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� <br />� � �� City of Orono FOR CITY USE ONLY <br /> ig,o,�\ �7 <br /> \� P.O.Box 66 Date Received: Permit# �O//—U a �/ <br /> (���, �'i� 2750 Kelley Parkway �/�') <br /> �'a y'' R�>.. a�� Crystal Bay,MN 55323 Amount: $ C✓'�' �SAC Credit: <br /> ����r�+,��n.�o�% (952)249-4600 <br /> ti�_�O� Homeowner(s)Signed: ❑Yes <br /> Resolutions(ifany)Signed:❑Yes ❑None Required <br /> Zoning Disclosure Signed: ❑Yes ❑None 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: <br /> Type: �Residential ❑ Commercial <br /> Site Address: l��J S �+C ��ra�`�Oi'� J�� <br /> Owner: /'-/�x,�c,rc� ��J�'�t �.�F^C` Mailing Address: �7 V����y `J ;��,1� <br /> c�ty: L�..� � �1�. z�p: ��3 �r <br /> , <br /> Home Phone: �j.s'z - `(�3 �' � s L r Alternate Phone: �'SZ " �`73 ' G �3 r <br /> Contractor/Applicant Information: <br /> Contractor/A '� � � Contact Person: �a �k <br /> PP• <br /> Address: ���f��'I ��:.v�; �1� � State License#: <br /> City: I'1U' t� Zip: 53��� Expiration Date: <br /> Phone: ���-� �.��-<-1/3,3 Alternate Phone: ���.X�`�" �3�� <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. Wark 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 as follows: <br /> 1. The structure(s) shall be kept enclosed and/or secured until such time as demolition is <br /> complete. <br />