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� � . � � i <br /> . -� <br /> � � <br /> C�Ty pF URONO A�PLxCAT�ON FOR XIEMULITIUI�T PERMIT <br /> P.O. Bax 66(2750 I�,elley Park«aY) <br /> Crystal Bay,MN 55323 <br /> Sl?EC�AL CO�IDITiONS& HO�D I�ARN�LESS AG1�iEEMENT <br /> General Xr�structions <br /> 1. You may be xequired to pbtain other permits,i.e.w�ll abandonmment,etc. <br /> 2. Worl�must not be$iu�unless the permit card is available on tlxe job site. <br /> 3, A 24 hour norice is required for all inspections. Call(612)249-460U. <br /> Jo�s szrE ann�ss:.�y �S N o r t� S h ��r t�r►v <br /> Dccupancy Type: .� -Residential Comnaercial <br /> OWNE�t'S NAIVIE: U � �✓' l•�c 1 Phone: ' O�7�C.�R <br /> Mai�ingAddress D�'. iry: M o c..ncl — <br /> CONTRA.C'�UR'SNAME:��lrr CG�L '� � ��us.No.: 63 q � - OoS <br /> iv�ailing Addr�ss• <br /> � City: <br /> Demolition�£�lazuzed by meax�.s�f: manual disassembly <br /> �� �; ��heavy equipxrient <br /> �� �� � <br /> � �/� Permits Issued: ear ho►'►1co�n e✓� �'`�e-1l i S t1J o t- 4-o be /��►cV�,l�y'b�, <br /> # Well Abandor�ment �� P • <br /> � <br /> In xeturn for issuartce of said Demol�tion Permit,the undersigncd ownet'hereby agrees as follows: <br /> �. The structure(s) shall Ue ke�t enclosed and/or secured untxl suck� time as demolition is <br /> complete. <br /> 2, I3emolition debris will be kept off adjoining propertY snd/ox the public rights-o�way unless <br /> specific prior approval is obtai�ned in writiag for iemporary use thareof <br /> 3, �oundations shall be c�3m,pletely removed fxom the ground• <br /> q, All demolition debris sh2111 be completely disposed of off sit� in accordance with a11 <br /> �pplicable PCA requirPm�ents. <br /> 5, Watex wells must be abandoned in accordac�ce with State�Iealth Departmcnt regulations. <br /> �. Inspection required wlzen all debris l�as been removed,before bacic�lling. <br /> Bl9-d ll0/Z00'd 889-1 919V6Ytt96+ ONOaO �0 Ali�-�o�j wdgZ:ZO IODt-9Z-9ad <br />