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�O`V City of Orono FOR CITY USE ONLY P.O. Box 66 Date Received: Permit 2750 Kelley Parkway Crystal Bay, MN 55323 Amount: $ SAC Credit: (952)249-4600 yHomeowner(s)Signed: ❑Yes Resolutions(if any)Signed:❑Yes ❑None Required tq'FESHO Zoning Disclosure Signed: ❑Yes ❑None Required GStxpw,fid✓ CITY OF ORONO - DEMOLITION PERMIT (All permits must be approved by the Building Official and/or Zoning Department) Job Site / Owner Information: Type: AR,esidential ❑ Commercial Site Address: U 6L./o MWN Owner: _ �A&41J< t C- Mailing Address: City: �� Zip: Phone: ( !IdQ L +Coo Email: S\J0yyG Contractor/Applicant Information: u-`+� ` e OD h►14 s how,Com Contractor/App.: (A VQ liL Wl a-Y-� Contact Person: Address: I, ��((.eo �T. .�'/LI'�1I1-SIS •Rn.ate License #: City: ISN Zip: `2E �65 Expiration Date: Phone: Email: SPECIAL CONDITIONS & HOLD HARMLESS AGREEMENT General Instructions: 1. You may be required to obtain other permits, i.e.: well abandonment, sewer, etc. 2. Work must not begin unless the permit card is available on the job site. 3. A 24-48 hour notice is required for all inspections. Call (952) 249-4600. 4. Sewer must be discontinued at the City service by qualified contractor before demo permit is issued. Demolition by means of: ❑ Manual Disassembly [Heavy Equipment ❑ Other Permit(s) Issued: �h Sewer Disconnection ❑ Well Abandonment# In return for issuance of said Demolition Permit, the undersigned owner hereby agrees to: 1. Submit a survey, aerial photo or sketch showing all structures on the property. Note which structures are to be demolished. 2. Submit a survey, aerial photo or sketch showing proposed erosion control measures in accordance with Chapter 79, Construction Site Runoff Control. 3. Submit a copy of permit approval from the Minnehaha Creek Watershed District (MCWD). The City will not issue a demolition permit without a copy of the permit(s) from the MCWD or documentation stating permit(s) are not required.