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GITY Of 040N0 � 612249461b 1�1�5/9� 12:�9i`� :�2/1� ti0.478 <br /> CITY �F ORONp APPLICA�'YQ�I Ft3�D�;1�U�.�IYTTCIN PE��I�' <br /> P��� ��� �� ����.�.�.���.��I��1���,�.� � ��.�,� ��,��:�,�.��.��n��n� <br /> ��nera] ��strucila�n� <br /> I, Yot�rn�y b�r�q�.3#r'�d to�+�t�in�ther pernvts, i.e. well abandonrnment, etc. <br /> 2, Wc��'k mus� ne�c begin un��sg t�c permit car9 is availabtt on the job 9itc. <br /> 3. A�4 kto�ar mbtic�is raquired fr�r e11 ins�ections. Call (6l2) 2�9-�6Qb. <br /> ,TCI�B 51"fE A�D��SS: 1`�� �L�� ��� _ ��� �c 1�� ,� ���,1 c��� <br /> 4ccupa�ncy Type: �_Resid�ntial �Commercial ---- <br /> U'VirNE�'t'�ri�: , � -i�,r ; _ ; � e_. �hone: � ��I `��: �` !___-_�_--:� <br /> Mauiri�Address: ;� City; �t��,, �� _ <br /> ; � ��' �; �- � J <br /> CONTRAG"TOR'S�TA1V�� � f r. �l�rl L�ti�YI��� Bu3.`No, ��' ' ����1 <br /> �81�1i1�t�.dG�i`�$8: r`�'J ��_ �2,I���'�.(��.�."'� ��Ity: �'' ����L��1 <br /> Dernoliti�r if planned by m�a:,s csf: ' manual disassembt}� � �u.�r� �eLc_�,i <br /> � <br /> . <br /> ___`__ ,_...___._----- - <br /> _..__.__ <br /> �heavg equigment <br /> Pcrr.uts I�sucd: <br /> #�Wett Abas�donrrrcnc <br /> In return for issuance of g�ld D�moiition Permit, tt�e us:dersigned owner hereby a�rees a� fc�llows: <br /> 1. The &tructur�(sj shail be kept �nclose�3 sndit�r secured a�ti1 �u�h tizn� �s �ernoti:ian is <br /> carnpl�te. <br /> 2. Demt�li.tion debris�wi1l b�kcp#off adjainin,�p:�p��ly ancilor th�pubIic ri�hts-n�way�nless <br /> specific prior�pproval is�btained in wrting�or tempo��y�se�ch�:�eof <br /> 3. F�urd�ti�ns�hstl bc completeiy removcd�ran�the�round. <br /> 4. Al; �emcatizion debri.s shall be c�r�pletely �is�yosed a£ oft` site in accordance a,rith e�ll <br /> applicabls PC�►,r�quirem�nts. <br /> 5. i�u'ater well� cnus�be a6endaned in acc�ard�n:.e �th St�.te I-iea�th�epartment regulatiQns. <br /> 6. Yn�pc�t'ton required when all deb�is has bc�r�r�movcd, b�f�r�b�cicHlling. <br />