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' - � � , �:��� � c� � U� <br /> ���x1 � �� <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 HARMLESS AGREEMENT <br /> General Instructions <br /> 1. You may be required to obtain otl�er permits, i.e. well abandorunment, etc. <br /> 2. Work inust not begin unless the permit card is available on the job site. <br /> 3. A 24 hour notice is required for all inspections. Call (612) 249-4600. <br /> JOB SITE ADDRESS: ;�- � .� ���, /�'.� �� <br /> Occupancy Type: �k` Residential Commercial <br /> OWNER'S NAME: ~� � Phone: �7/� �a- y�°7 <br /> Mailing Address: a `� /.J City: d,�s <br /> �s�. <br /> CONTRACTOR'S NAME: n� � � � Bus.No.: �/7 � �,��a1 � �L <br /> MailingAddress:�-�/G �a 5�,. y /I City: _�',�,,�,p <br /> Demolition if planned by means of: manual disassembly <br /> �( heavy equipment <br /> Permits Issued: <br /> # Well Abandonment <br /> In return for issuance of said Demolition Permit, the undersigned owner hereby agrees as follows: <br /> 1. The structure(s) shall be kept enclosed andlor secured until such time as deinolition 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. Inspection required when all debris has been removed, before backfilling. <br />