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CITY OF ORONO * 2012 - 00626 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 07/02/2012 <br /> ORONO,MN 55356- <br /> (952)249-4600 FAX: (952) 249-4616 <br /> ADDRESS 400 WILLOW DR S <br /> PIN 03-117-23-23-0021 <br /> LEGAL DESC UNPLATTED 03 117 23 <br /> LOT MB BLOCK MB <br /> PERMIT TYPE DEMOLITION <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : DEMO-PRINCIPAL STRUCTURE <br /> ACTIVITY : 649-ALL OTHER BUILDING&STRUCTURES <br /> NOTE: <br /> 1. 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 /> NOTE: A 24-48 HOUR NOTICE IS REQUIRED FOR ALL INSPECTIONS. CALL(952)249-4600. <br /> SEWER MUST BE DISCONTINUED AT THE CITY SERVICE BY QUALIFIED CONTRACTOR BEFORE DEMO PERMIT IS ISSUED. <br /> CHECK TO MAKE SURE THIS PERMIT HAS BEEN PULLED BEFORE ISSUING THIS PERMIT. <br /> VOLAPPLICANT DEMOLITION-PRINCIPAL STRUCTURE 75.00 <br /> 1030 CO RDD 83 <br /> INC. STATE SURCHARGE DEMO 5.00 <br /> 1030 CO 8 <br /> MAPLE PLAIN,MN 55359 DEMOLITION-ACCESSORY STRUCTURE 150.00 <br /> (763)479-1547 TOTAL 230.00 <br /> Minnesota State License#: 1709 <br /> OWNER <br /> NELSON,ARTHUR&EDITH <br /> 400 WILLOW DR S <br /> LONG LAKE,MN 55356- <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 governing this type of work <br /> shall be compied with 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 �(Y� <br /> revoke at any time for due,�ause. <br /> Applicant Permitee Signature Date ±j <br /> Issued By Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />