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_ .+ . � ���Y � <br /> � � City of Orono `" �� sE oNLY�fn <br /> �-O�O P.O. Box 66 Date Received: Permit# `�`�� �D� <br /> 2750 Kelley Parkway <br /> Crystal Bay, MN 55323 Amount: $ �. SAC Credit: <br /> (952)249-4600 <br /> � Homeowner(s)Signed: �Yes <br /> y � <br /> F �, Resolutions(if any)Signed:0 Yes j�""None Required <br /> `�kFSH��� Zoning Disciosure Si ned: Yes ❑None Required <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: �� ) �� `v �/ ��, � � <br /> ,��� <br /> � Z <br /> Owner: /�t�! �� ���t L �C��.S"�f�C,/ailing Address: �/���/� �G�� <br /> city: �i$'V7-�-i l�" , /'�� zip: J�J�� � <br /> Phone: %S� ��D G �� � Email: <br /> T <br /> Contractor/Applicant Information: <br /> Contractor/App.: ��-�/I,� � Contact Person: <br /> Address: State License#: <br /> City: Zip: Expiration Date: <br /> Phone: EmaiL <br /> SPECIAL CONDITIONS 8� 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 �leavy 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 will not issue a demolition permit without a copy of the permit(s) from the MCWD or <br /> documentation stating permit(s) are not required. <br />