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. ' , , <br /> .._ . .a,. , , v.. , _:3 .� ., a:��.i; �: ��J4� ..�E , �l�ii :�lt �;i� . t,��. ;Ji i �.. ,;t..... . <br /> �!i�i 1:.� �11��Ji:tj)�1�1}t i1� IS i511Ul1ilCi� llt ti�;illtl�'.�. 101 Ll'dTt�J�.)7"t#i��,� Lk�l lflf;l�i'Oi�. <br /> - ��r�undauuns shall be corr►pletety reruoved tr�m th��rouzicl_ <br /> a_ �13 deriiciliuon dehi-i5 shall Me completci�� d��spased of�qt't s�te in accordance witl�aEl <br /> ap�licable PC,� rcq�ircments. <br /> � ��:�ter wells 7i�ust be at>andoneii in accc�rclance��ith State H�alth Depattment reguiat�ons. <br /> ��: inspeetton reilutreci wl�c:.l� alt debns has h�;zi� removed. befc7r�backfiilin�_ <br /> � �l��tl��rt� 4varkln�day� L��f�i�perstru�nyre r�n�t���al, a tinaf inspe4tic�r� shall be req�i�stea_ The <br /> s�ze shal! be left clean ancl clear of all �ehns.r.�=�th any excavat�icu� i�illeci with earth le��el ��-ith <br /> thc ad}a:�ent�round �l�vanf�n (ercept when sueh excavatican is tc� b� used as part�i�i ne�� <br /> buiid��i�and sarli iiew bieldan� ts actually lancier constructiori). <br /> � °�e�uc �ysterns must be ab:����:3c�ned p��� Min��Gs,�t� l�ule5 C�hapter 7080. .a11 septic eank� <br /> must b��umped, crushed and fifieii w�ith native so�is .:-�i� inspect�on �s req�ure� after tl�e <br /> taiiks are pumpeci aiic��ef�;re th� tanks are crushed and filled. <br /> �� Tl�e undersi�;��ed owi�er shall and hereb}� does iiidemnify a►id i�old ha��inles�ttie Cit} of <br /> i�?r��no, �ts a�e�lts, zrnpli�yees a�ld assirns fr�in� a��d aga�rl��ali clait7��_ dan�ages, losses or <br /> expeiises, rilcludinz.ar[��i�ie� tees. ��aiilst the(�it�, its agents. empl��yee� and ass��,n�aris�ng <br /> ��iit of or resultiiig fi�t�rn the demoi�ti���i described hei�eul�is performcd bv the propert� uw�aei�, <br /> his employees, a�ents, subcUntraet��rs{>r assr�n�. <br /> 1'E12't'llT TY�P� .-1'rfy FEC.CAI_.CL�I..A�T10'�i <br /> �] $'�.t)i) !'rincipal Sn-��crure <br /> � �+5t')t}U- Accessory 52ructurc {l�c��c many? (�-13at) <br /> . �ut�total of abc�ve perrtru��equested $ �5.00 <br /> _. 5tate Surchar�;e � ---------SU__—_ <br /> `1`(f'T�AI, PF,R�,t�1IT f+�EE: {add i�r�es I-�� abo��e� � 'S.00 <br /> i 1ii: i�i�ders��netl her't�y :iE�pl�t��t�� ilie t"ity of�Oronc: for isstra�ice of a Demolit�on Pertlut,a�ree� <br /> ro �3o al! the:���ork iti a stnct ac�tir��r;�nce wiih the ordina�lces ��f the('it>> ai�d the r��nifat�ons ot' <br /> the State of!�9inneso[a. ai�c��e,�`i�ie�t{iat a)I statements �nade i,n this appiieatiur�arc con�plete. <br /> trur��nd currcc[. _=.-� -�� <br /> . .� <br /> :lppticni►C's Si�nature: � �' � Datc �- °3�� . <_�, <br /> U,Fner•'s �►�nature: '�� I)zit� 3-30`� / <br /> �,! _ _ _ <br /> :���proved t3��: � �,�C�t,-�,.P._..,_ I��zr� � - �L- O � <br /> � _ _---.. <br /> ���� ���i�i��i.�l� <br /> �:,., ; <br /> ° 1:t�ni��� Disclosurr Rt�c�i�rrc�tl'' .._✓ ` t . ;�; 'vO <br /> '�Ihi- u�u�i be fili�:i<ui h�;r_'.t�,_:,_ ; „ z.r.r.�r:in:.�.�ct.�Ltii;uts�'(>11i�cii iuuti� _.i.:I!a4��li.:.u��n>. <br /> �� ��j�f�ra�ed Br: � � ' I �� � � <br /> _ , � �'_.. � � <br /> �'�'S�� �OCfTt <br />