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Jun 271409:42a TaylorWest 6515288351 p.3 <br /> J�.in 2G 1�11�2P�� TaylorWest 6v152883F1 P� <br /> 4, Submit a �2,�00 escrow ar:d an escrow agreement signed by the properiy owner. <br /> 5. Keep al�struct�re(s}e:iclosed andlor secured until sueh time as�+emol3tion is complete. <br /> 6. Keep al! dert�olition debris ofF adjoining prdpert7l and/or the public rights-of way unless specrf�ic <br /> �riQr app►'ova!�s obtained in writing tor temporary use thereo�. <br /> 7. Compietely remove founda6on(s)from the ground. <br /> B. Compteteiy dispose af a!I dem�iition debr�s oFf site in accordance with aEl applicable PCA <br /> requirements. <br /> g. Abandon water welEs in accordance with State HealFh Depar�ment regufatians. <br /> 1 d.Call for an inspection when all debris has been remav�d,before back�tling. <br /> 11.W�hin 5 working days af superstnacture removal, a fnal inspection shalf be requested. The site <br /> shall be lefi de� and clear of all debris, w:ih any excavation filled wlth earth teve! with the <br /> adjacent gr�und elevation{except when such excavation is to be used as part of a new bu�lding <br /> and such new bu�lding is aatual{y under construction). <br /> 12.Abandcn septic systems per Minnesota RuEes Chapter 7pB�. A11 septic t.anks must be pum�ed, <br /> crushed and filled with native soils. An inspectnon is required after the tanks are pumped and <br /> before the tanks are a'ushed and filled. <br /> 13.The undersigned own�r shall and hereby does indemnify and hold ha��nless the City ot Orono, <br /> its egents. errrp9oyees and assigns#rarr antl against a!! ctaims, d�mages, losses or expenses, <br /> including attorney fees, against the Ciry, its agents, ernployees ar�d assigns arising out of or <br /> resulting from the demo�ition described herein as performed by the property owner, his <br /> ernployees,agents, subcontractors or assigns. <br /> PERM[T TYPE AhtD FF..�GALCi3LATtdN <br /> � �75.00—Principal Structure � ��' a � <br /> �, $50.Ot"3—Accessory Stsucture x 6 (how many} J�� " � �- <br /> 1. Subtofal dfi above permit requested $_�� � Q � <br /> 2. State Surcharge 5.00 <br /> 3. TdTAL PERMIT FEE (add lines 1-2 above) $ �.��� � <br /> i he undersigned herby app�ies to the City of Orono far issuance of a Derr�olition Permit, agrees to do <br /> all the work in a strict aceordance with the ordinances of the City and the regt�lation�s of the State of <br /> Minreesota,and certifies lhat aO statements made on this appl;cation are complete,true and correc�. <br /> I • � ��.- �2t�: ��' i_7�Ci' /1 1 <br /> A�alicant's Signature: • <br /> __�_-�l�r�� fv �a(o� �4' <br /> � Own�r's Signature: � . �r e�-.���_ �_.,�.`�..,�_..,,-. Date: <br /> ° ��Y <br /> Ap�roved$y: _ D�ate: <br /> uilding Officiai) <br /> I <br /> "Zoning Disclosure Required? YES ❑ �O <br /> 'This must be filled out hy Zoning D artment—Far either answer,a Zoning Of�icial rnust sign all aflplicat.ons. <br /> "APProveai By_ Date: �'f �� 1 <br /> (Zoning O�cia1) <br /> .,. <br />