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� — 1 �c ' <br /> * ,�' — .�J ��' �l.i .�� Y/'� <br /> Tz-r j � �-(C <br /> � ��.,.�� ;-��� <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 obtain other permits, i.e. well abandonmment, etc. <br /> 2. Work must not begin unless the permit card is available on the job site. <br /> 3. A 24 hour notice is required for all inspections. Call (612) 249-4600. <br /> JOBSITEADDRESS: ►�y� �.,.�. �,y�� �w�,� <br /> Occupancy Type: �Residential Commercial <br /> � r>'- � <br /> OWNER'S NAME: ��i o.,� �ve.`�. ���erc Phone: 9SZ `ly,\-Z�o2y <br /> MailingAddress: `����,p �,.... CitY� ['���� ss�t'�9 <br /> �� ���'i6�Dl <br /> CONTRACTOR'S NAME: Bus.No.: '(�3 g�9- y��� /- <br /> Mailing Address: ` � City:� -ss-<.ty� <br /> Demolition if planned by means of: manual disassembly <br /> �_heavy equipment <br /> Permits Issued: ,� <br /> # Well Abandonment �,.�-ll C�,.�r�.�-� g�-Z w•�` ��2 5�"-'��"r� GfL� /� <br /> ca.� AZ�.Cz,� QreQcr-�1 . • u�.�` <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 /> 2. Demolition debris will be kept off adjoining 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 with State Health Department regulations. <br /> 6. Inspection required when all debris has been removed, before backfilling. <br />