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r <br /> 03/03/2006 15:16 FAX 651222�831 Semple Excavating INC � l�002 <br /> 1 <br /> r 8• Within 5 working days of superstructure removal,a .fina) inspeciion shall b�requested. The <br /> site shall be left clean and clear ofa11 debris,with any excavation Flled with earth level with <br /> th�adjacer�t ground elevation (except when such excavation is to be used as part of a new <br /> building and such n�w buildinb is actually under construction). <br /> 9• The undcrsigned uwner shall and l�ereby does indennnify and hold harmless the City of <br /> Orono, iis agents, employees and assigns from a.nd against all claims, da�nagcs, losses or <br /> expenses,including attorney fees,against the City,its a�ents,employees and assigns arising <br /> ouc ofor resulting from the demolirtion described herein as perFormed by the properry owner, <br /> his employees, agenis, subcontractors or assigns. <br /> 10. Septic syst�ms must be abandoned petMinnesotaRules Chapier 70$0. All sepiic tanks must <br /> be pumped,crushed and f]led with native soils. An inspectian is required after the tanks are <br /> pumped and b�fore the taaiks are crushed and $lled. <br /> PERA�IT TYPE ANll FEE CALCU�,A,T10N <br /> ✓ �50.00-principal Structure <br /> $30.00-qccess�ry Structure <br /> 1• Subtota] of above perm.it requested $ 50.00 <br /> 2. State Surcharge $ .50 <br /> 3. TOT�L PERMIT F�E (add lines 1-2 above) � so.so <br /> The undersign�d hereby applies to thc City of Otono for issuance of a Demolition Permit,agrees to <br /> do all work in strict accordance with the ordinances of the City and the regula�ions of the State of <br /> Minnesota,and certif es that all statem nts ade on this appl' ation are co►npl�te,true and correct. <br /> APPLYCANT'S S�GNATLJRE; 3/�/G <br /> Date: <br /> OWNER'S SIGN,ATLrRE��G� � �' <br /> ' , <br /> � � ate: � -7�� <br /> A,PPitOVEn BY: Date: 3 - �,• O(p <br /> ( ilding Officivl) <br /> *ZONIlYC�DYSCLOSUR�REQUIX2ED? • •YES • •NO <br /> * This Must Be Filled Out $y Zoning Department - For Either Answer, A Zoning OfficiAl Must Sign All <br /> AppGca�ions <br /> *AI�PROVEv SY: / /�//1/��D���.��/I Dat�: ��l��o <br /> (7�oning OfGcial) ` <br /> ",���-f�if1�4 �lal.'�icl%,�j'�"n1lL'�q u�u�-•�l'I�n� <br /> �qG ,f� �,'i' '�P � �' �"I�J <br /> � I <br /> tti..�5.1 ;� � "� <br /> ��'�'�I� f� '� � <br />