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,CITY OF ORONO APPLICATION FOR DEMOLITION PERMIT <br /> P.O. Box 66 (2750 Kelley Parkway) <br /> Crystal Bay, MN 55323 <br /> ,:, <br /> � : <br /> SPECIAL CONDITIONS & HOLD HARMLESS AGREEMENT ;<;;� ' � D�p <br /> � '� �,`� .a0 <br /> GeneralInstructions � � �� <br /> 1. You may be required to obtain other permits, i.e. well abandonmment, etc. .\�� `j<� <br /> 2. Work must not begin unless the permit card is available on the job site. �;'y <br /> 3. A 24 hour notice is required for all inspections. Call (612) 249-4600. <br /> JOB SITE ADDRESS: �(��� �:�'�f.v�r,�-s S�- <br /> Occupancy Type: � " Residential Commercial <br /> r : <br /> OtiS"�1ER'S NAl11E: ���an ` • ,�-,�►� ���--�•,���,`�h� Phone: �f-�'i-{';�u� <br /> Mai:ingAddress: ,�.��k',`', �r,�,�,,�,, ��n City:Gi�,�,;�h,. /!'1N" 5537i <br /> CONTRACTOR'SNAME:1�ll�g � ���.�, Bus.No.: (�/�-�i3�-`H33 <br /> Mailing Address: II�fD� � Qo�( �3 City: �N,.a <br /> Demolition if planned by means of: manual disassembly <br /> ✓ 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 /> specitic 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 requirements. <br /> 5. 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 />