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D6 $ <br /> 3D sc <br /> C <br /> 1(.4c-o(.- ,. jo53 d <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 abandonment, 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 (952) 249-4600. <br /> JOB SITE ADDRESS: A-€55-• DiZc t'o Ceeu4-eo 36a4D ©��.�cs, (124.f 5,s1/ <br /> Occupancy Type: Residential Commercial <br /> OWNER'S NAME: —17 e. i—Lei misA Phone:65 41i3--9lL2. <br /> Mailing Address: 4,235 coo Coe ii,eeo -P64o City: O-e0,06, 7La ) 553 47/ <br /> CONTRACTOR'S NAME: '1E12.1404A) s-r. Co. Bus.No.:C7 c,3) 444—63 5. <br /> Mailing Address: 2774-1 l_34.)t veer - City: �l bA.�-1 , (ll.A ) <br /> Demolition if planned by means of: manual disassembly <br /> X 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. Sewer and water must be disconnected at the services at the street by qualified contractors. <br /> 7. Inspection required when all debris has been removed, before backfilling. <br />