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J��1/11/2014 7�10:27 AM MandM 952-466-2763 1/2 <br /> ,� �"f►. <br /> City of Orono ORCETYU o�vr�� <br /> P.O,6ox 88 Dote Rooelved:��em�it# O ��� <br /> �Q 2750 Kelley Parkway <br /> Cryatel8ay,MN 86333 Amount; 5�` 5AC�tedtt: <br /> (962)249-48a0 <br /> 'j ,�'° HorAcowdcc(a)Slgnedi ❑1'oa <br /> �ct' L� Rceplutiona(i£any)SiYncd;�Ycs O None Rar{uiro{i <br /> ��k�f H Q�ti Zonin Disclosure Si od; Yea �Nona$a ulrcd <br /> ClTY OF ORONO -DEIUIQLITIQN P�RM(T <br /> (All permifs must be approved by tha Bullding Offlclal andlor Zonlnq Depertment) <br /> Ja;���'�!;';,E���r1,�;r�c�r�ri��+ar�� � <br /> Type: �Residentlal ❑ Commercial <br /> Site Address: ���� f��l�,l'IA.Q,(,C.) �'TI(�t�ik(, , �,(,(;�� <br /> Owner: 1„��k 1 d C.)(�Q., 'T11�1���,Z. Maifing Address: <br /> City; Zip: <br /> Phone: �mall: <br /> �ontr��#�r%�,ppll�r�:t Inf�rmati4n; <br /> � n <br /> Cantractor/App,:_ �-� ��1^�1^�. Q�Q(;�i2S Cont�ct Person: �l� �Yl t Z. <br /> Address: � �� Stafie License#: <br /> City: Zip; � ���.�C��xplratlon Date: �,�����P <br /> Phone: �0��• ���� `���� Emaff, ��1tZ�-��.t,t`�(� ntiGldll.�/,�U� �.�V'v1 <br /> I �W�Ci�1L��3�tD11"lD1VS� k�?t�L�.;MAt�Mi:�.`��1�;Gi��EN�ENT <br /> General Instructions: <br /> 1. Yau may be required to obtaln other permlts, I.e.:well abandonment, sewer, etc. <br /> 2. Work must not begin unless the permit card is avallable on the Jab site. <br /> 3. A 24-48 hour notice is required for all Inspectlons. Cali(952)249-4600. <br /> 4. Sewer must be discontinued at the City service by qualEffed contractor before demo permit is <br /> fssued. <br /> Demolltinn by means oF: ❑ Manual Disassembly �Meavy�quipment ❑ Other <br /> Permlt(s) Issued. ❑ Sewer Dlsconnectlan ❑Well Abandonment# <br /> ln r�turn ior issuance of seid Demolition Permit,the undersigned owner hereby agr�es to: <br /> 1. Submlt a survey, aerial photo or sketch showing all structures on the property. Nots which <br /> structures are to be demollshed. <br /> 2. Submit a survey, aerial photo or sEcet�h showing proposed erosion cvntrol measures In <br /> accordance with Chapter 78, Construcfion Slte Runoff Control. <br /> 3. Submit a copy of permit approval from the Mlnnehaha Creek Watershed District (MCWD). The <br /> City will not issue a demolltion permlt without a copy of #he permlt(s) from the MCWD ar <br /> documentation stating permit(s)are not requfred. <br />