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- , . . <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 perinits, i.e. well abandomnment, 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: �1��� �y''(ti`�ti ���+'�� <br /> Occupancy Type: .� Residential Commercial <br /> OWNER'SNAME: r�+���,���u�x��� ��i'-���1��C;1� 1is���- Phone: 7(c�-=� 797 -�/�� <br /> MailingAddress:li-5� ��U;� ���'/V� l-•oe./�,r�i� ir�c�� ��ity: (�n����.�' v'��E=�,/ <br /> CONTRACTOR'SNAME:��''+�.7 (,��::�����'t-nC'��' �, /i:� Bus.No.: <br /> MailingAddress:�ltrn� i���uc �'��•r:���� /Y1�; j�:�c�E-r CitS': ���'�'�.'{x,1�G �i" <br /> Demolition if plamled by means of: manual disassembly <br /> �_heavy equipment <br /> Permits Issued: <br /> # Well Abandorunent <br /> In return for issuance of said Demolition Permit, the undersigned owner hereby agrees as follows: <br /> 1. The structure(s) shall be lcept enclosed and/or secured until such time as demolition is � <br /> complete. <br /> 2. Demolition debris will be lcept off adj oining property and/or the public rights-of-way unless .✓ <br /> specific prior approval is obtained in writing for teinporary use thereof. <br /> 3. Foundations shall be completely removed from the ground. �1 <br /> 4. All demolition debris shall be completely disposed of off site in accordance witli all ,� <br /> ap�licable PCA requirements. <br /> 5. Water wells must be abandoned in accordance with State Health Department regulations. •� <br /> 6. Iizspection required when all debris has been removed, before backf'illing. � <br /> �'e�9 �}�>hi�V�°V ���--�75� _�v- t,�� <br /> --- S^h ��r� 7�3 - 797- �/8� �"S� -�7�75-�'d�o <br /> L�u�� <br />