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11/09/2006 12:10 9524721810 PAGE 01 <br /> Nov-09-2006 11 ;212m Prom-CITY OF ORONO , +9522494618 T-022 P.001/010 P212 <br /> .'PcY4tC0 )-'— DM <br /> CITY OF ORONO APPLICATION FOR DEMOLITION PERMIT <br /> P.O. $ox 66 (2750 Kelley Parkway) <br /> Crystal Bay,MN 55323 l- f Ci ? <br /> SPECIAL CONDITIONS & HOLD HARMLESS AGREEMENT <br /> General Instructions ' <br /> 1. You may be required to obtain other permits, i.e. well abandonmrnent, 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: Pt7 :0(1. b27 [ 1X.Occupancy Type: I, Residential Commercial <br /> OWNER'S NAME: � " •` ZJ Nn Phone: ce,i3 -70' <br /> Id/ I L Y <br /> Mailing Address: -7 T PD. YY City: )i•,ti 42w <br /> CONTRACTOR'S NAME: , ,03 Bus.No,: 7 7 5606 <br /> Mailing Address: G. Ci <br /> Demolition if planned by means of: _ ,manual disassembly <br /> V- heavy equipment <br /> Permits Issued: (�`a4 >✓ <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 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 tae 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 />