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O City of Orono r R P SE ONLY <br /> P.O.Box 66 Date Received' - Permit# :Yon:Reg:I:7 <br /> 0 2750 Kelley Parkway I p0 <br /> Crystal Bay,MN 55323 Amount: $ I�A SAC Cred „(952)249-4600,)tsilc., <br /> Homeowner(s)Signed: des <br /> e. �tResolutions(if any)Signed:[]Yes ❑ <br /> 'FESHo�� 09-4, Zoning Disclosure Signed: ❑Yes <br /> /�❑None aired <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: 4/ZS" Did e gysini L l7 )y JZO'nel 54)1-t?"M <br /> Owner: 1O Oil Al AVt9L sr-17-1 Mailing Address: /,?1/.571 o$i iC/7 Fr Iza <br /> City: 5143V r9b(= Zip: 553 7 g <br /> Phone: Email: <br /> Contractor/App.: • __0-,,L ' •4" .' 'it Contact Person: 3'1E\11 13U1Z71) <br /> Address: 3L/70 Itaix..try Eime1 Z/ State License#: <br /> City: / /11/E/2 Zip: .SS 3 416 Expiration Date: <br /> Phone: (�31S1) q&S` 3// Z. Email: 5i VL(D 131<ti2K)cl3ed KJ l'xi71106. il-ACT <br /> i,r.,�r"`> h. , . a ,i= `t°" J� :y.L,_..i >.x.l .F 1 .:�,. hg. ln + I i x, ",u„ - <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 issued. <br /> Demolition by means of: [Manual Disassembly (.Heavy Equipment ❑ Other <br /> Permit(s) Issued: ❑ Sewer Disconnection 0 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 structures are <br /> to be demolished. <br /> 2. Submit a survey, aerial photo or sketch showing proposed erosion control measures in accordance with <br /> Chapter 79, Construction Site Runoff Control. <br /> 3. Submit a copy of permit approval from the Minnehaha Creek Watershed District (MCWD). The City will <br /> not issue a demolition permit without a copy of the permit(s) from the MCWD or documentation stating <br /> permit(s)are not required. <br /> Form Last Updated: July 2015 11 (11-t <br /> 150784 <br />