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� City of Orono �OR CITY USE ONLY <br /> r �O� P.O.Box 66 Date Receiv � Permit#�Qbl '�j <br /> 0 2750 Kelley Parkway z � <br /> Crystal Bay, MN 55323 Amount: $�c/�• SAC Credit: <br /> (952)249-4600 <br /> -a .�. Homeowner(s)Signed: ❑Yes <br /> F �� Resolutions(if any)Signed:�Yes ❑None Required <br /> `��f 5 H��� Zonin Disclosure Signed: ❑Yes ❑None R uired <br /> CITY OF ORONO - DEMOLITION PERMIT <br /> (All permits must be approved by the Building Official and/or Zoning Department) <br /> Job Site / Owner Information: <br /> Type: �� Residential ❑ Commercial <br /> Site Address: � �� ��`�"`�`'"'Tz" �`�`" <br /> Owner: �"%�SU`-"- c�� Mailing Address �-�3 SS� z5-f4 �✓�:� "���� <br /> �'�, c"�.���,a <�-�!s�, "3c�� <br /> City: Zip: <br /> Home Phone: �2 S��� S��� Alternate Phone: <br /> Contractor/Applicant Information: <br /> Contractor/App.: ���,(r�l�1.� �la C-L L� Contact Person: � /U �Lt-��--� <br /> I <br /> Address: J��SD �J'r� �1/'�- � State License#: <br /> City: b I.t.� Zip: J��e3C� Expiration Date: <br /> Phone: Alternate Phone: <br /> SPECIAL CONDITIONS & HOLD HARMLESS AGREEMENT <br /> General Instructions: <br /> 1. You may be required to obtain other permits, i.e.: well abandonment, sewer, etc. <br /> 2. Work 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 <br /> issued. <br /> Demolition by means of: ❑ Manual Disassembly Heavy Equipment ❑ Other <br /> Permit(s) Issued: ❑ Sewer Disconnection ❑ W II 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 <br /> structures are to be demolished. <br /> 2. Submit a survey, aerial photo or sketch showing proposed erosion control measures in <br /> accordance with Chapter 79, Construction Site Runoff Control. <br /> 3. Submit a $2,500 escrow and an escrow agreement signed by the property owner. <br /> 4. Keep all structure(s) enclosed and/or secured until such time as demolition is complete. <br />