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� (J �� . <br /> r► ,��� City of Orono O CIT USE ONLY /� <br /> � �.. P.O.Boa 66 Date Received�� Pennit# U/ '(� 7�� <br /> 2750 Kelley Parkway <br /> a �?'' �;; Crystal Bay,MN 55323 Amount: $ SAC Credit: <br /> e+ . c''.; (952)249-4600 <br /> t4Neex�g£ Homeo«1�er(s)Signed: ❑Yes <br /> Resolutions(ifany)Signed:0 Yes ❑None Required <br /> Zonin Disclosure Si ed: ❑Yes ❑None Re uired <br /> CITY OF ORONO-DEMOLITION PERNIIT <br /> (Al!permits must be approved by the Building Ofiicial and/or Zoning Departrnent) <br /> Job Site/Owner Information: <br /> Type: �Residential ❑ Commercial <br /> Site Address: I.3 � d C h � � R y I �I� G �- <br /> Owner: �R� �� /V!4 �S fif1-� Mailing Address: ��� 70 G/e R R� p�/¢ G� <br /> ��t,�: �Ro �a Z�p: �ss 3� � <br /> Home Phone: �5 oZ - o(,t�-- ��g Z Alternate Phone: / -sa 'o��S-`s/ g Z <br /> Contractor/Applicant Infoimation: --� <br /> Contractor/App.:�/t�� ������,/oQ�N� �,Contact Person: � /4 V� !�'�/ � ,/ /e���. <br /> Address:�� 7 � e0 K N��/ Rc� �O State License#: ,8 G DD J $O �f <br /> City: �� J°l'e ��l4�.� Zip:.s�3-S 9 Expiration Date: � - 3� -� � � 7 <br /> Phone: l0�02�o�.�d- 7` T g a Alternate Phone: �b.3-�79' � � � g <br /> SPECIAL CONDITIONS &HOLD H�FtD�ESS AGR�EMENT <br /> General Instructions: <br /> 1. You may be required to obtain other permits, i.e.a well abandonment, sewer, etc. <br /> 2. VVork 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 issued. <br /> Demolition by means of: ❑ Manual Disassembly �Heavy Equipment ❑ Other <br /> � <br /> Permit(s) Issued: (�Sewer Disconnection ❑ Well Abandonment#�� <br /> In return for issuance of said Demolition Permit,the undersigned owner hereby agrees to: <br /> 1. Submit a survey, aeria( 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$2,000 escrow and an escrow agreement signed by the property owner. <br /> 4. Keep all structure(s) enclosed and/or secured until such time as demolition is complete. <br />