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�r� 5-' -°7 <br /> � ' 40� City of Orono F C TY USE ONLY / <br /> P.O.Box 66 Date Received: `���Permit <br /> �" � 2750 Kelle Parkwa / <br /> �,<.�. Y v Ss p�c�Z�3t•�7 <br /> � ���.�,�`'_ � Crystal Bay,MN 55323 Amount: $ ��'� SAC Credit: ��i31� <br /> ��rr�y�..$o~ (952)249-4600 <br /> �axo Homeowner(s)Signed: ❑Yes <br /> Resolutions(if any)Signed: 0 Yes ❑None Required <br /> Zonin Disclosure Si ed: Yes ❑None Re uired <br /> CITY OF ORONO - DEMOLITION PERMIT <br /> (All permits must be approved by the Building Official and/or Zonin�Department) <br /> Job Site/ Owner Infornzation: <br /> Type: [� Residential ❑ Commercial <br /> Site Address: � y � �G"�'�'� ��� <br /> r ,,,w.... <br /> Owner: ��: r��.W�. �:��'�:rt:.��'�� Mailing Address: ���' Gs � ��� <br /> City: �.`'���d`!� Zip: ���-�� <br /> �,u., �, <br /> Home Phone: `"�`��`�c� �. �r ,'�` •�* _ �: ' ,y���` Alternate Phone: �/c�-_ ���I`�.��� <br /> Contractor/Applicant Infonnation: <br /> Conh•actor/App.: �' � � Contact Person: <br /> Address: State License #: <br /> City: Zip: Expiration Date: <br /> Phone: Alternate Phone: <br /> SPECIAL CONDITIONS& HOLD HARMLESS AGREEMENT -� <br /> General Instructions: <br /> 1. You may be required to obtain other permits, i.e.: well abandoiuzient, sewer, etc. <br /> 2. Work must not begin Linless the permit card is available oiz 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 pennit is <br /> issued. <br /> Demolition by means of: � Manual Disassembly � Heavy Equipment ❑ Other <br /> Permit(s) Issued: ❑ Sewer Disconnection �Well Abandonrrient #��_(�,e�� �``�,���j <br /> 76� -a�y-abc�� <br /> In return for issuance of said Demolition Pernlit, the undersigned owner hereb�,- a�rees as follows: <br /> � l. T}ie structure(s) shall be kept enelosed andior secured until sucii time as demolition is <br /> complete. <br />