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� � ��� <br /> �i�/� <br /> nV�.� v <br /> �� <br /> �O City of Orono FoG2��USE ONLY S <br /> - � P.O.Bax 66 Date Roceived: Permitt! ���3— ��� <br /> 0 2750 Keiley Parkway <br /> Crystal Bay,MN 55323 Atnount: $ SAC C?edit: <br /> (952)249-4600 <br /> � Horneowner(s)Signed: ❑Yes <br /> ��' �,� Resolutions(if eny)Signed�Yes ❑None Required <br /> ��'�FSH�0.� Zonin Disclosure Si ned: ❑Yes None R uirod <br /> `:�J v�' I�KJ�1 V`►i <br /> CITY OF ORONO - DEMOLITION PERMIT <br /> (All permits must be approved by the Building Offidal and/or Zoni�g Department) <br /> Job Site/Owner Information: <br /> Type: �{Residential ❑ Commercial <br /> Site Address: '�39� /✓S2 t�f� Sffa�Z� /��.1 t/E <br /> owner: T��" g��3Hr2�} eoRN�35 Mailing Address: <br /> Ciry: O}�0�1'a Zip: <br /> Phone: ��Z� q4 0— (0 7�$ Email: �r3�RN�SS�ih C9M�4'l�.,CO�f. <br /> Contractor/Applicant Information: <br /> Contractor/App.:� � [S �/'/Q�«7?I�,,,,�A,� Contact Person: ��F�i'�I�S <br /> Address: �('71� r'U(.C/��T-��Z� State License#: <br /> City: '" Zip: _55�/� Expiration Date: <br /> Phone: (�Sz,��S ��/� z.- EmaiL ��J�L.t�.��SL-"Y/� 1l64��L� ,J1.1� <br /> ` <br /> SPECI�4L CONfll7'IC�NS 8'HOLD HARMLE3�AGF�EEMENT <br /> General Instructions: <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# <br /> In return for Issuance of sald 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 cont�ol 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). ''he <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. �1 � � r_D <br /> J l0 <br />