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, � <br /> • , <br /> ,�0� City of Orono FO CI USE ONLY / <br /> O O P•0.Boa 66 Date Receiveda� / /Z Permit# �� —� �07fo <br /> �;,,.��,.. 2750 Kelley Parkway �p <br /> ���r�� � Crystal Bay,N1N 55323 Amount: $ SAC Credit: <br /> ���f���yc (952)249-4600 <br /> ��O$ Homeowner(s)Signed: ❑Yes <br /> Resolutions(if any)Signed:0 Yes ❑None Required <br /> 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 Zonin,Department) <br /> t_,� �'te/Owrier<Information �" <br /> Type: �Residential ❑ Commercial <br /> SiteAddress: 35� �1 )t� ���C� <br /> . <br /> � • �� <br /> Owner: ,� �G�-� �l:C�Z ����- Mailing Address: '��CU � �-1," �L <br /> � �,. <br /> ^ Zl �. ���'� <br /> Clty: ��' ��,�s' �7: <br /> '� C �- 1 <br /> Home Phone: �^ � •� - �i��-` � �, '� )�1 Alternate Phone: �� I�- �>�n�' � �`. 7 `�� <br /> _,., , �ctor/Applicant.Iriformation: � <br /> � `, <br /> ContractoriApp.: ��-� ���i;JC�-� ,� Contact Person: �+Y� c e, � <br /> � . <br /> Address: c <br /> Y ��`1 � �-���U}t-t v� State License #: <br /> Cit �'�OY�- Zi ��-���`� <br /> y: p: �� � Expiration Date: <br /> � �., <br /> Phone: ��/i�_ - �� '==� �-- �(i� `�t:_� Alternate Phone: � ( �'� - � ��.' ��` `�1 ��1 � <br /> �� � �� ��. '' SPECTAL�;�(.�1�LDTT�°ONS &`HOI�D 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 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, ConstYuction Site Runoff Control. <br /> 3. Submit a $2,000 escrow and an escrow agreement signed by the property owner. <br /> 4. Keep all structure(s) enclosed and/or secured until such time as demolition is complete. <br />