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�� '`��� <br /> CITY OF ORONO APPLICATION FOR DEMOLITION PERMIT <br /> P.O. Box 66 (2750 Kelley Parlcway) <br /> Crystal Bay, MN 55323 <br /> SPECIAL CONDITIONS & HOLD HARMLESS AGREEMENT <br /> General Instructions <br /> 1. You may be required to obtain other permits, i.e. well abandoninent, etc. <br /> 2. Worlc inust not begin unless the perinit card is available on the job site. <br /> 3. A 24 hour notice is required for all inspections. Call (952) 249-4600. <br /> JOB SITE ADDRESS: 3U)5 C�i-�5�.� (�i'��} (�pc;�� t,,;n.,��?���eti �ld,J �S 3�� <br /> Occupancy Type: ✓ Residential � Commercial <br /> OWNER'SNAME: `�0.t���.1 �� �e�n� ����� Phone: �5'1-�(�� -�.5�75 <br /> Mailing Address:a�5y� pw'lu;�c�'-� � City: ;,�i.�'2a,�ti <br /> CONTRACTOR'SNAME: �pM �,rMe�rr��.; ,,� Bus.No.:_c�� ���-��aq -�3�0 <br /> Mailing Address: �03 7 �o R� �7 5E City: ��,(�-� <br /> Demolition if planned by�neans of: manual disassembly <br /> �avy equipinen� <br /> Permits Issued: <br /> # Well Abandomnent <br /> In return for issuance of said Demolition Permit,the undersigned owner hereby a�rees as follows: <br /> l. The structure(s) shall be kept enclosed and/or secured until such tiine as demolition is <br /> coinplete. <br /> 2. Demolition debris will be kept offadjoining property and/or the public rights-of-way unless <br /> specific priar approval is obtained in writing for teinporary use thereof. <br /> 3. Foundations shall be coinpletely reinoved froin the ground. <br /> 4. All deinolition debris shall be completely disposed of off site in accordance with all <br /> applicable PCA requirements. <br /> 5. Water wells inust be abandoned in accordance with State Health Department regulations. <br /> 6. Inspection required when all debris has been reinoved, before backfilling. <br />