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CITY OF ORONO APPLICATION FOR DffiKOLITION Pffi2MIT <br /> P.O. Box 66 (1335 So Brown Rd) <br /> Crystal Bay, MN 55323 <br /> � SPECIAL CONDITIONS & HOLD HARMLESS AGREEMENT <br /> **************��*�*�*�*******�**:****�*�******************�*�****::******* <br /> General Instructions <br /> 1. You may be required to obtain other permits, i.e. burning, well <br /> _ _ abandonmment, etc. - ._..__,.. .._ <br /> 2. Work must not begin unless the permit card is available on the job <br /> site. <br /> 3. A 24 hour notice is required for all inspections. Call 473-7357. <br /> :******�t��*******:***:****:t**#****#�****�***:t**t*:::***t****:**:***�*t** <br /> JOB SITS ADDRESS: / ,� .: � �-' l � Z� � �< ;,`���� /�z �'� <br /> Occupancy Type: Residential Commercia <br /> OWNER'S NAME: av �t�'�% Phone: ���v-- �l��S � <br /> Mailing Address: i� e City: � ;� <br /> /nh <br /> CONTRACTOR'S NAME: C�/���'' Bus. No. : <br /> Mailing Address: City: <br /> **#**#t*�*�t*******:::***:t*��******:*�*******************:*:***:*f*****:** <br /> Demolition if planned by means of: manual disassembly heavy equipment <br /> �burning (by fire department) <br /> Permits Issued: <br /> # Burning Fire Department <br /> # Well Abandonment � <br /> In return for issuance of said Demolition Permit, the undersigned owner <br /> hereby agrees as follows: <br /> l. The structure(s) shall be kept enclosed and/or secured until such time <br /> as demolition is complete. <br /> 2. Demolition debris will • be kept off adjoining property and/or the <br /> pub 1 i c rights-of-way un 1 es s specif i c prior approva 1 i s obtained in <br /> 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 <br /> accordance with al 1 applicable PCA requirements. - <br /> 5 . Water wells must be abandoned in accordance with State Health <br /> Department regulations. <br /> 6. Inspection required when all debris has been removed , before <br /> backfilling. <br /> 7. Within 5 working days of superstructure removal , a final inspection <br /> shall be requested. The site shall be �Ieft clean and clear of all <br /> debris, with any excavation filled with earth level with the adjacent <br /> _ ground elevation (except when such excavation is to be used as part of <br /> a new building and such new building is actually under construction). <br /> � ��� �' <br /> � <br />