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O City of Orono c►T U ONLY <br /> � � P.O.Box 66 Date Receivec� ��rmit# � `'d ��� <br /> � 2750 Kelley Parkway <br /> Crystal Bay,MN 55323 Amount: $ ,�_ SAC Credit: � ` - <br /> (952)249-4600 il <br /> �, ,` Homeowner(s)Signed: ❑Yes <br /> F � Resolutions(if any)Si}�ed:Q Yes ❑Nonc Required <br /> l9kE S H v�� Zonin Disclosure Si ed: ❑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 /> Site Address: � � ' �� �c�33 <br /> Owner: ��1��61/� lJ� �� MailingAddress: � � ��> � <br /> City: ,`C'T- -���`�-�-- Zip: �_J I U`1 <br /> Phone: Email: �� �+11► �����'�C;p � ��''"I'"' <br /> Contractor/Applicant Information: <br /> Contractor/App.: l�� � ' ��`-Y1�V'�`Contact Person: <br /> Address: ��� ✓�I lJ"��� J�� State License#: fJI�GJ�� � b 1 <br /> City: �- ip: � Expiration Date: � � �1 �l � � <br /> Phone: N�2�1��1,.s�.>Ul� Email: � � I� (.�� CT� , ' ' � <br /> 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 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 <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 />