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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: 4�j:!2 : " I LIMN <br /> Occupancy Type: Residential Commercial <br /> OWNER'S NAME: A:d P EVL A Phone:`7 -7-Z <br /> Mailing Address: G :f?_y -5- (LL . L-Ie City: m Dcot--F <br /> CONTRACTOR'S NAME: 4J�,A /d--a] Bus.No.: Y91 Z43 15-67 '767.3 <br /> Mailing Address:_] �°� I J . 514264 264 —City: y"611 a <br /> Demolition if planned by means of manual disassembly <br /> heavy equipment <br /> Permits Issued: <br /> # Well Abandonment <br /> In return for issuance of said Demolition Permit,the undersigned owner hereby agrees as follo-vvs: <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 />