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� �L. .�.C)/1-Q�L> ' � <br /> . �" c /C : �-G�vJ cY L�; / � <br /> , / <br /> � � G-IJ�-Ld�`'l �`�7�' � J <br /> /�L2.��.�(�� `� V J <br /> $.5C . s� �l � �-�-�y ��� /'.�y/�� <br /> CITY OF ORONO APPLICATION FOR DEM LITION PERMIT <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 permits, 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: �•?��`� �-'� �J7� r� /�w�- <br /> Occupancy Type: �Residential Commercial <br /> OWNER'SNAME: �v.���c �� /� , !�� ,��.� ��� Phone:_y.��2 - y7� �� ,i��;d' <br /> , <br /> _ � MailingAddress: "' ���l /V Sl��;-e l>� City: I,�-:•.y z�•T�� �-��3y�% <br /> � � . - <br /> CONTRACTOR'S NAME: ��i:'� L���' ��� k" . -� j c,,��; i c `Bus.No.: /1•3 - (�:i y:i <br /> a11111�T AC�dTeSS:�._l j(:' o'�:G��r": c / o�:t�� Cl�: 1� i'i c���r4"� ��-�.9 f <br /> �����. �����t s�`-r� � ,�� L� 1�- -�S -��� � � <br /> / Demolition if planned by means o£ manual disassembly �� � <br /> )'` heavy equipment '-? � `'� � � <br /> �-�� � � � <br /> Permrts Issued: <br /> # Well Abandonment <br /> In return for issuance of said Demolition Permit,the undersigned owner hereby agrees as follows: <br /> l. The structure(s) shall be kept enclosed and/or secured until such time as demolition 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 backfilling. <br />