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ti <br /> ' �;�Q�� City of Orono FOR CITY OSE ONLY <br /> �,, P.O.Box 66 Date Received: Permit# <br /> (j�� �'i'� 2750 Kelley Parkway <br /> ��'� �� ��I Crystal Bay,MN 55323 Amount: $ SAC Credit: <br /> ��"�;,� ;�y�r (952)249-4600 <br /> ����O%� Homeowner(s)Signed: ❑Yes <br /> Resolutions(if any)Signed:❑Yes ❑None Required <br /> Zoning Disclosure Signed: ❑Yes ❑None Required <br /> CITY OF ORONO - DEMOLITION PERMIT <br /> (All permits must be approved by the Building Official and/or Zoning Department) <br /> Job Site/Owner Information: <br /> Type: � Residential ❑ Commercial <br /> Site Address: � T� / �a���� -�� <br /> � / <br /> Owner: ,1'✓S��N/� �!�G �� Mailing Address: �� /1 n-(�� <br /> , <br /> c�ty: ���-Y� o zip: ,5-s- `�� (� <br /> Home Phone: �o �:z - :���� ' ���� � Alternate Phone: �l � � a� �� ��'� � <br /> Contractor/Applicant Information: <br /> y`��%'�/_,,,. {-'�•-�C',cGJF• <;. ��(t!'- -�- / <br /> c <br /> Contractor/App.: � l �/�.z v�r,.v� S��? ; Contact Person: ��� ���--��6�z �•-� <br /> � <br /> Address: �� �`�v C�� State License#: :� � � � `� Z o l � <br /> City: �� /'� '�.�c�,. r Zip:.s-S ��� Expiration Date: 2 C3 �,� <br /> Phone: � � � � � T� U � `� � Alternate Phone: / � Z 2' r��� � l� <br /> SPECIAL CONDITIONS & HOLD HARMLESS AGREEMENT <br /> General Instructions: <br /> 1. 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 o£�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 rime as demolition is <br /> complete. <br />