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�1����� <br /> CITY OF ORONO APPLICATION FOR DEMOLITION PER�iVIIT <br /> P.O. Box 66 (2750 Kelley Parkway) <br /> Crystal Bay, NIN 55�23 <br /> SPECIAL CONDITIONS & HOLD HARII�ILESS AGR�EMENT <br /> General Instructions <br /> 1. You may be required to obtain other pennits, i.e. well abandonrrunent, etc. <br /> 2. Work must not begin unless the perniit card is available on the job site. <br /> 3. A 24 hour notice is required for all inspections. Call (612) 249-4600. <br /> 30B SITE ADDRESS: a7(� � � 4}-Sc-.0 t'O/,v� (Zci�-�� <br /> Occupancy Type: �Residential Corrunercial <br /> OWNER'S NAME: L-l�IC_.- lX>C-, Si�l���-r Phone: <o/�- a��' `�'S���� <br /> Mailing Address: ,,7��+-t v UHi-rr.�,��� /Jrz,�.=- City: G�a�.z�,�..�:,� SS�3/ <br /> CONTRACTOR'S NAME: Bus.No.: <br /> Mailing Address: C�tY� <br /> Demolition if planned by means of: manual disassembly <br /> ��heavy equipment <br /> Permits Issued: <br /> # Well Abandorunent /Uj1F <br /> In return for issuance of said Deinolition Pernlit,the undersigned owner hereby agrees as follows: <br /> 1. The structure(s) shall be lcept enclosed and/or secured until such time as demolition is <br /> complete. <br /> 2. Demolition debris will be lcept off adjoining property and/or the public rights-of-way tinless <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. Inspection required when all debris has been removed, before backfilling. <br /> ` I <br />