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CITY OF ORONO APPLICATION FOR DEMOLITION PERMIT <br /> P.O. Box 66 (1335 So Brown Rd) <br /> Crystal Bay, MN 55323 <br /> SPECIAL CONDITIONS & HOLD HARMLESS AGREEMENT <br /> ************************************************************************** <br /> General Instructions <br /> 1. You may be required to obtain other permits, i.e. burning, well <br /> abandonmment, etc. <br /> 2. Work must not begin unless the permit card is available on the job <br /> site. <br /> 3. A 24 hour notice is required for all inspections. Call 473-7357. <br /> ******************************** ******************************************�/ <br /> JOB SITB ADDRESS: ��o ?j 4) f,rte; L C,,,c D _,-.e_ <br /> 1.. Ck_ i2-tS1 <br /> Occupancy Type: ) V Residential Commercial 1 <br /> OWNER'S NAME: I l VA 1)10\1- Phone: 3 3 z - !? T ' G/ -yo, 7- <br /> Mailing Address: City: S� / <br /> CONTRACTOR'S NAME: 410y <br /> (10 S - ti�J 5 Bus. No. : v? 3_ C) /2 <br /> Mailing Address: I City: <br /> *************************************************************************** <br /> Demolition if planned by means of: ?ynanual disassembly &heavy equipment <br /> burning (by fire department) <br /> Permits Issued: <br /> # Burning Fire Department <br /> # Well Abandonment <br /> In return for issuance of said Demolition Permit, the undersigned owner <br /> hereby agrees as follows: <br /> 1. The structure(s) shall be kept enclosed and/or secured until such time <br /> as demolition is complete. <br /> 2. Demolition debris will be kept off adjoining property and/or the <br /> public rights-of-way unless specific prior approval is obtained in <br /> 6,-34writing for temporary use thereof. w(/l 4.e ,6,-- <br /> 3 <br /> Foundations shall be completely removed from the ground Lev ow-+.%� <br /> 4. All demolition debris shall be completely disposed of off site in <br /> accordance with all applicable PCA requirements. <br /> 5. Water wells must be abandoned in accordance with State Health <br /> Department regulations. <br /> 6. Inspection required when all debris has been removed, before <br /> backfilling. <br /> 7. Within 5 working days of superstructure removal , a final inspection <br /> shall be requested. The site shall be left clean and clear of all <br /> debris, with any excavation filled with earth level with the adjacent <br /> ground elevation (except when such excavation is to be used as part of <br /> a new building and such new building is actually under construction). <br /> 4 <br /> �0 <br />