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v �� <br /> �o � � . <br /> ��-G� <br /> ,���` City of Orono FOR CITY USE ONLY <br /> `r P.O.Box 66 <br /> � � Date Received: Permit# <br /> � . ��,3 2750 Kelley Parkway �d <br /> � �����, �;�. h Crystal Bay,MN 55323 Amount: $� SAC Credit: <br /> o�� (952)249-4600 <br /> ��O$y Homeowner(s)Signed: ❑Yes <br /> Resolutions(if any)Signed:❑Yes ❑None Required <br /> Zonin Disclosure Si�ned: ❑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: ��� ��r�2����2 �S G/•, <br /> Owner: ��/,/,��(�!���/v i /� Mailing Address: �� f-��S��i2�'S �� <br /> City: �f2�/�� Zip: ,�5 �� <br /> Home Phone: 1�.�2- 3 g-� �,5 � Z� Alternate Phone: 9�Z ��� .�62 G <br /> ,.� iitractor/`Applicant"Iriformation: <br /> Contractor/App.: Contact Person: <br /> Address: State License #: <br /> City: Zip: Expiration Date: <br /> Phone: Alternate Phone: <br /> �` SPECIAL CONDITIONS & I30LD HARIVILESS 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��ewer 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 are to be demolished. <br /> 2. Submit a survey, aerial photo or sketch showing proposed erosion control measures in <br /> accordance with ChapteJ� 79, Construction Site Runoff Control. <br /> Submit a $2,000 escrow and an escrow agreement signed by the property owner. <br /> Keep all structure(s) enclosed and/or secured until such time as demolition is complete. <br />