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pet- U µ-9-' <br /> CITY OF ORONO APPLICATION FOR DEMOLITION PERMIT <br /> P.O. Box 66 (2750 Kelley Parkway) <br /> Crystal Bay, MN 55323 <br /> SPECIAL CONDITIONS & HOLD HARMLESS AGREEMENT <br /> General Instructions <br /> 1. You may be required to obtain other permits, i.e. well abandonmment, etc. <br /> 2. Work must not begin unless the permit card is available on the job site. <br /> 3. A 24 hour notice is required for all inspections. Call (612) 249-4600. <br /> JOB SITE ADDRESS: 44-4(P P o y-1 h Sere 7 r v-e <br /> Occupancy Type: Residential Commercial <br /> OWNER'S NAME: pj 1 1 ( I -ra n Z Phone: 12-- 7--7 <br /> Mailing Address: 449(a Porth Shore Dr lc City: <br /> CONTRACTOR'S NAME: Bus.No.: -1&9 -- 54-5-3S5 7 <br /> Mailing Address: IkOl bQ- Ave N City: Cf.VSfc-- SS�f Z7 <br /> Demolition if planned by means of: manual disassembly <br /> X heavy equipment <br /> Permits Issued: <br /> # Well Abandonment <br /> In return for issuance of said Demolition Permit,the undersigned owner hereby agrees as follows: <br /> 1. The structure(s) shall be kept enclosed and/or secured until such time as demolition is <br /> complete. <br /> 2. Demolition debris will be kept off adjoining property and/or the public rights-of-way unless <br /> specific prior approval is obtained in writing for temporary use thereof. <br /> 3. Foundations shall be completely removed from the ground. <br /> 4. All demolition debris shall be completely disposed of off site in accordance with all <br /> applicable PCA requirements. <br /> 5. Water wells must be abandoned in accordance with State Health Department regulations. <br /> 6. Inspection required when all debris has been removed, before backfilling. <br />