Laserfiche WebLink
�O�TO City of Orono FOR CITY USE ONLY �y <br /> 1 y P.O.Box 66 Date Iteceived: 5-3D-�3 Permit# Q�` � <br /> 2750 Kelley Parkway <br /> Crystal Bay,MN 55323 Amount: $ SAC Crcdit: <br /> (952)249-4600 <br /> "� � Homeo��ncr(s)Signcd: ❑Ycs <br /> � <br /> F �,� Rcsolutions(if any)Signcd:�Ycs ❑Nonc Rcquircd <br /> ��kESHO�� Zoning Disclosurc Signed: ❑Yes ❑Nonc Rcquircd <br /> CITY OF ORONO - DEMOLITION PERMIT <br /> (Ail permits must be approved by the Building Official and/or Zoning Department) <br /> Job Site / Owner Information: <br /> Type: �Residential ❑ Commercial <br /> Site Address: �3/� �o�'� S�►.Sr—e .��:v�2 <br /> —� .-- <br /> Owner: �ra��-}�a.� e�2✓� �[1.v[c� Mailing Address: �YS=O u�Qa� 2cc�e �p,-�-� <br /> City: �r�o�"� /N � � Zip: 55�To <br /> Phone: 763. 5S?. �7�f1/ Email: ��-Qd . c[eJelcc�►�( �c-o�o�4b5. c.om <br /> Contractor/ Applicant Information: <br /> Contractor/App.:/1�IS.I'C�s'�-ayv► ��►t25,6.�L' Contact Person: l�,Q,� M J ��vl �l Q n <br /> Address: ,/-�io/�one :c(.s� T�u�P State License#: i�C(o3`� 7Z� <br /> City: � Zip: �3�j� Expiration Date: D <br /> Phone: �D��7 ��l�S Email:���/�n r�a a�(a��ns� c vs-�a�hflW125. C p� <br /> SPECIAL CONDITIONS & HOLD HARMLESS AGREEMENT <br /> General Lnstructions: <br /> 1. You may be required to obtain other permits, i.e.: well abandonment, sewer, etc. <br /> 2. Work must not begin unless the permit card is available on the job site. <br /> 3. A 24-48 hour notice is required for all inspections. Call (952) 249-4600. <br /> 4. Sewer must be discontinued at the City service by qualified contractor before demo permit is <br /> issued. <br /> Demolition by means of: ❑ Manual Disassembly [�,Heavy Equipment ❑ Other <br /> Permit(s) Issued: � Sewer Disconnection ❑ Well Abandonment# 3�3z.3 �b <br /> �.w:-�-�- �, r3- 003�,o <br /> In return for issuance of said Demolition Permit, the undersigned owner hereby agrees to: <br /> 1. Submit a survey, aerial photo or sketch showing all structures on the property. Note which <br /> structures are to be demolished. <br /> 2. Submit a survey, aerial photo or sketch showing proposed erosion control measures in <br /> accordance with Chapter 79, Construction Site Runoff Control. <br /> 3. Submit a copy of permit approval from the Minnehaha Creek Watershed District (MCWD). The <br /> City will not issue a demolition permit without a copy of the permit(s) from the MCWD or <br /> documentation stating permit(s) are not required. ��r, Q��,�s� 1 � �� <br /> I <br />