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�O ` City of Orono FOR CITl'USE ONLY <br /> l�/ P.O.Box 66 Da[e Received: 2.•�15 Permit# 2��7 '�� <br /> � 2750 Kelley Parkway �/,� <br /> Crystal Bay,MN 55323 Amount: $�...�J.�SAC Credit:N��." <br /> (952)249-4600 <br /> � � <br /> y ,� Homeowner(s)Signed: ❑Yes <br /> E' �,� Resolutions(if any)Signed:❑Yes ❑None Required <br /> !�'�f S H��� Zonin Disclosure Si ed: ❑Yes ❑None Re uired <br /> CITY OF ORONO - DEMOLITION PERMIT <br /> (All permits must be approved by the Building Official and/or Zoning Department) <br /> Job Site / Owner Information: RECENED <br /> APR 10 2015 <br /> Type: (� Residential ❑ Commercial <br /> C�-�pF ORONO <br /> Site Address: 4565 Bayside Road, Orono, MN <br /> Owner: Tim and Mary Doubek Mailing Address: 17046 Valley Road <br /> �;�y: Eden Prairie Z;p; 55347 <br /> Phone: Tim's Cell Phone: (612)801 .3076 Email: tjdoubek�gmail.com <br /> Contractor/Applicant Information: <br /> Contractor/App.: Denali Custom Homes Inc. Contact Person: Joe Mailhot <br /> Address: 18352 Minnetonka Blvd State License#: BC175394 <br /> City: Deephaven Zip: 55391 Expiration Date: 03/31/2017 <br /> Office - (952)476.2679 <br /> Phone: Joe's Cell - (763)452.8347 Email: Joem@denalicustomhomes.com <br /> SPECIAL CONDITIONS & HOLD HARMLESS AGREEMENT <br /> General I nstructions: <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 mus# 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: ' ❑ Well Abandonment# Pending <br /> Septic System <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 all 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 (MGWD). 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 />