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Jul 30 0z Ol : llp paul 952-461 - 1946 ,-�, p. 2 <br /> . ��\ , �� I r G� <br /> � �.i <br /> . . � C� -�-� � ��� � - ��r�1 � �� <br /> � � .� <br /> • � f��� � <br /> � 9 <br /> ���� /�v� <br /> � < (. C-�` � PLICATION FOR DEMOLITION PERMIT <br /> �-�'CITY OF ORO O �� <br /> p,p,Box 66 (2750 Kelley Pazkway) <br /> Crystal Bay,MN 55323 <br /> 5PECIAL CONDITIONS & IIOLD HA.KIVII-E5S AGREEMENT <br /> General Instructions <br /> 1, You may be requir in unless the peermit carld is av ilable on�the obl srte etc. <br /> 2, Work must not beg <br /> e uired for all inspections. Call (612)249-4600_ <br /> 3, A 24 hour natice is r q <br /> �37� C� ��� � �� <br /> JOB SITE�D�SS' Residential _Comrz�ercial <br /> Occupa.ncy Type: <br /> � � Phone: �v )Z Z-So-��Qv <br /> OWNER'SNAME: �,^�i�i JC� t r,...— C;ty: L ,c-cf-J'� 1 ( Q, /�'� K.s <br /> ��iJ �('��� n� ���u i �". <br /> ddress: Z � � SS v�f If <br /> lViailing A ---- <br /> l�l�c� � ����Bus.No.: !'vr� �E� <br /> CONTRACTOR'5 NAME: f��,�J�►J t'�-c� �.4�; City: <br /> Mailing Address: Z�3C�'� . <br /> inanual disassembly <br /> Demolition if planned by means of: �heavy equipment <br /> permrts Issu <br /> e <br /> d: <br /> # Well Abandonment <br /> In retum for issuance of said Demolition Permit,the undersigned owner hereby agrees as follows: <br /> t� e as demolition is <br /> lbek <br /> e t encl <br /> osed and/or secur <br /> ed until s <br /> uch un <br /> s shal P <br /> 1. The structure( ) <br /> complete. <br /> 2, Demolition debris will be kept off adjoining property and/or the public rights-of-way unless <br /> -' ic rior approval is obtained in writing for temporary use thereof. <br /> s e�if p <br /> P <br /> I Foundations shall be completely removed from the ground. <br /> 3. <br /> 4. All demolition debris shall be completely disposed of off site in accordaz�.ce with aIl <br /> applicable PCA requirernents. <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 /> _ _.____-- -----.z�*vrn-paper recycled by consumers. <br /> � <br />