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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: goo � LOA)6 ,Ltj<a k!),kl <br /> Occupancy Type: 17- Residential Commercial <br /> 4%2y (tu�N <br /> OWNER'S NAME: kI/ C� `i'�'0 JJ Phone: q,,--q{76r-0 D.-LE <br /> Mailing Address: c On Lb�F gp�.b City: W7V-(7 -j }- 9I <br /> CONTRACTOR'S NAME: L 1 � Bus.No.: 3)-o—'9'33-(0 61z=733=,p.bcK <br /> Mailing Address: 17,772-- CO-r#�VE. City: Rp,S'la n) I A) 563 36 <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 follows: <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 />