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t <br /> �0� City Of OCOnO FO TY USE ONLY <br /> O Q P.O.Box 66 Date Received: o�- Permit# d� o�-�� QD <br /> 2750 Kelley Pazkway py� <br /> � F Crystal Bay,MN 55323 Amount: $D�/•�Q SAC Credit: <br /> �.� � o` (952)249-4600 <br /> <���KO�� Homeowner(s)Signed: ❑Yes <br /> Resolutions(if any)Signed:�Yes ❑None Required <br /> Zonin Disclosure Si ed: ❑Yes ❑None Re uired <br /> CITY OF ORONO - DEMOLITION PERMIT �1�L . C� <br /> (All pern�iis mus[be approved by the Buii�ing 017icial anuior Zaning Departmeni) l ..#�-� �D 3 3�o <br /> Job Site /Owner Information: <br /> � <br /> Type: ❑ Residential ❑ Commercial <br /> Site Address: ZZ. 1'J _�,�W �p,�,_> � �qL� <br /> ���r:.er: � I i'r ��7 i�Y� "✓Iailing Address: �v � ?��7`_� <br /> City: --�% �C`Yl0 'Gip: 5s?�Z�_ <br /> Home Phone: Alternate Phone: ��Z -�C����T��'1 <br /> Contractor/ Applicant Information: � <br /> Coniractor/App.: >-1 �c,rc�;1�r��_�;5�1��Contact Person: �('��r,,ti <br /> Address: ���� .3f7 r-,`— State License#: ��37�O ) <br /> City: Zip:5 S�Z- Expiration Date: ? � <br /> Phone: � C�S rt ��1 -rZ��l� Alternate Phone: <br /> --- So�lcs @.Qulumnt, _�me�mn •cam <br /> _ -- - ___.__.� _ <br /> �— SPECIAL CQNDITIONS & HOLD RMLESS AGREEMENT 1 <br /> Generat Instructions: <br /> L You may be required to obtain other permits, i.e.: ��ell abandonment, sewer, etc. <br /> 2. V��ork m�ust not begin unless the perm�t card is availa�le an the jab site. <br /> 3. A 24-48 hour notice is required for all inspections. Call (952) 249-4600. <br /> 4. Sewer inust be discontinued at the Ciiy service by qualitied contractor before demo pernlit is issued. <br /> Demolition by means of: ❑ Manual Disassembly .�Ieavy 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 /> l. 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 Xunoff Control. <br /> 3. Submit a$2,040 escrow and an escrow agreement signed by the property owner. <br /> 4. Keep all structure(s) enclosed andl�r secured until such time as demolition is complete. <br />