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� , , <br /> City of Orono FOR�Y USE ONLY � <br /> �O� P.O. Box 66 Date Received:��Zq��' Permit# 0��3'd �� <br /> � 2750 Kelley Parkway Q <br /> Crystal Bay, MN 55323 Amount: $ U b' � SAC Credit: <br /> (952)249-4600 <br /> y � <br /> Homeowner(s)Signed: ❑Yes <br /> e� �,� Resolutions(if any)Signed:�Yes ❑None Required <br /> `�kESH��� Zoning Disclosure Signed: ❑Yes ❑None Required <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: <br /> Type: ❑ Residential ❑ Commercial <br /> Site Address: �s �S l ��S����� ��t/Z=4ilz'1 _ <br /> Owner: �45�v1 (,c��I�p�+� Cl��r_S Mailing Address �v���✓��/" ��" �"/Ir�P/��of' <br /> c�ty: ��no �onK-a G�ue.i�rnc��f �p: .�S-3 3 � <br /> Phone:Ln I/�`�7� ' O 8 7� Email: �J�H e y C! ��,$��'��df��,����ps'�eS, C�s� <br /> Contractor/Applicant Information: <br /> � -, J � - <br /> Contractor/App.: ���'� Contact Person: / A4�t C � D�� <br /> Address: State License#: �� � 276�J �� <br /> City: Zip: Expiration Date: � � 3� ' j� <br /> Phone: Email: <br /> SPECIAL CONDITIONS 8� HOLD HARMLESS AGREEMENT <br /> General Instructions: <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 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 /> l' <br /> Permit(s) Issued: ❑ Sewer Disconnection ❑ Well Abandonment# <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 (MCWD). 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 />