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O City of Orono oNL� / <br /> �- � P.O. Box 66 Date Received�� � ermit� �� ( <br /> � 2750 Kelley Parkway <br /> Crystal Bay, MN 55323 Amount: $ �� � SAC Credit: <br /> (952)249-4600 <br /> � ,` Homeowner(s)Signed: ❑Yes <br /> E' <,� Resolutions(if any)Sib ed: �Yes ❑None Required <br /> `�kESH OR� Zonin�Disclosure Signed: ❑Yes ❑None Re uired <br /> CITY OF ORONO - DEMOLITION PERMIT <br /> (All permits must be approved by the Building Official and/or Zoning Department) <br /> Job Site / Owner Information: <br /> Type: Q�Residential ❑ Commercial <br /> SiteAddress: __ �y�� ��Yy ���c� �i'owo� I"fN s'S3�o� <br /> // /,_.. --� <br /> Owner: �tv�K � �t,vosa /o�,Scvso�Mailing Address: �y�� C��'% �1a� Ko� <br /> r��s�3�y <br /> ��ty: o�o� Zip: SS3�`� <br /> Phone: 97Z '�039 -Cso53 EmaiL �tv�µ�vv�rivSou Q�c�ca�� cou.c <br /> Contractor/Applicant Information: <br /> Contractor/App.: ��+��woo� � LLG Contact Person: �a.so�.. ���l�oS <br /> Address: �3 ��z S�r�_ �s� State License #: <br /> City: �ty2�-{a Zip: �3`�� Expiration Date: <br /> t � ��KG!.✓00�, GO�''� <br /> Phone: G/Z'�D/-33;r$ EmaiL_ _ /�SoK <br /> SPECIAL CONDITIONS & HOLD 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 avaitable 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 [�Heavy Equipment ❑ Other <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, 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. <br />