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� . . , �, /��i <br /> ��-� <br /> 1 g,�3 <br /> �' <br /> �O City of Orono ��F,/�R TY usE oN�Y <br /> �O P.O. Box 66 Date Received`iJ Permit# Q��/3— �� <br /> 2750 Kelley Parkway '! <br /> Crystal Bay,MN 55323 Amount: $ SAC Credit <br /> (952)249-4600 <br /> �, ,� Homeowner(s)Signed: ❑Yes <br /> F' �,� Resolutions(if any)Signed:❑Yes ❑None Required <br /> `�kf S H 0�� Zonin Disclosure Si ned: ❑Yes ❑None Re uired <br /> �sc..�ov�/ ��.�'d ��Z•13 <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 /> SiteAddress: ��� ��� �`'�^'`- �-RY`.Q- <br /> Owner: `�Yi kh °� ��y �ZR.r Mailing Address: 3�0o No� A-t�1n� Lu,,�,� <br /> city: (��-o vw zip: 553b y <br /> Phone: �It -382- �f98S� Email: ����'�Vir�die�nqrpQl►��-uls�. t,o�n <br /> Contractor/Applicant Information: <br /> Contractor/App.: �2Snc�R.�. �o�.� Contact Person: �e.- �U.�'v�n.� <br /> S,,.�1e <br /> Address: l5Z�S0 l.�a.yte��3l�d �� State License#: �C.)�1230$ <br /> City: Zip: 553Q ( Expiration Date: 3�3t �2p I S <br /> � Phone: `1 Sa ��}��{ - `1 Z-O`� Email: 1�1,q�c_.�a �(��n.p�►.Qg , c,�� vi,. <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 �eavy Equipment ❑ Other <br /> Permit(s) Issued: ❑ Sewer Disconnection ❑ 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 <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 copy of permit approval from the Minnehaha Creek Watershed District (MCWD). The <br /> City witl not issue a demolition permit without a copy of the permit(s) from the MCWD or <br /> documentation stating permit(s) are not required. �.�2 ^ �I � <br /> {�7 <br />