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City of Orono FOR CITY USE ONLY yy��/`z / 0)61 <br /> PO.BDate Receivedal 2-/3 Permit# (fi ✓^ v I <br /> 0 2750 Keoxiley66 Parkway <br /> Crystal Bay, MN 55323 Amours: •�U�• SAC Credit: <br /> (952)249-4600 <br /> Homeowner(s)Signed: Yes <br /> SF C. Resolutions(if any)Signed:0 es None Required <br /> lq k£S H Zoning Disclosure Signed: ( 1 es 0 None Required <br /> CITY OF ORONO - DEMOLITION PERMIT <br /> (All permits must be approved by the Building Official and/or Zoning Department) <br /> Job Site/ Owunerinformation: <br /> Type: 1� Residential ❑ Commercial <br /> Site Address: 66,C 7(- i,ar' J ark ic)ci ci <br /> Owner: �I�W V►loth- KPS olds Mailing Address: 3630 f—'VIb r' °, <br /> City: (Ai;ft 2.t4- Zip: <br /> Home Phone: &!' 2--' L4- s--7L/7 Alternate Phone: <br /> Contractor/Applicant Information: <br /> Contractor/App.: Su obt- �f IJ(Ai r ✓s Contact Person: IZ 6 <br /> Address: 5/ ,41a ci 9- g&K 382 State License #: } 6.36 /61 <br /> City: /1 �i Zip: cr3c1 Expiration Date: 3/3///-Y <br /> Phone: 76 3'" 17- Alternate Phone: (o/2-- 20 q-S-q/ <br /> SPECIAL CONDITIONS & HOLD HARMLESS AGREEMENT <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 <br /> issued. <br /> Demolition by means of: ❑ Manual Disassembly ZHeavy Equipment ❑ Other <br /> Permit(s) Issued: ❑ ion ❑ 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 <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 $2,500 escrow and an escrow agreement signed by the property owner. <br /> 4. Keep all structure(s) enclosed and/or secured until such time as demolition is complete. <br />