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f 1 <br /> � ��r7Zc� <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 /> �.. ����� <br /> V <br /> General Instructions �/ <br /> 1. You may be required to obtain other permits, i.e. well abandonrriment, etc. � <br /> 2. Work must 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: �e � t, F�,;Zr�s�A�,F rZ��e�) W F<,i <br /> Occupancy Type: �_Residential Commercial <br /> OWNER'S NAME: �j L�i..v��)� i�i s fi,r� G r'�� ti' E: 1`60 �1,E S Phone: �S�• 4��• ����''�"' <br /> Mailing Address: �? c� 1 �,n S�+� 1.��, Sl- *� �4 / City: t�.�A���„�-�.�. <br /> CONTRACTOR'S NAME: SN r� � �lS v i,L•��- F �'. Bus.No.: <br /> Mailing Address: City: <br /> Demolition if planned by means of: manual disassembly <br /> X heavy equipment <br /> Permits Issued: <br /> # Well Abandonment <br /> In return for issuance of said Demolition Permit,the undersigned owner hereby agrees as follows: <br /> 1. The structure(s) shall be kept enclosed andlor secured until such time as demolition is <br /> complete. <br /> 2. Demolition debris will be kept off adjoining 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 />