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I <br /> � 08i31i95 10:0? Tlf CITY OF ORONO 612-473-7357 002 <br /> � �� <br /> � J . <br /> CITY OF ORONO A�'PLiCAT�ON FOR DEMOi,iTInN PERMIT <br /> P.O. Box 66 (2750 Kelley Parkway) <br /> Crystal Bay, MN 55323 � <br /> SPECIAL COND�'I'iONS & HOLD HARMLESS AGREEMENT <br /> General instructions <br /> 1. You may be ttiquired to ubtain other perriilts, i.e. burning, well abandonmment, etc. <br /> Z, Wock must not begin unless the permit card is available on the job site. <br /> 3. A 24 hour notice is requirrd for all inspections. Cai] 473-7357. <br /> JOB S1TE ADDRFSS: � 3`F Z-- �O�-� �''t'� I��''"� - <br /> Occupancy Type: _,_.��Residential �Commercial <br /> OWNER'S NAME:�_ Phone: 29'?�v�i'�l <br /> Mailutg�Address:� l,o -��+ C1ty: mn 5S iblo � <br /> COTV'!'RACTOR'S N�+iN�: �� t�� � Bus. No.: 42�2?�/�-- <br /> MaiJing; Address: )�,oau �l�vr' �1.r� _ , City:0?.,,��.,c . t-w►-. �3�`1� <br /> , Demoli�on if planned by mr.a��s of: manual disassembly <br /> � _ heavy cquipment <br /> � � burning (by firc department) <br /> I <br /> Permits I Issued: <br /> ' � Burning Fin Aepartment . <br /> � wcu Abenaonmenc <br /> I In retucip for issuance of said Deraolition Pcrmit, the undersigned owncr hereby agrees as <br /> � foltowsi <br /> 1, The swcture(s) shall be kept enclosed and/or securod until such time as demoGtion is <br /> � ¢omplete. <br /> i <br /> 2. Demolition debris will be kept off adjoining property and/or thc public rights-of-way <br /> � . 1�nless specific prior approval is obtained 'w writing for temporary use thcreof. <br /> I <br /> 3. Foeu�datiuns sliall be complctcly removed from the �round. <br /> ; q, pll demolition debris shatl be eompletely disposed of off site 'vn accordamce with all <br /> applicable PCA requircm�nts. <br /> I : <br /> ' S, Water wells must tx abandoned in aeeordance wi[h State Health Depgrtment regulations. <br /> I <br /> ' 6. lnspeciion required whcn al1 debris has been rcmoved. before backfiiling. i <br /> ; <br /> ; i <br /> � I I <br /> � ' <br /> , I <br /> I ' I <br />