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O City of Orono FOR CITY USE ONLY <br /> P.O.Box 66 Date Received: 2 L Permit# <br /> 2750 Kelley Parkway <br /> Crystal Bay, MN 55323 Amount: $ SAC Credit: <br /> (952)249-4600 <br /> Homeowner(s)Signed: ❑Yes <br /> s <br /> Resolutions(if any)Signed:❑Yes [I None Required <br /> t9kESH0�� Zoning Disclosure Signed: ❑Yes ❑None Required <br /> CITY OF ORONO - DEMOLITION PERMIT <br /> (All permits must be approved by the Building Official and/or Zoning Department) <br /> Job Site / Owner Information: <br /> Type: Q Residential ❑ Commercial <br /> Site Address: zo �IP// JL—r <br /> Owner: ��� 1 G F� r Mailing Address: Gv� <br /> City: CLD kk�o- Zip: iNN` J <br /> Phone: 7'&3 Email: al�IOhNT0o3 e= V/1 143 -CO-f-f <br /> Contractor/Applicant Information: <br /> kw/'t'ontact uoContractor/App.: �t1w4 C IS ��,� Person: <br /> Address: ' 7 - L State License#: <br /> City: Zip:�S l 2" Expiration Date: <br /> Phone: 71�>G- 6,-2:0 G Email: <br /> SPECIAL CONDITIONS & HOLD HARMLESS AGREEMENT <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 EJLeavy Equipment ❑ Other <br /> Permit(s) Issued: ❑'Sewer Disconnection ❑ Well Abandonment# <br /> In return for issuance of said 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 control 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). The <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. <br />