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— <br /> � - <br /> O¢��`O City of Orono ITY USE ONLY �'7 <br /> `r P.O.Box 66 Date Received:� Permit#C���" / �O� <br /> 2750 Kelley Parkway <br /> ,a �i`'x> �' Crystal Bay,MN 55323 Amount: $ SAC Credit: <br /> s� '.►k',,ryo'� (952)249-4600 <br /> �ssaos Homeowner(s)Signed: ❑Yes <br /> Resolutions(ifany)Signed Q Yes ❑None Required <br /> Zonin Disclosure Si ed: ❑Yes ❑None Re uired <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:�u�� ���✓�f-��L� ��� �L/�� � <br /> /��9�h'�?�%,�.�� ���t / ,��15 T <br /> C� r• �1�L FU� '���75 j'�-� Mailing Address: �/��/�V f��✓���L� ����� <br /> /��Ili��S�/�/7�'D $Y IJif'�!�"i',�7 U�t <br /> City: Cy/1 y�.��'",�'� /��?/�/ Zip: ��,�� � <br /> Home Phone: ��r�- '��t�"1��7 Alternate Phone: �fo2 '��� � � l��� <br /> Contractor/Applicant Information: <br /> Contractor/App.:�f�/R�' ��L L �����`��Clontact Person: ��,��/� �/y�'`� <br /> Address:/(r/�C� ��/��� �-09�� State License#: <br /> City:V���"��'`i �i�`� Zip:�3��- Expiration Date: <br /> Phone: ��� ����� ���� � 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 /> l. Submit a survey, aerial photo or sketch showing all structures on the property. Note which <br /> structures aze 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 al( structure(s)enclosed and/or secured until such time as demolition is complete. <br />