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4009 <br /> 40 -70c -) <br /> 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: id "5 u / 1 ���'� L.141C£ A .41. <br /> Occupancy Type: ,K Residential Commercial <br /> OWNER'S NAME: Dn l cLL d /2-(,5 �ct.cd Phone: <br /> Mailing Address: w 0 5 /cF Z�� Zo,(c:e / W City: CiJc-t. zez. <br /> CONTRACTOR'S NAME: D-fr vi (o(IS C D P51 �s Bus.No.: q 5 ) ' <br /> Mailing Address: 2-t) i G 2. s� -e e_- City: i.e)ccy 74;4e, ,C1 A-) 5-5- ?/ <br /> Demolition if planned by means of: }X manual disassembly <br /> x heavy equipment <br /> Permits Issued: <br /> # PA 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 />