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�O�T City of Orono FOR CITY E ONLY L' <br /> 1 y P.O.Box 66 Date Received�-- ermit D���b�� / <br /> � 2750 Kelley Parkway �y <br /> Crystal Bay, MN 55323,, Amount: $ O�� SAC Credit: <br /> (952)249-4600 <br /> r ,,a <br /> ''` Homeowner(s)Signed: ❑ Yes <br /> �E' �,� � � Resolutions(if any)Signed:�Yes ❑None Required <br /> tqkFS H p�� �{I r�I�� Zoning Disclosure Signed: ❑Yes ❑None Re uired <br /> I I <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: � Residential ❑ Commercial <br /> Site Address: /�/D C�',�j�,¢.Q y D�AC� <br /> Owner: STdiv+�y✓��, �G/�� , Mailing Address: <br /> City: __!�/1�S/Zj¢y'� Zip: <br /> Phone: Email: <br /> Contractor/Applicant Information: � �- �� j� �,�j�� <br /> Contractor/App.: ��,�',�, ��4v�N(��il,�, Contact Person: /,�i�� �a�N��iv,�i <br /> Address: a7'/G �ivi��,n2�� �, State License#: <br /> City: S`rti Zip: ���� Expiration Date: <br /> Phone: lv�l �d "���� Email: <br /> SPECIAL CONDITIONS 8� 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 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 [�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, 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 />