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, t , . � <br /> City of Orono FO CIT USE ONLY <br /> / !�O^/\ P.O.Box 66 Date Received:ly � r Permit# ��—'<` �� <br /> 0 ` 2750 Kelley Parkway <br /> i � Crystal Bay,MN 55323 Amount: $ SAC Creclir. <br /> � (952)249�600 �/'��Zj,r.�� ./y� -f-//� �jj� <br /> ��� <br /> � � + Homeowner(s)Signed: ❑Yes /� <br /> -* : ; <br /> F � Resolutioos(if any)Signed:0 Yes ❑None Required � H�1'� <br /> �-P,�-�`H���� Zonin Disclosure Si ed: ❑Yes ❑None Re uired r����� <br /> � ----- ul�p�� G�p'OVv �h'.Q.l�►'�+ Ye,(,Gtv�. '�7 <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: � � � J C�� C�� <br /> Owner. �f�y \�a��� MailingAddress: �J�u /--�rC�l�f� �-l� <br /> City: �l�n�.`�'1 �� Zip: � � j�� <br /> Phone: Email: <br /> Contractor/Applicant Information: <br /> Contractor/App.: ����`� � ��n-� Contact Person: ���v ��� <br /> Address: I f �N� W I w .� State License#: <br /> City: �t ����5 Zip: .��t'"�5����♦� Expiration Date: <br /> ^�,1 � " <br /> Phone: �S�-�� �0- I�� Email: ����� �n =�'`'�� � m�'n� ��e <br /> SPF���' ^^"—"— :SS AGREEMENT <br /> Generallnstructic �, S � <br /> 1. You may be ��� ient, sewer, etc. <br /> 2. Work must rn b site. <br /> 3. A 24-48 hour I� -4600. <br /> 4. Sewer must t �� �ctor before demo permit is issued. <br /> Demolitio i by means _ ❑Other ��� <br /> Permit(s) ssued: �: i `�r� I � �'�' �; <br /> II ' � <br /> In return for issuan �d owner hereby agrees to: <br /> 1. Submit a survE '��� ���' he property. Note which structures are <br /> to be demolish� <br /> 2. Submit a surve i control measures in accordance with <br /> Chapter 79, Co <br /> 3. Submit a copy � �rshed District (MCWD). The City will <br /> not issue a den ,_, .,�,�� the MCWD or documentation stating <br /> permit(s)are no ���� ����,;�1 I�>• �� <br /> ,� <br /> Form Last Updated: July 2015 <br /> icnoon <br />