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� <br /> l <br /> CITY OF ORONO APPLICATION FOR DEMOLITION PERMIT <br /> P.O. Box 66 (2750 Kelley Parkway) <br /> Crystal Bay,MN 55323 <br /> SPECIAL CONDITIONS &HOLD HARMLESS AGREEMENT <br /> General Instructions <br /> 1. You may be required to obtaiu other permits, i.e. well abandonment, etc. <br /> 2. Work must not begin unless the permit card is available oii the job site. <br /> 3. A 24 hour notice is required for all inspections. Call(952) 249-4600. <br /> JOB SITE ADDRESS: � -S �-e'� � S �- <br /> Occupancy Type: � Resideiitial Commercial <br /> OWNER'SNAME: Ed ►'h u n�l Gra ��m Phone: � I 2- � 6�.-��`�O <br /> Mailing Address: �9 0 9 R �u ce ��e City: �d��4 <br /> CDI�TRAC'TOR'S NAIVIE: 6 �✓ h e r' Bus.No.: <br /> Mailing Address: City: <br /> Demolition if planned by means of: � manual disassembly <br /> heavy equipment <br /> Pemiits Issued: <br /> # Well Abandonment <br /> In return for issuance of said Demolition Peimit,the undersigned owner hereby agrees as follows: <br /> 1. The struciure(s) shall be kept enclosed aiid/or sectued until such time as demolition is <br /> complete. <br /> 2. Demolition debris�vill be kept off adjoiizing property and/or the public rights-of-way unless <br /> specific prior approval is obtained in writing for temporary use thereof. <br /> 3. Foundations shall be completely removed from the ground. <br /> 4. All demolition debris shall be completely disposed of off site in accordance with all <br /> applicable PCA requirements. <br /> 5. Water wells must be abandoned in accordance witli State Health Department regulations. <br /> 6. Se�ver and water nrust be discomiected at the services at the street by qualified contractors. <br /> 7. Inspection required when all debris has been removed,before backfillin�. <br />