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' ����,��� `11 Z <br /> U <br /> Ci of Orono - <br /> O�,p,�,o h' c Kci � ��5�ovi.1� <br /> P.O.f3ox 66 Date Rzcei�cd:���y_ /� Pemut= ��J��- /�� <br /> 2750 Kellzy Parlcway .� <br /> � ' �* Crystal Bay,MN 55323 ;lmount: S �T�� � S:'1C Creciit: _ <br /> x <br /> � o' (952)249-4600 _ <br /> ��04� Hcmi�r�ner(s)Signzd: ❑1"es <br /> Resolutions(if'any}Si�ied:❑ti'es ❑None Reyuired <br /> 7.onvi�Disclosure Si ed: ❑Yes ❑\one Rc uired <br /> CITY OF ORONO- DEMOLITION PERNIIT <br /> (All pt�rmits must be approved by the Building Of£cial andior"Loning Department) <br /> Job Site/Owner Information: <br /> Type: �Residential ❑ Commercial <br /> Site Address: �ZS �2i�11�dc�.Q.p If�d � �< <br /> Owner: ���� ��q S�u-'��-�'� Mailing Address: <br /> c��: �vo�� z�p: �39 I <br /> Home Phone: �� � ���P��y�3 Alternate Phone: �� -�D.-7737 <br /> Contractor/Applicant Information: <br /> Contractor/App.:�o�cldw��� �v..i�t�ti� �Dv-�, Contact Person: �0.� �u.V��� <br /> Address: �A�� RO..kQ�r �'1172.�J State License#: aC�"13(0'L��f <br /> City: � Zip: � Expiration Date: � 1 I."c <br /> Phone: („p 1� - �,t I l,Q--�1)� Alternate Phone: <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 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$2,000 escrow and an escrow agreement signed by the property owner. <br /> 4. Keep all structure(s) enclosed and/or secured until such time as demolition is complete. <br />