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�O TO City of Orono FOit <br /> ?CT)FY JjSE ONLY �1,5-4?1,5-4?1 V P.O. Box 66 Date Received Permit# / <br /> 2750 Kelley Parkway /��� �`` <br /> Crystal Bay, MN 55323 Amount: S. S. 00 SAC Credit: /y/A <br /> (952)249-4600 <br /> Homeowner(s)Signed: ❑Yes Cd&W <br /> Resolutions(if any)Signed:❑Yes L2.None Required <br /> tgkFSH��� Zoning Disclosure Signed: ❑Yes ZNonc Required <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: i <br /> Type: residential ❑ Commercial <br /> Sit,z 1.juress: <br /> Owner: Mailing Mailing Address: 30 `"' � <br /> City: Zip: <br /> Phone: (6I Z - Z 72 -2?3-2 Email: <br /> Contractor/Applicant Information: <br /> Contractor/App.: �� 2,01" lael--5 Contact Person: N► �` <br /> Address: oS�_��,-� !f A-(2-- State License #: -631/3 96 <br /> City: Zip: X334-1 Expiration IDate: r 3 3l !S <br /> Phone: Email: N1; � U-. ��e �c�wwr'•c�k_%- <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 of: Manual Disassembly ❑ Heavy Equipment ❑ Other <br /> fff <br /> E)( 15)IN(o DF—e- Y, 0NQ; <br /> Permit(s) Issued. ❑ Sewer Disconnection ❑ Well Abandonment <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 <br /> structures are 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 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 />