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r� �/'7•2(Z <br /> , i <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. buming, 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 473-7357. <br /> JOB SITE ADDRESS: <br /> Occupancy Type: Residential Commercial <br /> OWNER'S NAME: ' Phone: �T3-�a/B' <br /> Mailing Address: City: �,�� � p <br /> Gog9 ��ci h'i1� �i'S"35',L <br /> CONTRACTOR'S NAME: /YI2 Bus. No.: <br /> Mailing Address: City: <br /> Demolition if planned by means of: �anual disassembly <br /> 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 hereby agrees as <br /> follows: <br /> l. 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 <br /> unless 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 />