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O City of Orono FOR CITY USE ONLY <br /> • �- � P.O. Box66 DateReceived:Q'�u_�3 Permit# oZlSl�—G'G 1�.6 <br /> � 2750 Kelley Parkway p <br /> Crystal Bay, MN 55323 �/ Amount: $ 0� SAC Credit: <br /> (952)249-4600 f�/�' , <br /> � � a�" �3 Homeowner(s)Signed: ❑Yes <br /> yF L� �/ � Resolutions(if any)Signed:❑Yes ❑None Required <br /> t-9,�FSH��� Zonin Disclosure Si ned: ❑Yes ❑None Re uired <br /> ��f f(;�l� e S C�M� C�n�..YYI�►�"'1�,� �� <br /> CITY OF ORONO - DEMOLITION PERMIT �� LZ�� <br /> (All permits must be approved by the Building Official and/or Zoning DepaRment) � <br /> Job Site / Owner Information: <br /> Type: �esidential ❑ Commercial <br /> Site Address: D�-�� �� �a'�'"�� I� <br /> Owner: � ���'� Mailing Address: <br /> City: Zip: <br /> Phone: Email: <br /> Contractor/Applicant Information: <br /> Contractor/App.: �, S.IM. ���` Contact Person: l�t��/�-✓`vl"� <br /> Address: �-� l�o � State License #: �.? �I S <br /> City: �� Zip: Expiration Date: <br /> Phone: 6 5�— `��Q— J 3 S Email: <br /> ��� -�q� - ��o Ce�-� <br /> SPECIAL CONDITIONS H D 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�vy Equipment ❑ Other <br /> Permit(s) Issued: ewer 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. `��/�r,�� <br /> "[V <br />