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` -� ` *�SC(QS�,��r u� S� I�D�.��� <br /> . ��� City of Orono FOR C[TY USE ONLY J ` <br /> P.O.Box 66 Date Received: ��j Permit# �/f/ 5 <br /> �"' � 2750 Kclley Parkway <br /> `�,c•R.p, <br /> '�% <br /> � ��.;�,r;�` F Crystal Bay,MN 55323 Amount: $ SAC Credit: <br /> �'�i�M�i��y,a~ (952)249-4600 <br /> �'eKO¢ Homeo�v�ier(s)Signed: ❑Yes <br /> Resolutions(if any)Signed:�Yes ❑None Required <br /> Zonin Disclosure 5i ed: ❑Yes ❑Noue Re uired <br /> CITY OF ORONO - DEMOLITION PERMIT <br /> (Ail permits must be approved Uy the Building Official and/or Zoning Department) <br /> JoU Site/ Owner Infornzation: <br /> Type: (�C,Residential ❑ Coininercial <br /> Site Address: Z�a�S ���tFF �c;�� ��'� � Z�--�-/� ���`j � <br /> Owner: S�"'���v �} A f�[- Mailing Address: ��S ��t� ,�{��R E Q� <br /> City: �n.�� �1 �Z��i�i Zip: � �..� 3`� � <br /> Home Phone: �SZ -��7�- �� �`i Alternate Phone: �S 2 -Z�7c -�q2�; <br /> Coiitractor/Applicailt I�lformation: <br /> Contractor/App.:�c��� t, t- Sc r--�� Contact Person: ,4►:� FC.S�� <br /> Address: I�yn I t�p K o � State License #: C T� � � E-�,1 � '�� <br /> City: �N Zip: ��3 Expiration Date: <br /> Phone: '1� Z--`1 �� -� �{ I 3 � Alternate Phone: �, I�Z�- 3� �( --��.' ��2..0 <br /> SPECIAL CONDITIONS & HOLD HARMLESS AGREEMENT <br /> General Instructions: <br /> 1. You may be required to oUtain other permits, i.e.: well abandomnent, sewer, etc. <br /> 2. Work inust not be�in unless the pennit 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 �f Heavy Equipment ❑ Other <br /> Permit(s) Issued: ❑ Sewer Discoimection ❑ Well Abandonment # <br /> In return for issuance of said Demolition Perrnit, the undersigned owner hereby agrees as follows: <br /> l. The struct�ire(s) shall be kept enclosed andior secured until such time as demolition is <br /> complete. <br />