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+ ��T City of Orono OR ITY SE ONLY, <br /> � i VO P.O.Box 66 Date Received:�2"��� ermit# �� S�� <br /> 2750 Kelley Parkway � ) <br /> Crystal Bay,MN 55323 Amount: $ N SAC Credit: <br /> � �. Phone:(952)249-4600 <br /> y � Homeowner(s)Signed: ❑Yes <br /> F'� �,� Fax: (952)249-4616 Resolutions(if any)Signed:❑Yes ❑None Required <br /> qkFSH��� 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 /> .� �; <br /> Site Address: -� ��� � L � '.��� v'� .����� �° �'C' <br /> ., " � <br /> / � <br /> Owner:(<�6"cc�� � ��,�,�- � `�Mailing Address: `-�°U �r1 � <br /> , <br /> City: i�'��1� ��l �'�✓ Zip: �'.,��,7 ��ri <br /> Phone: ' Email: � <br /> Contractor/Applicant Information: <br /> Contractor/App.: r�r�� ��t��` �'�C�G'�'f�_�c; Contact Person: �� No 1 (��'1'��-li���;�Ic=' <br /> �� _ <br /> Address: `"� %� �� ��u'r� /��� 1��C1 State License #: <br /> City: ��,(�"����G'����� ���Zip: �_7 . � ��� Expiration Date: <br /> � <br /> r <br /> Phone: `���`�- �--� ��G "� <<'� �� Email: <br /> � <br /> SPECIAL CONDITIONS � HOLD HARMLESS AGREEMENT <br /> General I nstructions: <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# <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 <br /> 150784 <br />