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� <br /> . . �'D�s-sz <br /> A <br /> CITY OF ORONO APPLICATION FOR DEMOLITION PERMIT <br /> P.O. Box 66 (2750 Kelley Parkwayj <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: ��� $ /V o�T"I-� 5 j-�vRk <br /> Occupancy Type: \� Residential Commercial <br /> T <br /> OWNER'SNAME:ppV�b ct T��'tic /=rr'► "7^NbNrp5a�v Phone: /-��i- 8?o--�S.,!/S <br /> MailingAddress: 98ab 5vuT7� a?S4�a ,�=�Sr CitY:_5qu,pyt-�r�ff S�of,� <br /> CONTRACTOR'S NAME: OH/-J��D.S c°la n�F Bus.No.: yS'�— �70-624�b�' <br /> Mailing Address: �,j a T� S i`Z i�"N 7`v L�'.r� fi'l� City:„S/"/o�i t r.��v o I> <br /> Demolition if planned by means of: manual disassembly <br /> �'heavy equipment <br /> Permits Issued: <br /> # Well Abandonment <br /> In return for issuance of said Demolition Permit, the undersigned owner hereby agrees as follows: <br /> 1. 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 adj oining 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 />