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� �� �a I�-e� ---}-p �-� 1 (LC X ,�.,tn i L.�. ��� <br /> I I �� � _i <br /> � c ,� �_:�� ►�2 ' �� �-�1 �<� � � < <br /> CITY OF ORONO APPLICATION FOR DEMOLITION PERMIT <br /> P.O. Box 66 (2750 Kelley Parkway) <br /> Crystal Bay, N1N 55323 �� s�,�- / <br /> ,``-�i � (�(.! (C �� <br /> SPECIAL CONDITIONS & HOLD HARMLESS AGREEMENT <br /> ;�1 .� � �-, � <br /> General Instructions <br /> l. You may be required to obtain other pennits, i.e. well abandoiuninent, 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: .��a--� ,/U�.�`=' �� �.-��>c>/G �r�i v/� (� <br /> Occupancy Type: �Residential Corriinercial � � � y��� <br /> , � ��,�ti� : �� ; <br /> �l`� . � <br /> \. ` ��.�. � L.� <br /> OWNER'S NAME: �Ui�'�.�.� �• y�.:-� 7- � - � ; P11one; �y.�� - �.��-_ �r,.� t�� <br /> MailingAddress: ������~ C>��T �5,�/�/1� ,�•` City: /1�G`�,/�r �) <br /> CONTRACTOR'S NAME: I� .�. �JAr(,U i� �S T Bus.No.: �I,�a — �/�/- ?'7'� 3 <br /> Mailing Address: City:.�qti,c�-�, ���C,�. I�'!il/ <br /> Deinolition if planned by means of: manual disassembly <br /> _�heavy equipment <br /> Perinits Issued: <br /> # Well Abaildomnent3 <br /> 5 ��( �� �. �(�� o� �'3an.��z a� -C'�c�c-�( t , �.�c.. <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 Lmtil such time as deinolition is <br /> complete. <br /> 2. Demolition debris will be lcept off aclj 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 />