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' I <br /> J 4. Submit a$2,500 escrow and an escrow agreement signed by the property owner(copy attached). <br /> 5. Keep all structure(s)enclosed and/or secured until such time as demolition is complete. <br /> 6. Keep all demolition debris off adjoining property and/or the public rights-of way unless specific prior <br /> approval is obtained in writing for tempore ry use thereof. <br /> 7. Completely remove foundation(s)from the ground. <br /> 8. Completely dispose of all demolition debris off site in accordance with all applicable PCA requirements. <br /> 9. Abandon water wells lin accordance with State Health Department regulations. <br /> 10. Call for an inspectionwhen all debris has been removed,before backfilling. <br /> 11. Within 5 working days of superstructure removal, a final inspection shall be requested. The site shall be <br /> left clean and clear of all debris, with any excavation filled with earth level with the adjacent ground <br /> elevation (except when such excavation is to be used as part of a new building and such new building is <br /> actually under construction). <br /> 12. Abandon septic systems per Minnesota FNles Chapter 7080. All septic tanks must be pumped, crushed <br /> and filled with native soils. An inspection is required after the tanks are pumped and before the tanks are <br /> crushed and filled. <br /> 13. The undersigned owner shall and hereby does indemnify and hold harmless the City of Orono, its agents, <br /> employees and assigns from and against all claims, damages, losses or expenses, including attorney <br /> fees, against the City, its agents, employees and assigns arising out of or resulting from the demolition <br /> described herein as performed by the property owner, his employees,agents,subcontractors or assigns. <br /> PERMIT TYPE AND FEE CALCULATION <br /> 00 <br /> ® $75.00—Principal Structure $ � <br /> It $50.00—Accessory Structure x I (how many) 50 °� <br /> 1. Subtotal of above permit requested bD <br /> $ /25 <br /> 2. State Surcharge 1.00 <br /> 3. TOTAL PERMIT FEE (add lines 1-2 above) $ 12-(P <br /> The undersigned herby applies to the City of Orono for issuance of a Demolition Permit, agrees to do <br /> all the work in a strict accordance with the ordinances of the City and the regulations of the State of <br /> Minnesota,and certifies that all statements made on this application are complete, true and correct. <br /> Applicant's Signature: 41( gate: <br /> r <br /> Owner's Signature: Date: id////7 <br /> Approved By: / ffic <br /> .�;t! Date: /Z1/� / 7 <br /> Bui Ing - } <br /> 4 <br /> *Zoning Disclosure Required? El YES NO <br /> *This must be filled out by Zoning Department—For either answer,a Zoning Official must sign all applications. <br /> (A' Ikf3VVV I2 • ! •tl <br /> *Approved By: Date: <br /> (Zoning Official) <br /> Lad tow, 3Q(000 <br /> Form Last Updated: July 2015 B �ti1 11�( 1 * 2_01-1 - 01(o Oo <br /> 150784 <br />