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.�'� �� � �.so �-���� 5 <br /> �� �� �� <br /> CIT 5�' OF ORONO APPLICATION FOR DEMOLITION PERMIT <br /> r P.O. Box 66 (2750 Kelley Parkway) <br /> Crystal Bay, MN 55323 <br /> SPECIAL CONDITIONS & HOLD HARMLESS AGREEMENT <br /> General Instructions <br /> 1. You may be required to obtain other permits, i.e. well abandonminent, etc. <br /> 2. Work inust not begin unless the perinit 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���'� �C��� �c��ie_. ��''z�_f <br /> Occupancy Type: ' Residential Commercial <br /> OWNER'S NAME: 1`��-�-ec�c`� L � �-'�Z��'� Phone: �I a, . �O I - 1 I`�'C� <br /> Mailing Address: 3�C.�1 CCc�S� �a-�e.- S-E-ve e f City: �C'��c�-� v <br /> CONTRACTOR'SNAME: C�:.►'re--`'{"�-�v�f��+z���� I��cLs Bus.No.: <br /> Mailing Address: City: <br /> Demolition if planned by means of: manual disassembly <br /> G� 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 adj oining 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 />