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O City of Orono R CTTY USE ONLY. <br /> � � P.O. Box 66 Date Received:� �� Permit# <<'�>� / - 7-�j <br /> � 2750 Kelley Parkway �f <br /> Crystal Bay, MN 55323 Amount: $ `G' ��� SAC Credit: <br /> (952)249-4600 j"�'��C'C`kCc� �� ��Q-�'� <br /> � ,�- Homeowner(s)Signed: ❑Yes 4 <br /> y� �,� Resolutions(if any)Signed:�Yes ❑None Required <br /> 19kESH��� Zonin Disclosure Si ned: ❑Yes ❑None Re uired <br /> � <br /> 1r1���+� "_rl<i>liS <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: �� / ' / 3�r��-��/b 6 G� ��� <br /> , <br /> Owner (,�a�^f1a-C/'�Q� n l.G.(J�,� LL�' Mailing Address: �����' (�f'!ai'�1,��t��a�� C� <br /> City: ��-f�h P�'a���-c, � �N' Z;p: �s37 d <br /> Phor�/e: 7�d"l9 �Q- �� S-3 Email: � L (" l,nar�'��iP��a�✓� Ca . Con� <br /> Contractor/Applicant Information: <br /> ., p l � <br /> Contractor/A .����'''�����a�� ���� (y�`'m ���m Contact Person: ���L La�'�✓6�- <br /> pP • <br /> Address: State License #: �3����y�� <br /> � a a � J�.. <br /> City: a Zip: Expiration Date: 3��3���d/l <br /> Phone: Email: <br /> SPECIAL CONDITIONS & H4LD HARIVILESS AGREEMENT � <br /> General I nstructions: <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 iss�,ea. <br /> Demolition by means of: ❑ Manual Disassembly (�(Heavy Equipment ❑ Other <br /> Permit(s) Issued: ,❑ Sewer Disconnection ❑Well Abandonment# _ <br />� �-'`� �� `��'lY C�C� � � ��c_`-� ��� r�= G L )�'l�� '� L� �.C�� � <br /> (/ � <br /> In return for issuance o�sai�Demoliti�n Permit, the undersig�d 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 Controf. <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 �I� _�I <br /> 150784 <br />