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� ,�,��o � <br /> �;,�d� City of Orono FO CIT SE ONLY <br /> p �;,. P.O.E3ox 66 Date Received:/D O�ermit# �Od4—Q �7� <br /> � �! 2750 Kelley Parkway <br /> � 9�y r Crystal Bay,MN 55323 Amount: $/��D SAC Credit: <br /> 1 , a�� (952)249-4600 <br /> ��"O$�� Homeowner(s)Signed: Yes � <br /> Resolutions(if.any)Signed:❑Yes None Required <br /> Zonin Disclosure Si ned: ❑Yes ❑None Re uired <br /> CITY OF ORONO-DEMOLITION PERMIT <br /> (All permits must be approved b_y the Building Official and/or 7oning Department) <br /> Job Site/Owner Information: /'�(�O /.� <br /> Type: �Residential � Commercial � "v � <br /> � <br /> Site Address: ��g� CDJ�C��Z.DLA Jf'T�(3l3� �� <br /> Owner: K811/n.� �UL�/v Mailing Address: �ZS.S Gt>Nl�D�?-t�F ��• <br /> c�ty: �.��uo z�p: �v�3Gll <br /> Home Phone: � ��- ��� � �3� Alternate Phone: <br /> C�ntractor���App�iaant�I�formation: � � <br /> n � <br /> Contractor/App.:�oN6wD�D L,L.C� ContactPerson: �//411� �OLGi1�p <br /> Address: '���T G�J�tY�r'tTA B��D. State License#: oG��9�31�7 <br /> City: �/N,�}�'yi4f�t.+�+ Zip: %��?� Expiration Date: c�j 2�� <br /> Phone: �IJrZ'G`�1'�Jr9� Alternate Phone: �Z� �2''�'�� <br /> SPECIAL CONDITIONS & HOLD HARMLESS AGREEMENT <br /> General Instructions: <br /> l. 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 /> Permit(s) Issued: ❑ Sewer Disconnection � 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 />