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� �� ����� �09/ 7� <br /> . � � 9/�-D� <br /> CITY OF ORONO APPLICATION FOR DEMOLITION PERMIT �SD� <br /> P.O. Box 66 (2750 Kelley Parkway) � <br /> Crystal Bay, MN 55323 <br /> SPECIAL CONDITIONS & HOLD HARMLESS AGRE�MENT <br /> General Instructions <br /> l. You may be required to obtain other permits, i.e. well abaizdoiuninent, etc. <br /> 2. Work niust not begin unless the permit card is available on the job site. <br /> ;. A 24 hour notice is required for all inspections. Call (612) 249-4600. <br /> JOB SITE ADDItESS: '�i'��a ,;y c-� r-�;� > ,�;z���_: /l�l. �;,2�-.�c� ,�;r.�% �� 4' � <br /> Occupancy Type: iC Residential Commercial <br /> OWNER'SNAME: .�-r—r�; cT �--.»✓�F�^�� _✓" Phone: 9..5'� -v7/� p,s't� 5� <br /> Mailing Address:�t�r2� Sfi�?Fu-���' �R�v� City: s.�.�.Nc- �°.t,¢.r <br /> CONTRACTOR'SNAME: ,�..i�i„eo/� oc's,r„n•�,ct�i�D Bus.No.: 9s� - S�7/- czt s�/ <br /> Mailiilg Address: �l�IZo s���'t�•vc /�,t �.ve City; S/.i���-P.�'�.r <br /> Deinolition if plamled by means of: manual disassembly <br /> �_heavy equipment <br /> Permits Issued: <br /> # � Well Abandoiunent <br /> In return for issuance of said Deznolition Permit, the undersigned owner hereby agrees as follows: <br /> 1. The structure(s) shall be lcept enclosed and/or secured until such time as demolition is <br /> complete. <br /> 2. Demolition debris will be lcept 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 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 />