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CITY OF ORONO PERMIT NO.: 2010-00376 <br /> 2750 KELLEY PARKWAY <br /> : <br /> ' � ORONO, MN 55356- DA7'E IssUEn: 06/08/2010 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 2172 SHADYWOOD RD <br /> PIN : 17-117-23-42-0010 <br /> LEGAL DESC : WILEYS PARK LAKE MTKA <br /> : LOT 000 BLOCK 001 <br /> PERMIT TYPE : DEMOLITION <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : DEMO-PRINCIPAL STRUCTURE <br /> ACTIVITY : 645-SINGLE FAMILY HOUSES(ATT& DET <br /> NOTE: <br /> I. FOUNDATIONS/ALL DEMO DEBRIS TO BE REMOVED FROM GROUND&DISPOSED OF OFF SITE,PER PCA REGULATIONS. <br /> 2. WELLS MUST BE ABANDONED. <br /> 3. INSPECTIONS DONE BEFORE BACKFILLING. <br /> DEMO PRINCIPLE STRUCTURE& 1 DETACHED GARAGE <br /> ESCROW PERMIT 2010-00377 <br /> BUILDING PERMIT 2010-00336 <br /> APPLICANT DEMOLITION- PRINCIPAL STRUCTURE 75.00 <br /> TRUE NORTH HOMES INC MISC FEE 50.00 <br /> 410 LAKEVIEW AVENUE <br /> TONKA BAY, MN 55331- STATE SURCHARGE DEMO 0.50 <br /> (612)281-2540 TOTAL 125.50 <br /> Minnesota State License#: 20636839 <br /> OWNER <br /> DORE, STEVEN <br /> 8351 WEST 109TH STREET <br /> BLOOMINGTON,MN 55438- <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for which this permit is issued shall be performed according to <br /> the approved plans and specifications,applicable City approvals,and the <br /> State Building Code. This permit is for only the work described and does <br /> not grant permission for additional or related work which requires separate <br /> permits. All provisions of laws and ordinances goveming this type pf work <br /> shall be compied with whe[her or not specified herein.This permit will <br /> expire and become null and void if construction authorized is not <br /> commenced within 180 days of the date of issuance,or if construction is <br /> suspended for a period of I 80 days at any time afrer work has commenced. <br /> The applicant is responsible for assuring all required inspections are <br /> requested in co formance with the State Building Code.This permit may be � <br /> revoked�t time or du ause. � ` �— <br /> � - / S� / �cv � (��'Yl�F�i � � l0 <br /> pplica ermitee Signature Date Issued By ignature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />