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� ' CITY OF ORONO * Z 0 1 4 — 0 0 4 5 3 * <br /> ' ' 2750 KELLEY PARKWAY DATE ISSUED: OU20/2015 <br /> ORONO, MN 55356- <br /> (952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 2216 SHADYWOOD RD <br /> PIN : 17-117-23-42-0004 <br /> LEGAL DESC : WILEYS PARK LAKE MTKA <br /> : LOT O11 BLOCK 001 <br /> PERMIT TYPE : ZONING PERMIT <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : LAND ALTERATION(0-500 CU YDS) <br /> NOTE: HARDCOVER PERM[T&MINOR LAND ALTERATION <br /> APPLICANT MINOR LAND ALTERATION 50.00 <br /> ENGINEERING REVIEW COSTS <br /> GRAY GARDENS TOTAL 50.00 <br /> PO BOX 207 <br /> VICTORIA,MN 55331- Payment(s) <br /> CASH 50.00 <br /> OWNER <br /> SHABAZ,REBECCA L <br /> 2216 SHADYWOOD RD <br /> WAYZATA, MN 55391- <br /> AGREEMENT AND SWORIv 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 governing this type of work <br /> shall be compied wi[h whether 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 180 days at any time after work has commenced. <br /> The applicant is responsible for assuring all required inspections are <br /> requested in conformance with the State Building Code.This permit may be <br /> revoked at any time for due cause. <br /> � <br /> / ,�C� l lS <br /> A plicant Permitee S�gnature Da Iss d By Signature Date <br />