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O City of Orono FOR CITl�v ONLY <br /> � � P.O. Box 66 Date Received: ' '�1����rmit# �—/G•-f <br /> � 2750 Kelley Parkway lp� oo , _- <br /> Crystal Bay, MN 55323 Amount: $ /W-�SAC Credit�c_Fd �0�l�(p <br /> (952)249-4600 ... , C��•��tf <br /> � � _..,...,.,,...,,.���a�gr�ea: ❑Yes _. ��� <br /> yF� '\ �,� Resolutions(if any)Signed: ❑Yes ❑None Required <br /> q,rFSH��� Zoning Disclosure Signed: ❑Yes ❑None Required <br /> CSc�v�a��2�� '� <br /> CITY OF ORONO - DEMOLITION PERMIT <br /> (All permits must be approved by the Building Official and/ r Zoning Department) <br /> ��� � ,��'� <br /> Job Site / Owner Information: �°�'" Q� <br /> Type: � Residential ❑ Commercial <br /> n <br /> Site Address: ���'� �v� S�:�� <br /> l� <br /> Owner: ����1{ac�l�.��? 1�4��'� �� �� ? �' Mailing Address: �15�� (,���m��r✓!�� �� C f <br /> ° �'�n r',�c,��� �",v. <br /> City: ��n �-�:�,,d�.: Zip: 5��3 y`l <br /> (� � �/ <br /> � <br /> n �, , <br /> Phone: I ��, `�G y �`" �� �-� Em ai l: ��z�� ��!��i m�i�lc��il �'c��G'- �;.,,,,r, <br /> Contractor/Applicant Information: <br /> v�� � <br /> Contractor/A �1�;��� � � � � � �� � � � <br /> pp.: �,/�-- �-� �� �:� �r Contact Person: cr t ci�'j''.� � •�•� <br /> ��. �� � I(/ <br /> Address: State License #: / � <br /> . �i <br /> City. � �� � Zip: Expiration Date: 3 %C <br /> , <br /> r� <br /> Phone: ������� � EmaiL ��"r't-� <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 <br /> issued. <br /> Demolition by means gf: ❑ Manual Disassembly � Heavy Equipment ❑ Other <br /> � <br /> Permit(s) Issued: � Sewer Disconnection ❑ Well Abandonment# <br /> � ��5-aG5�U �,l�R// <br /> In return for issuance of said Demolition Pe�mit, 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. �� -t5 � <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 copy of permit approval from the Minnehaha Creek Watershed District (MCWD). The <br /> City will not issue a demolition permit without a copy of the permit(s) from the MCWD or <br /> documentation stating permit(s) are not required. <br />