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�O� City of Orono F R C }�YJSE ONLY 5 /� <br /> P.O. Box 66 Date Receive� Permit#4�� � l <br /> � 2750 Kelley Parkway �r�,�/ <br /> Crystal Bay, MN 55323 C/" Amount: $ � � SAC Credit: <br /> (952)249-4600 l/ JJ�/ <br /> � � �n Homeowner(s)Signed: ❑Yes <br /> �' �,� � Resolutions(if any)Signed: ❑Yes ❑None Required <br /> `�kFSH��� Zoning Disclosure Signed: ❑Yes ❑None Re uired <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: \, �� ����� �" � U <br /> Owner: ��� L ����� Mailing Address: <br /> , <br /> City: l '(G� l.�r�- Zip: <br /> Phone: ��� ��<�'��� � 2- Email: <br /> Contractor/Applicant Information: <br /> ,^ , � <br /> Contractor/App.: `��V 1-z l�✓ �� Contact Person: �f`� � "�f��� <br /> Address: 1�L��1 �'���`�-y �/ State License #: L�j�' ��-� �� <br /> City: �` j Zip: SS�� �/' Expiration Date: ��- / - � S <br /> / „ <br /> � / ,� � � <br /> Phone: �'f �- �2- 3 i �3 Email: -Jc ��-cY,�(,.�i �.Q,���'ut; `��'�1 <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 of: ❑ Manual Disassembly �eavy Equipment ❑ Other <br /> Permit(s) Issued: (�Sewer Disconnection ❑ Well Abandonment# <br /> In return for issuance of said Demolition Permit, the undersigned owner hereby agrees to: <br /> 1. Submit a survey, aerial photo or sketch showing all structures on the property. Note which <br /> structures are to be demolished. <br /> 2. Submit a survey, aerial photo or sketch showing proposed erosion control measures in <br /> accordance with Chapter 79, Construction Site Runoff Control. <br /> 3. Submit a copy of permit approval from the Minnehaha Creek Watershed District (MCWD). The <br /> City will not issue a demolition permit without a copy of the permit(s) from the MCWD or <br /> documentation stating permit(s) are not required. <br />