Laserfiche WebLink
�fl A` CitV of Orono / `j FOR CITY U�E ONLY <br /> .,O p `VO P.O.Bo�66 V�� Date Received: ,S'�7-c Peimit# ��� __ �� <br /> �,R,� 2750 Kelley Park�vay �,���'.,�>�-� . � % <br /> ���';7��;r F Crystal Bay,MN 55323 �� Amount: $� SAC Credit: <.Lt�-� �h <br /> ��^ �,������.�o` (952)249-4G00 � � >� � <br /> �Eexo¢ Homeowner(sj Signed: [�Yes � <br /> -��'1 •- j Resolutions(if any)Signed:❑Yes ❑Noite Required � ��j_ <br /> 7onin Disclosure Si ed: [�''S'es ❑None Re uired � «� <br /> ��tN,� � <br /> CITY OF ORONO - DEMOLITION PEI2NTIT r__��p �� <br /> (All permits must be approved by the Building Official and/or Zoning Department) ��� � <br /> � �� �� <br /> Job Site/ Owner Infornlation: <br /> Type: �,Residential ❑ Commercial <br /> Site Address: � � � � `-� '°� S �� �'' '•--���'� `�- `-� �_ <br /> %' r.�,� <br /> ll-MP. ,�f D�1R£55 <br /> OwtZer: ��ov'�/'��''�" '`>. ��.-'l � Mailing Address: ��a ��E-*�'.-�a�c�•t,r�"'d,, �p�, �'�i <br /> Clt _�'/�r?/'!`,'� Zi _. �'!;.1!�,f'r ��-/6..��C � 'I N� � � ��5' T <br /> Y� P� i <br /> Home Phone: 1'S �- �'�,�',� �.::_ % , _. <br /> Altenlate Phone: �=�����`� ��E� <br /> Contractor/Applicant Information: � .� <br /> ontractor/A ���� t ������ � ����'�''� �'��' � <br /> c rr.. �� VD� C�n act rers�n: <br /> Address: �1�1�{� i�U�1��� � State License#: fZ���'L � `���" <br /> � City: ��� � �� N�.% Zip: ���� Expiration Date: <br /> Phone: Alternate Phone: <br /> SPECIAL CONDITIONS & HOLD HARMLESS AGREEMENT <br /> General Instructions: <br /> 1. You may be required to obtain other permits, i.e.: well abandorunent, sewer, etc. <br /> 2. Worlc 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. discontinued at the City sei-��ice b qualified contractor before demo pennit is <br /> issued. <br /> Demolition by means of: � Manual Disassembly ❑ Heavy Equipment ❑ Other <br /> Pernlit(s) Issued:,[� Sewer Disconnection ❑ Well Abandonment # �' ' <br /> C`�..�� � 5"�}�/�(� ly(U SLSZVZ� /.�r 5 G.�.�n.4 a` � � <br /> In return for issuance of said Demolition Pernlit, the undersigned owner hereby a,�rees as ollo�vs: <br /> l. T�le structure(s) shall be kept enclosed and/or sec�ired tultil such time as demolition is <br /> complete. <br />