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Oct • 4� 2006 11 � 02AM FM FRRTTRLONE No � 9604 P , 2 <br /> U'�'t- �°��3�� ,� /(;��-� 1 S <br /> � jJ; � ��:E - `'1�,�����-t��C�� <br /> � <br /> CITY OF ORONO � A��LICATION FOR DEMOLITION PE� ~RMIT <br /> � P.O. Box 66(2750 Kelley Parkway) <br /> Crt�stal Bay,MN 55323 <br /> SPECTAL CONDITIONS &HOLD HARMLESS AGREEMENT <br /> Ge+neral Instructions <br /> 1. You znay be zequized to obta�n ot�e��ezmits,i.e. we11 abandonment,etc, <br /> 2. Work must not begin unless t3�ie pemut card is available on the job site. <br /> 3. A 24 hour nc�tice is required for all inspec�i.ons. Call (952)249-4600. <br /> JOBSITEADDR�+SS: �A`�o F'oz S-��«-+� dvo�c� MtJ S_S`3 �i 1 <br /> Occu�aracy Type: X Resideatia� Cozxamercxa� <br /> OWNER'S NAME: �'o�.,,. �,�s c� o,� ._s � Phone: 6 l 2 j 3 3 6 - g�o� <br /> MailingAddress: 18 �o �'o�c 5���.�.4- City: �r��..�, <br /> CON'�'�tA►.CTOR'S�T,A.ME: �,,.r�.�1�1� C�w_o��.rts Bus.No.: 6 S I /`�6 S-I t�S <br /> Mailing Address:��?o� g��,,����-y����,.� City: S l� ��.,,...� M N �s'� l 1 <br /> . <br /> Demolition if�lanned by means of manual disassembly <br /> _�heavy equipment <br /> Permits Issued: <br /> # We11 Abando�nmtent <br /> In reh�m for issuance of said Dem,olilion Pemut,the�mdersigned owner hereby agrees as£ol�ows: <br /> 1. The stiucl�ire(s) sha11 be k��t ex�,closed and/oz secwed wati� suck� tiz�e as demolition is <br /> comple�te. , <br /> 2. Demolition debris wx�l be�Cept o�£adj oiniqg properiy ar�d/orthe public rights-of wacy t�nless <br /> s�ecific prior a��roval is obtair�ed iurx wz�itaz�g�oz teznporazy use thezeof <br /> 3. Founda�ions shall be completely removed from the ground. <br /> 4. A11 demolition debris shall be coz�ap�ete�y disposod o� off site in accordance with all <br /> applicable PCA requiremen�s. <br /> 5, Water wells must be abandoned in accordance with State Health DePartment regulations. <br /> 6. Sewer and water must be discrnin�ected at the services at the st�ceet by yualified cflntzactozs, <br /> 7, Inspection required when all debris has been removed,be�are bacicfillvng. <br />