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. � <br /> � �T City of Orono �'J1 '� FOR CITY USE ONLY <br /> �!V P.�. BOX 66 ��/� Date Received:�- �� Permit# �3 dI� � <br /> � 2750 Kelley Parkway �( <br /> Crystal Bay,MN 55323 Amount: $ 5�•�� SAC Credit: <br /> (952)249-4600 <br /> '� ,` Homeowner(s)Signed: ❑Yes <br /> y�. . <br /> ��, Resolutions(if any)Signed:�Yes ❑None Required <br /> `�KESH�� 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 �-�- 7 G� SG� G-i'�''l��� <br /> Owner: ���5 �1�0u(���— Mailing Address: I � rs� 1/G�rS,�` �-�✓�"� <br /> ��ty: PI��U�. Z�p: ss��� <br /> Phone: 76 3. ��.. (�l 70 EmaiL ��i. �l����',�.��MoS�,G �. Gd✓''t <br /> Contracta�/Applicant Information: <br /> Contractor/App.: � Contact Person: I <br /> Address: State License#: <br /> City: Zip: Expiration Date: <br /> Phone: Email: <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 qualified 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 />