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� <br /> � ��' j ��, <br /> �,' �� _ <br /> CITY OF ORONO APPLICATION FOR DEMOLITION PERMIT <br /> P.O. Box 66 (2750 Kelley Parkwayj <br /> Crystal Bay, MN 55323 �,�``� �_ - � � � � <br /> ..<. ,'�. <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: C,� S- L°y y ,,..��' i�� <br /> Occupancy Type: �Residential Commercial <br /> OWIVER'S NAME: r�2,;;,�*f l�Y:�.G��z ,C%� ,,�rl�y� Phone: `rS-� -4��G '-i s � S <br /> Mailing Address: �,� �':.,�,,,,�� ��,�.� City:_v2�y,,,,f; <br /> CONTRACTOR'SNAME: ,�,�{-u.I,�_r� ,(�L,�{J� G'�(c�c,�:��� Bus.No.: L.I3. �t£s� -�/3y <br /> r � <br /> MailingAddress:�`�- �' ��� C�.�s�.( ����� City:��R•� �/,,, ss°�,5� <br /> Demolition if planned by means of: manual disassembly� <br /> heavy equipment �L1� '��""� <br /> Permits Issued: <br /> # Well Abandonment -'Sc�,,�.�� �e,����,� i64�-�� <br /> � <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 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 />