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O City of Orono FO[t CITY USE ONLY <br /> g- � P.O. Box 66 Date Received: —�� Permit# �� � � � y y�• <br /> � 2750 Kelley Parkway <br /> Crystal Bay, MN 55323 Amount: $� SAC Credit: <br /> (952)249-4600 <br /> ,' ,` ��� Homeowner(s)Signed: ❑Yes <br /> y� � �l� Resolutions(if any)Signed:❑Yes ❑None Required <br /> G <br /> ��KES H��� ��� Zonin Disclosure Si ed: ❑Yes ❑None Re u'ued <br /> CITY OF ORONO - DEMOLITION PERMIT <br /> (All permits must be approved by the Building O�cial and/or Zoning Department) <br /> Job Site I Owner Information: <br /> Type: �,Residential ❑ Commercial <br /> Site Addres� �-y� L ' � <br /> Owner: ` f� � Mailing Address: <br /> � � <br /> City: ` Zip: <br /> Phone: Email: <br /> Contractor/Applicant Information: <br /> 4 <br /> Contractor/App.: A��(✓L�(.'+-�►i �u � Contact Person: �f ��"`'�'—�'�Y,r�" <br /> Address: �/�o� 7� L�_ v'" State License#: <br /> � <br /> City: �—�'` � �--t--�Zip: � Expiration Date: <br /> Phone: l.�l� -������� Email: <br /> SPE�IAL CONDITIONS & HOLD HARMLESS AGREEM:ENT <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#�� ��C I <br /> �����1�f a���, o����� <br /> In return for issuance of said Demolition Permit, the undersigned owner hereby agrees to: <br /> 1. Submit a survey, aerial photo or sketch showing all structures on the property. Note which structures are <br /> to be demolished. <br /> 2. Submit a survey, aerial photo or sketch showing proposed erosion control measures in accordance with <br /> Chapter 79, Construction Site Runoff Control. <br /> 3. Submit a copy of permit approval from the Minnehaha Creek Watershed District (MCWD). The City will <br /> not issue a demolition permit without a copy of the permit(s) from the MCWD or documentation stating <br /> permit(s) are not required. � <br /> Form Last Updated: July 2015 (n ' � <br /> 150784 `,�,� <br />