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5'10 <br /> 0 city of Orono o CITY E ONLY /y <br /> P.O.Box 66 t <br /> Date Receive A—/ Permit#�/ (.,w.9 <br /> W <br /> 2750 Kelley Parkway <br /> Crystal Bay,MN 55323 1 Amount: $ SAC Credit: <br /> (952)249-4600 <br /> yI Homeowner(s)Signed: ❑Yes <br /> Resolutions(if any)Signed:0 Yes ❑None Required <br /> Kf S H o - �' Zoning Disclosure Signed: ❑Yes 0 None Required <br /> -5 2.13110-001-5E1 <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: Residential ❑ Commercial <br /> Site Address: a, 5 OU cosi-rd Dili Rota) S <br /> Owner: / VOrmQI\ R','Y Mailing Address: .N C h€T Y\ de Slaney <br /> City: --50.&S1 Zip: DIY) / W IZfr kJ <br /> Phone: Email: /Vor inun 0_ liar @ Cirri,i•Lo►�'! <br /> Contractor/Applicant Infprmation: <br /> ISO <br /> Contractor/App.: WI9 tSonS It1C. Contact Person: Carl Fix <br /> Address: 11 1101 CO Rd :3 State License#: — " "'` <br /> 3 3 <br /> `i <br /> City: rCinS Zip: Expiration Date: <br /> Phone: .7380 p. Email: b0iil,)Qfj5OV S 0 IY131r.Cod <br /> SPECIAL CONDITIONS & HOLD HARMLESS AGREEMENT <br /> General Instructions: <br /> 1. You may be required to obtain other permits, i.P • 1 (i lwer, etc. <br /> 2. Work must not begin unless the permit c2- ' t 44' <br /> 3. A 24-48 hour notice is required for all ins <br /> 4. Sewer must be discontinued at the City se � / )re demo permit is <br /> issued. `' <br /> Demolition by means of: Ill Manual Disassembly je. (Vj <br /> 4 <br /> Permit(s) Issued: ❑ Sewer Disconnection ❑ Well A, <br /> In return for issuance of said Demolition Permit, the , .. owner hereby agrees to: <br /> 1. Submit a survey, aerial photo or sketch showinc .Aructures 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 />