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1si r\-tom- 01'251 14 <br /> City of Orono 03 TY USE ONLY f0 ,7 Rio <br /> t Ait,,,OTAt <br /> P.O.Box 66 Date Received/ , Permit ft !//�� / b <br /> 2750 KelleyjParkway <br /> Crystal Bay,MN 55323 Amount: $ SAC Credit: <br /> (952)249-4600 <br /> Homeowner(s)Signed: ❑Yes <br /> loc., <br /> 6L4') Resolutions(if any)Signed:❑Xes 0 None Required <br /> �g/CPQ„E s ti UV-�,/ Zoning Disclosure Signed: 0 Yes 0 None Required <br /> 0oo E 1.- g0/49 <br /> CITY OF ORONO - DEMOLITION PERMIT <br /> (All permits must be approved b y the Building Official and/or Zoning Department) <br /> Job Site-/:,-Owner:Informalonc <br /> Type: RI Residential ❑ Commercial <br /> • <br /> Site Address: I5a5 Lor L I ie 6IVet <br /> Owner: tp�� LI cU]�i,,trloSUi.no,S Mailing Address: q30 P1PA ► Q <br /> T,Poi <br /> City: WayZg}-a Zip: 55 <br /> Phone: (OW--tiCg' q�55Email ytWt8 GLO1• CO(Y\ <br /> Conti for I ApplicantInformation <br /> Contractor/App.: MT Carpen4 r tirckigpfj inc... Contact Person: ro C <br /> Address: 493-3oi Verdrt S4-Nk) State License#: <br /> City: IS -; Zip: 55oL1b Expiration Date: <br /> Phone: 91,5- 419 - lolO3 Email: hias 1n-FCarpn-k'. Carr <br /> "_ SPECIAL CONDITIONS&HOLD,HARMLESS AGREEMENT . . ,, <br /> General Instructions: <br /> 1. You may be required to obtain other permits, i.e.:well abandonment,€r)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 /> (� Sewer must b discontinued at the City service by qualified contractor before demo permit is issued. <br /> L. 6 R etr'O\9.49 oRQ 01 0 <br /> Demolition by means of: 0 Manual Disassembly IA Heavy Equipment 0 Other <br /> Permit(s)Issued: gl Sewer Disconnection 0 Well Abandonment# <br /> In return for issuance of said Demolition Permit,the undersigned owner hereby agrees to: <br /> J 1. Submit a survey, aerial photo or sketch showing all structures on the property. Note which structures are <br /> to be demolished. <br /> ✓2. Submit a survey, aerial photo or sketch showing proposed erosion control measures in accordance with <br /> Chapter 79, Construction Site Runoff Control. <br /> 1-3-.3 Submit a copy of permit approval from the Minnehaha Creek Watershed District (MCWD). The City will <br /> L0 cnot issue a demolition permit without a copy of the permit(s) from the MCWD or documentation stating <br /> .odor permit(s)are not required. <br /> Form Last Updated: July 2015 ( n L 0 <br /> 150784 1 ci <br />