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�n�T City of Orono Fo� CI Y U E ONLY � <br /> Q ����y P.O. Box 66 Date Received p2��'�,'z�l"� ermit#� <br /> � 2750 Kelley Parkway <br /> Crystal Bay, MN 55323 Amount: $_ l� SAC Credit:�� <br /> (952)249-4600 ��., Q��-5.71 �� <br /> Homeowner(s)Signed: ❑Yes /����3 <br /> yE' �,� Resolutions(if any)Signed: ❑Yes ❑None Required <br /> tqKFSH��� Zoning Disclosure Signed: ❑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: <br /> Type: �Residential ❑ Commercial <br /> Site Address: 3 a 2 .� C� S�� L i 1'G�� <br /> Owner: ,�"7u r^ty MailingAddress: J� ,� �S G� SC� C: �'�/� <br /> c�ty: �,^d n� z�p: .� �3 � 3 <br /> Phone: ��✓� � "� ��� - y� 70 Email: <br /> Contractor/Applicant Information: <br /> Contractor/App.: ��v j%�t°� C��� �%- Contact Person: G+��S I��,X� � <br /> Address: �,�--b 7 �% !�-L� r� �T State License#: �� � S L/� � �/ <br /> City: �wv c��� Zip: 5 S � Expiration Date: � -.�O - �'o/� <br /> Phone: tr2[�'3 �3-��y(� Email: � P�,,K�� �J!'�;dS�W�15TiK�T:��� .��� <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. 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 qualifisd 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 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 />