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� � �v���� <br /> g-3�-a`� �'�5'0. so <br /> CITY OF ORONO APPLICATION FOR DEMOLITION PERMIT <br /> P.O. Box 66 (2750 Kelley Parkway) <br /> Crystal Bay, MN 55323 <br /> SPECIAL CONDITIONS & HOLD HARMLESS AGREEMENT <br /> General Instructions <br /> 1. You may be required to obtain other permits, i.e. well abandomninent, etc. <br /> 2. Work inust not begin unless the permit card is available on the job site. <br /> 3. A 24 hour notice is required for all inspections. Call (612) 249-4600. <br /> JOB SITE ADDRESS: -�� � ��d� �I G' KC� l`�s ` Q YO i�� <br /> Occupancy Type: Residential Commercial <br /> OWNER'SNAME: K������+Ct� � M. '���'os� Phone: ��a� — ��`1 "' 1�'� q <br /> Mailing Address: �,(p'1,6 L' R45!3 Y lZ Q City: w/�}- }� ��`�'.� <br /> CONTR.ACTOR'S NAME: �� �O LL-I � '1'� S�y►S Bus.No.: �I�. — ��$" LI'1�3 <br /> MailingAddress: / I �p t ��'n7r-c, �l �3 City:,� DP�I�N S SS 3 �f-.3 <br /> Demolition if planned by means of: manual disassembly <br /> �t/� heavy equipment <br /> Permits Issued: / <br /> # Well Abandonment � ��d�� Cr't ��'dP{-j�y � W���� l'1��� pe <br /> � <br /> lC.�lt.c��ov+� . <br /> In return for issuance of said Deinolition Permit, the undersigned owner hereby agrees as follows: <br /> 1. The structure(s) shall be kept enclosed and/or secured until such time as deinolition is <br /> complete. <br /> 2. Demolition debris will be kept off adj oining property and/or the public rights-of-way unless <br /> specific prior approval is obtained in writing for temporary use thereof. <br /> 3. Foundations shall be completely removed from the ground. <br /> 4. All demolition debris shall be completely disposed of off site in accordance with all <br /> applicable PCA requirements. <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 />