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� � (.�(�i�k i c i� l,�? � ��1 �1 c.s�. - ? �C� 2(cc i'1C�. <br /> � � ... <br /> �.� �, _�� ,� � <br /> CITY OF ORONO APPLICATION FOR DEMOLITION PERMIT <br /> P.O. Box 66 (2750 Kelley Parkwayj <br /> Crystal Bay, MN 55323 <br /> SPECIAL CONDITIONS & HOLD HARMLESS AGREEMENT <br /> General Instructions <br /> l. You may be required to obtain other permits, 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 /> JOB SITE ADDRESS: ��1 `-I � I�c�r�'�.. �r� �r�� � <br /> Occupancy Type: �_Residential Commercial <br /> OWNER'S NAME: s�.� �-L �-a.� ���pi�r,,.e.,.� Phone: ��.l - �y 3 -� h a � <br /> Mailin Address: �` � <br /> g �'-1�\ ��-�s���-. ��e.,� CitY: i=c\e,.. '1 v-c�.i....o <br /> CONTRACTOR'S NAME: �--v�. - ��,.�, �.� ��cGn�L ��� Bus.No.: `��) — `j�� -<3'h� <br /> Mailing Address: `�`-1� � �-�s .;�. �l.c..,�y . � ��¢�City: �c�� � r r�,�, � <br /> � ' <br /> Demolition if planned by means of: manual disassembly <br /> _ C heavy equipment <br /> Permits Issued: � <br /> # Well Abandonment � e �o�^� � ��s�"^�� � �l( <br /> In return for issuance of said Demolition Permit, the undersigned owner hereby agrees as follows: <br /> l. The structure(s) shall be kept enclosed and/or secured until such time as demolition is <br /> complete. <br /> 2. Demolition debris will be kept off adjoining property andlor the public rights-of-way unless <br /> specific prior approval is obtained in writing for temporary use thereof. <br /> 3. Foundations shall be completely removed from the ground. <br /> 4. All demolition debris shall be completely disposed of off site in accordance with all <br /> applicable PCA requirements. <br /> 5. Water wells must be abandoned in accordance with State Health Department regulations. <br /> 6. Inspection required when all debris has been removed, before backfilling. <br /> ����,rr�. �y,,�� Sc,o ft- -�i�- pv,bl r G wa�s h-�- <br /> /�✓.�fl. � �� �`f',,1 .7,,1,,c °���f��;`' �-� o�'„� �� �-'w� �,�D�'�-� a�S �, . <br /> � � ,h <br /> �V'„e.�-c�' a�-C .�-e�z.�' �y���� �� `--��-�� <br />