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S '� <br /> � <br /> ( � / <br /> 4 <br /> �O�T City of Orono sE oxi,Y����/�33 <br /> �V P.O.Box 66 Date Received• ermit# <br /> � 2750 Kelley Parkway �, <br /> Crystal Bay,MN 55323 Amount: $� SAC Credit: <br /> (952)249-4600 <br /> � ,� Homeowner(s)Signed: ❑Yes <br /> d�, <br /> �,� Resoludons(if any)Signed:�]Yes ❑None Required <br /> l�k£SHO�� Zonin Disciosure Si ed: ❑Yes ❑None R uired <br /> CITY OF ORONO - DEMOLITION PERMIT <br /> (All permits must be approved by the Building Official and/or Zoning Department) RECEIVED <br /> ,�e� /�r�1� ' �:. <br /> OCT 1 9 2016 <br /> Type: (`�Residential ❑ Commercial <br /> c�nr oF oRONo <br /> Site Address°��� ��� C� � � � �� � �C ��G� l a� <br /> Owner: C�.�vt,}�e�'/ci`� Mailing Address: � �� �G � ��+��r�e,i-� � ~�- <br /> c�ty: �� t��a`re z�p: S�3 y�/ <br /> Phone: ��� �7� - � l�� Email: �o��t (1 e`'�C'�✓�► �� �a� ►'� CaP. Gv�-. <br /> ��t�a�i`J " . ��t�~= ., t�r� � : <br /> Cont�actor/App.: � �a� �'��011 � Contact Person: �Gbl J��-SWPo�h���' <br /> Address: I I S 7� C�Us•rr► ,�����c�-• State License#: 13C ° (v(o �y�C� <br /> City: ��� �Y��r1� Zip: ��3�/�/ Expiration Date: ���3 �� � � <br /> (J���7"0 ��oZ Email: k�ob�(� �+r-► <br /> Phone: C �/'�a�� cc�,0•�d� <br /> . . ; � <br /> ,. �► �►�: ���.�:� �. .. � ��►� ��fi= <br /> x � <br /> General Instructions: <br /> 1. You may be required to obtain other permits, i.e.: well abandonment, sewer, etc. <br /> 2. Worlc must not begin unless the permit card is available on the job site. <br /> 3. A 24-48 hour notice is required for all inspections. Call (952)249-4600. <br /> 4. Sewer must be discontinued at the City service by qualified contractor before demo permit is issued. <br /> Demolition by means of: ❑ Manual Disassembly �}-Fieavy Equipment ❑ Other <br /> Permit(s) Issued: ❑ Sewer Disconnection ❑Well Abandonment# <br /> In return for issuance of said Demolition Permit, the undersigned owner hereby agrees to: <br /> 1. Submit a survey, aerial photo or sketch showing all structures on the property. Note which structures are <br /> to be demolished. <br /> 2. Submit a survey, aerial photo or sketch showing proposed erosion control measures in accordance with <br /> Chapter 79, Construction Site Runoff Control. <br /> 3. Submit a copy of permit approval from the Minnehaha Creek Watershed District (MCWD). The City will <br /> not issue a demolition permit without a copy of the permit(s) from the MCWD or documentation stating <br /> permit(s) are not required. <br /> Form Last Updated: July 2015 <br /> 150784 <br />