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�ia�i� <br /> CITY OF ORONO APPLICATION FOR DEMOLITION PERMIT <br /> P.O. Box 66 (2750 Kelley Parkway) <br /> Crystal Bay, MN 55323 <br /> SPECIAL CONDITIONS & HOLD HAR�VILESS AGREEMENT <br /> General Instructions <br /> 1. You may be requircd to obtain other permits, i.e. well abandonment, etc. <br /> 2. Work must not begin unless the pernlit 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:�� �� G�-��--1 �C.-'g C�� <br /> Occupancy Type: �Residential Commercial <br /> OWNER'S NAME:� ���- �� �'�l`�J Phone: `' ` ���� <br /> Mailing Address: ��� �� ��"'�iTfZ �r @, City: Q- � /�-� <br /> `��- ��s 310 -��.�{ <br /> ;:L1�I'�IZACTOR'SNAME: �,;]�,� `��� ` � Bus.No.: - yz � C <br /> Mailing Address: �-�I.��� __ City: ��t�� � � <br /> Demolition if planned by means of: ianual disassembly <br /> �heavy ec�uipment <br /> Permits Issued: <br /> # Well Abandonment <br /> In return for issuance of said Demolition Pennit, the undersigned owner hereby agrees as follows: <br /> 1. The structure(s) shall be kept enclosed andlor secured until such time as demolitiozi is <br /> complete. <br /> 2. Demolition debris will be lcept off adjoining property and/or the public rights-of-way unless <br /> specific prior approval is obtained in writing for temporary use thereof. <br /> 3. Foundations shall be completely removed from the ground. <br /> 4. All demolition debris shall be completely disposed of off site in accordance with all <br /> applicable PCA requircments. <br /> 5. Water wells must be abandoned in accordance with State Health Department regulations. <br /> 6. Sewer and water must be disconnected at the services at the street by qualificd contractors. <br /> 7. Inspection required w�hen all debris has been removed, before backfilling. <br /> �� ��5�� '��-� ��- S <br /> � ��u �� �s <br />