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• �O�O City of Orono FOR CITY USE ONLY <br /> P.O. Box 66 Date Received: Permit# <br /> 2750 Kelley Parkway <br /> Crystal Bay,MN 55323 Amount: $ SAC Credit: <br /> (952)249-4600 <br /> � >- Homeowner(s)5igned: ❑Yes <br /> yFr �,� Resolutions(if any)Signed�❑Yes ❑None Required <br /> �k£SH��� 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: ��� l�C���P K'�- �� <br /> Owner. ���4Ce <'V�Q•✓1� Mailing Address: �r'�.J"� �3?�A1P��,►�, <br /> c�ty: ����9T�� z�p: ��3q� <br /> Phone: �Cf�_ ��a.- �l �� Email: �� (] Cv�.�/��, �c�►�^ <br /> �T <br /> Contractor/Applicant Information: <br /> Contractor/App.:��,ve,rzir�rr 1�t ? �-r��r�Jtic'�m Contact Person: �-2�})Lh �YZ�'ck <br /> ,�. <br /> Address: 'P� �J� �� State License #: <br /> City: ���"��d�n� Zip: ��� Expiration Date: <br /> Phone: >l�- �i��[- �?D`I�_ Email: C.a��q��[� ��zr[l`p�l�✓1•S� <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 �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 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 />