before <br /> backfilling. <br /> 7. Within 5 working days of superstructure removal , a final inspection <br /> shall be requested. The site shall be left clean and clear of all <br /> debris, with any excavation filled with earth level with the adjacent <br /> _ ground elevation (except when such excavation is to be used as part of <br /> a new building and such new building is actually under construction). <br />