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"�� City of Orono EOR CITY USE ONLY ' <br /> ��4 ��� P.O.Box 66 Date Received: Permit# o�������� � <br /> �;., � 2750 Kelley Parkway <br /> � )�`'*�• �� Crystal Bay,MN 55323 Amount: $ SAC Credit: <br /> ���,�o$$o j`� (952)249-4600 <br /> Homeowner(s)Signed: ❑Yes <br /> Resolutions(if any)Signed:Q Yes ❑None Required <br /> Zoning Disclosure Signed: ❑Yes ❑No�e Required <br /> CITY OF ORONO - DEMOLITION PERMIT <br /> (All permits must be approved by the Building Ot�icial and/or Zoning Dcpartment) <br /> --- _-- --� <br /> Job Site/ Owner Infonnation: <br /> Type: Q Residential ❑ Commercial <br /> Site Address: / —1 � /l� a�.TH /�,2 a. � ��Q. <br /> Owner: G�I.u.VdCQ, C�0 ML� �,(,L Mailing Address: Co�I Car�Sor��a,rk� �s56 <br /> c�ty: Ivi;h n� �k� z�p: �5 _�d 5 <br /> Home Phone: �� Alternate Phone: <br /> Contractor/Applicant Information: <br /> ��� <br /> Contractor/App.:����'�, ��s��S,ttr� �4�Contact Person: ��i,iC �� �ursc�,� <br /> Address: �(�I ��h e���tx., #'' S� State License#: O�O I S <br /> City: �i �' /`Zip: ����� Expiration Date: )�3� �/� <br /> Phone: �S2– �? y` D 00'-� Alternate Pho e: �(Z� g3� - ��D�j �u,�l ) <br /> r' � <br /> SPECIAL CONDITIONS & HOLD HARM SS AGREEMENT <br /> General Instructions: <br /> \ \____ — <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 issued. <br /> Demolition by means of: ❑ Manual Disassembly Heavy Equipment ❑ Other <br /> Permit(s) Issued: [V�Sewer Disconnection [/�Well Abandonment # 0�O,�Y��f�y� <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 /> accardance with Chapter 79, Construction Site Runoff Control. <br /> 3. Submit a $2,000 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 />