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. <br /> �O�T City of Orono �USE ONLY 4 �� <br /> " 1�/ P.O. Box 66 Date Received:� L / Perrnit# oZ6�.��0 <br /> 0 2750 Kelley Parkway �,,- <br /> Crystal Bay,MN 55323 Amount: $J���' SAC Credit: <br /> (952)249-4600 <br /> '� � Homeowner(s)Signed: ❑Yes <br /> �� � <br /> �, Resolutions(if any)Signed:❑Yes ❑None Required <br /> t�kESH��� Zoning Disclosure Signed: ❑Yes ❑None Re uired <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: 3(�y� /yd�`� �y�� D�- <br /> Owner: �7�Id��h/U�j� /�3G1��S• Mailing Address: Z�/�7 w19�� ��' <br /> C ity: /ni�✓N�6L1f� Zi p: ��� <br /> Phone: 9�Z 9DS' 9d5� Email: <br /> Contractor/Applicant Information: <br /> Contractor/App.: �.5�/!� �X.�91�4'1f�L //�• Contact Person: /�/�'� l�d���N+� <br /> Address: 7i9/!o �ilrl'�2-ls� h'Y� State License#: <br /> City: �V�S Zip: ��33 Expiration Date: <br /> Phone: GS'1 �4"/3� Email: <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 ❑ Heavy Equipment ❑ Other <br /> 1 ��l��-d�'�1�3� <br /> Permit(s) Issued: � Sewer Disconnection ❑ Well Abandonment# <br /> is�uv� ��/, �/,_3 <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 />