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� � ��to� �a <br /> —� �. <br /> ,¢0�` City of Orono FO�LISE ONLY <br /> `r P.O.Box 66 Date Received:3 /2' Permit#a�0/,►�—D� 3� <br /> ��, � 2750 Kelley Parkway <br /> ��y <br /> � ����?�F r Crystal Bay,MI��5323 <br /> Amount: $ SAC Credit: <br /> " of (952)249-4600 <br /> �a°"O�y Homeowner(s)Signed: ❑Yes <br /> Resolutions(if any)Signed:�Yes ❑None Required <br /> Zonin Disclosure Siened: ❑Yes ❑None Required <br /> �ITY OF ORONO - DEMOLITION PERMIT <br /> (All p�rmits must be approved by the Building Official and/or Zonino Department) <br /> \ <br /> ; ���Site/Owner:Information :: <br /> Type: �Residential ` ❑ Commercial <br /> Site Address: ! � �� �/� �i��d �S-3� <br /> Owner: �'1�L'�� J��i���:��� �Mailing Addre : �Yr �'T�'f �� <br /> �ei�enSK� <br /> City: �� d�� Zip: 5��3 l�'� <br /> Home Phone: �/ 2— ��j ��� 2-2� � lte te Phone: <br /> ''�,� (cZ�lg- 61 i Ye..{' �v'�S; �i C4� 2(d.55�Z3 <br /> .;�, ,'�r.�ctor�I;'Applicant Iriformation: <br /> Contractor/App.:���$�ro.,,� �,�.,rp.tlo ntact Person: �t G 4�►�-� <br /> Address: q�l !4 �'' I�E �. '�t Stat License#: ! 4 4'7 <br /> City: Y��/•Md✓a-- Zip: SS y! Expirati n Date: �-3* �T3 <br /> Phone: 7G 3- 5 i/�/- Q"7L J � Alternate P ne: 7G 3' o?�g'- $/33 <br /> �`' � ' 'SPE•CTAL COl�'DITIONS & HOLD HARMLE AGREEIVIENT <br /> General Instructions: <br /> 1. You may be required to obtain other permits, i.e.: well abandonme , sewer, etc. <br /> 2. Work must not begin unless ihe permit card is available on the job si . <br /> 3. A 24-48 hour notice is required for all inspections. Call (952) 249-46 . <br /> 4. Sewer must be discontinued at the City service by qualified contractor b ore demo permit is issued. <br /> Demolition by means of: �Manual Disassembly ❑ Heavy Equipment ❑ Oth <br /> i <br /> Permit(s) Issued: ❑ Sewer Disconnection ❑ Well Abandonment# , <br /> i <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 $2,000 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 />