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: � � <br /> � ���Oa <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 HARMLESS AGREEMENT <br /> General Instructions <br /> 1. You may be required to obtain other permits, i.e. well abandonmment, etc. <br /> 2. Work must not begin unless the permit card is available on the job site. <br /> 3. A 24 hour notice is required for all inspections. Call (612) 249-4600. <br /> JOB SITE ADDRESS: � ,� �,S G �%��'N�w A � �n;�' <br /> Occupancy Type: ��Residential Commercial <br /> OWl\'ER'SNAME: So l� � �d G�?�-TC�i<�l ��R� G�p r2c� Phone: %S�- ��8- OG.�� <br /> Mailing Address: / ,� i,l S /�(� n� �E K D/1�`v e City: rr��d ;,r� S S 3 9 i <br /> CONTRACTOR'S NAME: �E� ✓a�/ �s l�nl.�", �`N'C Bus.No.: Co i 1 -s j.�-o � 95� <br /> Mailing Address: 0?0,(3 a x. � � ss�.� City: �� �s�,'Ns d�c.f,_�,.�,� 5 s�r�2 <br /> Demolition if planned by means of: �' manual disassembly <br /> X heavy equipment <br /> Permits Issued: <br /> # Well Abandonment <br /> In return for issuance of said Demolition Permit,the undersigned owner hereby agrees as follows: <br /> 1. The structure(s) shall be kept enclosed and/or secured until such time as demolition is <br /> complete. <br /> 2. Demolition debris will be kept off adjoining property and/or the public rights-of-way unless <br /> specific prior ap�roval 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 requirements. <br /> �. Water wells must be abandoned in accordance with State Health Department regulations. <br /> 6. Inspection required when all debris has been removed, before backfilling. <br />