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O Cityf Of OlO�IO -/ C NLY c�� <br /> � � P O.8oz 66 Date Received' it Il �L'_�l <br /> � 2754 Kelley ParkwBy ��� �, <br /> Crystal Bay,MN 55323 Amount S��-�v — SAC Cr�dit .___.�__ <br /> � <br /> (952)249�600 <br /> �, ,�` Homcowr�er(s)Sigmd. ❑Y�s <br /> E' �,� Rtsolutions(if arry)Sigrxd 0 Yes 0 Nosx Requiml <br /> ��KESlipR� � Zoni Uiscloswe Si Yes None Re uircd <br /> CITY OF ORONO - DEMALfTION PERMIT <br /> (Atl permlts musl be approved by ihe Building Offictai and/or ZoMng Department) <br /> Job Si#e/Owner Informatian: <br /> Type: �esidential ❑ Commercial <br /> Site Address: �f�Q C.D_VY1'�7�1 �{�Q(G� �O <br /> Owner: ���e�'j 'C` MailingAddress: ZOf �.��,�_S�• <br /> city: v�1 G���-� z;p: 55 3"1 / <br /> Phone� �52 . y 7 �!. ����� Email: �S�GI�-V1�C lI (� CSg1,cY►'►��I • �M <br /> Contractor/Appl'scant lnforma�on: <br /> � <br /> � �,1�:.'�r.,t�,� Urr� ( �/ <br /> Contractor/App.: � �Contact'F�rson: ��?� <br /> Address: 3��7c.� �'�a f��l � I State License#: <br /> City: Zip: ���(1 Expiration Date: <br /> Phone: .s�pve �1�'�.. ��S=`/3 2� Email: <br /> SPEGIAL CONDITIDNS & HOLD HARMLESS A(3REEMENT <br /> General tnstructions: <br /> 1. You may be required to obtain other permits, i.e.:well abandonment, sewer, etc. <br /> 2. Wotic must not begin unfess the permit card is availabEe on the job site. <br /> 3. A 24-08 hour notice is required for all inspections. Call(952)249-4600. <br /> 4. Sewer must be discont�nued at the City service by quat�ed contractor before demo permit is issued. <br /> Demolition by means of: ❑Manual Oisassembly ❑ Heavy Equipment ❑Other <br /> Permit(s) Issued: ❑ Sewer Oisconneciion ❑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 propased erosion control measures in accordance with <br /> Chapter 79, Constructian Site Runoff Contml. <br /> 3. Submit a copy of pertnit approvai from the Minnehaha Creek Watershed District {MCWD}. The City wili <br /> not issue a demolition permit without a copy of the permit(s) from the MCWD or dacumentation stating <br /> permit(s)a�e not required. <br /> Form Last Updated: Juty 2015 <br /> 150784 <br />