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� � g�� City of Orono FOR CITY USE ONLY <br /> • O y O P.O.Box 66 Date Received: Permit# <br /> � ,�,,, 2750 Kelley Parkway <br /> � j�� s� Crystal Bay,MN 55323 Amount: $ SAC Credit: <br /> ��-���o�' ��sz>za9-46o0 <br /> ��xos <br /> Homeowner(s)Signed: ❑Yes <br /> Resolutions(if any)Signed:❑Yes ❑None Required <br /> Zonin Disclosure Si ned: ❑Yes ❑None Re uired <br /> CITY OF ORONO - DEMOLITION PERMIT <br /> (All pem�its must be approved by the Building Official and/or Zoning Department) <br /> � Job Site/ Owner Information: � <br /> Type: � Residential ❑ Commercial <br /> Site Address: J 3 rf 5 L3� c�w i)/' l�' �� SG' <br /> Owner: �Y, ; � .�n 'La'rrq✓Ncu I�ci� ailing Address: � 39 S� �'u ev� �.,/S�� Gr/���� <br /> � <br /> c�ty: - ��� z�p-� �S�'3�1 ► <br /> Home Phone: �5�r}- �J � �, �/�7 7� Alternate Phone: <br /> Contractor/ Applicant Informati�n: <br /> Contractor/App.: Contact Person: <br /> Address: State License #: <br /> City: Zip: Expiration Date: <br /> Phone: Alternate Phone: <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. Wark 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 far'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 />