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, ;�Oti\ City of Orono Fnx I'1'Y U E ONLY �j <br /> P.O. Box 66 Date Received:/�rI�ermit# D�� O �/ <br /> � �, 2750 Kelley Parkway <br /> , Crystal Bay,MN 55323 Amount: $ �i�7'�SAC Credit: ��' <br /> � ' � (952)249-4600 y,� � y�S <br /> � , �/� Homeowner(s)Signed: ❑Yes�f'�'���Z4 �j E"7 <br /> �' ` Resolutions(if any)Signed:❑Yes ❑None Required �i'it� <br /> ��'�E"S H������� Zonin Uisclosure Si ned: ❑Yes ❑None Re uired �'�r'�L' <br /> --- ��)� � �('S�Gb+� af�( �U�(1'1�1te�1 ,���I� G��1�f <br /> C��rsg � � <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: ��SC` ��.--#�Cc= 7'( � j���� ��c%�+O l�-�.�1. <br /> Owner: ���-�U (/���'VTU2�-� G«'Mailing Address: /�l 7Z �4'�y 7 <br /> city: ��.v.��-�ti-h=�- z�p: .ss�3�f 5-- <br /> Phone:��%Z � 7 71-�17� Email: ���f�'-�`"f��S � ���-�-z - G�'"� <br /> Contractor/Applicant Information: <br /> Contractor/App.: d !u GM��S Contact Person: l��Zz��i�� <br /> Address: b /�����'�2����� State License #: <br /> City: D D� Zip: J u J7Z Expiration Date: <br /> Phone: ��Z� ,��'�� Email: �SG(�twL(a� �G���f,n�' <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 /> . Sewer must be discontinued at the City service by qualified contractor before demo permit is issued. <br /> Demolition by means of: ❑ Manual Disassembly �Heavy Equipment ❑ Other <br /> it(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 structures are <br /> to be demolished. <br /> 2. Submit a survey, aerial photo or sketch showing proposed erosion control measures in accordance with <br /> Chapter 79, Construction Site Runoff Control. <br /> 3. Submit a copy of permit approval from the Minnehaha Creek Watershed District (MCWD). The City will <br /> not issue a demolition permit without a copy of the permit(s) from the MCWD or documentation stating <br /> permit(s) are not required. <br /> Form Last Updated: July 2015 � I �J ��� <br /> 150784 <br />