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,04/18/20U6 09:03 FAX 61`L 746 5505 BENESYST �(�/I/�L� C�002 <br /> C.(� <br /> ' `� � <br /> � �, <br /> � r)�••, .;�� <br /> � ; '/�,�' y�(�01D <br /> ' ��1 <br /> CITY OF ORONO APPLICATION FOR DEMOLITION PERMIT <br /> P.O. Box 66 (2750 Kelley Parkway) <br /> Crystal Bay, MN 55323 <br /> SPECIAL CONDITIONS & HOLD NARMT,ESS AGREEMENT <br /> General Instructions <br /> l. You may be required to obtain ofihex permits, i.e. welI abandontnent, etc. <br /> 2. Work must not begin unless the permit card is available on the job site. <br /> 3. A 24 hour notice is reyuired for all inspections. Call(952) 249-4600. <br /> JOB SITE ADDRESS• 3251 Casco Circle,Orono,Mn 55391 <br /> Occupancy Type: ✓ Residential Commercial <br /> OWl1'ER'S NAME: Mark Gaylord (612)720-1547 <br /> Phone: <br /> Mailing Address: �s2 2na st Cj�,: Excelsior <br /> CONTRACTOR'S NAME: Tom Lodahl,�.oa�t�n�. Bus.No�.`��S� -�17d- `�9 y!o <br /> Mailing Address: City: <br /> Demolition if planned by means of: ✓ manual disassembly <br /> ✓ heavy equipment <br /> Permits Issued: <br /> # Well Abandonmenfi <br /> Tn return for issuance of said Demolition Permit,the undersigned owner hereby agrees as follows: <br /> 1. The structure(s) shall be kept enclosed and/or secured until such time as demolition is � <br /> complete. <br /> 2. Demolition debris will be kept off adjoining property and/or the public rights-of-way unless <br /> specific prior approval is obtained in writing for temporary use thereof. <br /> 3. Foundations shall be completely removed from the ground. <br /> 4. All demolition debris shall be completely disposed of off site in accordance with all <br /> applicable PCA requirements. <br /> 5. Water wells must be abandoned in accordance with State Health Department regulations. <br /> 6. Sewer and water must be disconnected at the services at the street by qualified contractors. <br /> 7. Inspection required when all debris has been removed,before backfilling. � <br />