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CITY OF ORONO APPLICATION FOR DEMO I RMIT <br /> P.O. Box 66 (2750 Kelley Parkway) <br /> Crystal Bay, MN 55323 <br /> SPECIAL CONDITIONS & HOLD HARMLESS AGREEMENT <br /> General Instructions <br /> 1. You may be required to obtain other pennits, i.e. well abandonmment, 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:��S �J N�/�r� S� �r� �r�v-�.�r <br /> Occupancy Type: _ 1�� Residential Cormnercial ��D/vU, f'j1N S S 3�'� <br /> (f�)9SL—Y7G—d419 <br /> OWNER'SNAME:(�/^�je�/�` e�er'yL- ��NGS Phone�0)(olZ-�i/7-5�/ 1�v <br /> MailingAddress: /a-�LrJo od�!-,��l/ �v City: �,Q ONo , /'r�i✓ S S�j�/ <br /> � CONTRACTOR'S NAME: Bus.No.: <br /> Mailing Address: City: <br /> Derrfolition if plaiined by means of: manual disassembly <br /> heavy equipnlent <br /> — �u�� c�d w� �y C.be�tia ��e l��'�- <br /> Permits Issued: /V �- <br /> # Well Abandonment <br /> In return for issuance of said Deinolition Permit,the undersigned owner hereby agrees as follows: <br /> 1. The structure(s) shall be kept enclosed and/or secured until such time as deinolition is <br /> complete. <br /> 2. Demolition debris will be kept off adjoining property and/or 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 backf'illing. <br />