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� <br /> � ��0 . s� �,� I C� � � ��I �� � �� �e� <br /> � � � <br /> � � � �j �,0 <br /> CITY OF ORONO APPLICATION FOR DEMOLITION PE IT <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 obtain other permits, i.e. well abandorunment, etc. <br /> 2. Work must not begin unless the permit card is available on the job site. <br /> 3. A 24 hour notice is��equired far all inspections. Call (612) 249-4600. <br /> JOB SITE ADDRESS: ��J I.�'�C%. Lw���. �` <br /> Occupancy Type: X Residential Commercial <br /> OWNER'SNAME: �1�15�� �,�,`��r�.r'�� Phone: �}��- ���J <br /> Mailing Address: ��.r'�.�2� City: <br /> CONTRACTOR'S NAME: C�,�,'�- ����(;�.� Bus.No.: �-I-]�-- -7�a� � <br /> Mailing Address: City: C�' yv��l,u,'►C�, <br /> Demolition if planned by means of: manual disass�bly � <br /> }C heavy equipment`, �Z~��� ��� <br /> ��l�`?�... �J� � <br /> Permits Issued: � ��`—�,�� <br /> i <br /> # Well Abandonment 3� ����--....� <br /> In return for issuance of said Demolition Permit, the undersigned owner hereby rees as follows: <br /> 1. The structure(s) shall be kept enclosed and/or secured until such time as molition is <br /> complete. <br /> 2. Demolition debris will be kept off adj oining 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 emoved 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 with State Health Department regulations. <br /> 6. Inspection required when all debris has been removed, before backfilling. <br /> ��� `,�'?/L��(1 �"' �-��'�' �'f �` 2�� ��-�- <br /> � � � i� <br /> ��� � � � �J G2� <br /> y�'�� ��- � - v � � <br /> � � <br />