Laserfiche WebLink
�O�T City of Orono �,pox ITY USE ONLY � <br /> �y P.O.Box 66 Date Received� Permit�! �� � � <br /> � 2750 Kelley Parkway d� <br /> Crystal Bay,MN 55323 Amount: $ !` , SAC Credit: <br /> (952)249-4600 <br /> � ,` Homeowner(s)Signed: ❑Yes <br /> ci' �,� Resolutions(if any)Signed:�Yes ❑None Required <br /> ��KESH�R� Zonin Disclosure Si ed: ❑Yes ❑None Re uired <br /> � �GYGV✓✓'„ � ��`1 I�� <br /> �.,v✓�J`� <br /> CITY OF ORONO - DEMOLITION PERMIT <br /> (All permits must be approved by the Building O�cial and/or Zoning Department) <br /> �������� <br /> .lob Site / Owner Information: AUG 2 2 2016 <br /> Type: �Residential ❑ Commercial CITY OF ORONO <br /> � (� <br /> Site Address �� U� '_J Uk n j Pt��� n� �� <br /> Owner. r�e'�•� �an,�r�.C...�1. Mailing Address: �C'^„�� ��,� a �'�� �o,•t� <br /> /�1` �`/O <br /> c�ty: �,,. ��,��) ► ; z�p: �'S y�i � <br /> Phone:�- S l "��,� ���� � Email: <br /> Contractor/Applicant Information: <br /> Contractor/App.:!n;�-t ������> S P�v�"t P�� LZL Contact Person: ��P� S'�o�'}"'-�"� <br /> Address: �`�`�7 �w�Sc�� I��%1 State License#: <br /> City: L���}'�U Zip: /�'' � Expiration Date: <br /> Phone: b�� �3�C yC� �� Email: � 'i r-1 c���� �5 S�r�i r�:.s(� �i�G��,, , ��n�. <br /> �T— <br /> SPECIAL CONDITIONS & H�LD HARMLESS AGREEMENT <br /> General I nstructions: <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 �J-leavy Equipment ❑ Other <br /> Permit(s) Issued: Sewer Disconnection ❑Well Abandonment# �/ .3 ����'7 � <br /> ,�f�►�►�i-( Z c%I tc -C�3 3 <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� - �3q <br /> 150784 <br />