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���` City of Orono FOR CITY USE ONLY <br /> , ` O , `rO P.O.Box 66 Date Received: Permit# <br /> a�, 2750 Kelley Parkway <br /> � �a� �'''4����'"""����� :�= � Crystal Ba�-,MN 55323 Amount: $ SAC Credit: <br /> �^�i^�-y�j�y�fc.�o (952)2�9-4600 <br /> �sao$ <br /> Homeowner(s)Signed: ❑Yes <br /> Resolutions(if any)Signed:0 Yes ❑None Required <br /> Zonin Disciosure Si ed: ❑Yes ❑None Re uired <br /> CITY OF ORONO - DEMOLITION PERMIT <br /> (Ali permits must be approved by the Building Official and/or Zoning Department) <br /> i Job Site/ Owner Inforniation: <br /> Type: �Residential ❑ Cominercial <br /> Site Address: �9� � �u-� r�.e 5 S �� � � <br /> Owner: 1/��1�. -e �'�1 �-� �� W�� ����"''Mailing Address: /�/ F��-y�".,ss P� �L <br /> City: ���� c� Zip: <br /> Home Phone: Alternate Phone: <br /> Contractor/Applicant Information:" <br /> Contractor/App.: ���C���t� ���c�5 �ci�,5��• Contact Person: �a� ���� S <br /> Address: �3� �(�� ��� State License #: � a�d� �`��b <br /> City: ��``'"`� �N Zip: ��3 Z� Expiration Date: vu4-- 2� i� <br /> Phone: �� �- -��S - � � i� Alternate Phone: v� z- z bv 3 y 3 7 <br /> SPECIAL CONDITIONS & HOLD HARMLESS AGREEMENT <br /> General Instructions: <br /> 1. You may be required to�obtain other pern7its, 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 �Heavy Equipment ❑ Other <br /> Pernlit(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 time as demolition is <br /> complete. <br />