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` � ����� � os <br /> �, � � <br /> CITY OF ORONO APPLICATION FOR DEMOLITION 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 abandonment,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(952)249-4600. <br /> JOB SITE ADDRESS: �� ` g ' v 01`� S�a P�- �i":v� � �Un�U <br /> Occupancy Type: Residential Commercial <br /> OWNER'S NAME: l�-'a SZ � rl3��wv�;h Phone� � a'���- � � �� <br /> Mailing Address:3$ � D* �,.o r . �� City:��-�,,.�a <br /> CONTRACTOR'S NAME: I` ��C�- Bus.No.: �b� - a 9 s"34�� <br /> Mailing Address: � � "C' h.a City:�,�.�.��,,,�,l-a <br /> Demolition if planned by means of: manual disassembly <br /> �heavy equipment <br /> Pernuts 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 adjoining property andlor 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 FCA requirements. • , <br /> 5. Water wells must be abandoned in accordance with State Health Department regulations. <br /> 6. Sewer and water must be disconnected at the services at the street by qualified contractors. <br /> 7. '; �Inspectipn required when all debris has been removed,befor�backfilling. <br /> .. F�..7�. ' . - ... ...f � . � • <br />