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CITY OF ORONO * 2 0 1 5 - 0 0 1 6 3 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: OS/14/2015 <br /> ORONO, MN 55356- <br /> � (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 4565 BAYSIDE RD <br /> pi� : 06-117-23-21-0010 <br /> LEGAL DESC : BAYSIDE BERRY FARM <br /> : LOT 2 BLOCK 1 <br /> PERMIT TYPE : DEMOLITION <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : DEMO-PRINCIPAL STRUCTURE <br /> ACTIVITY : 645-SINGLE FAMILY HOUSES(ATT&DET <br /> NOTE: DEMO PRMCIPAL STRUCTURE AND POOL <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 /> RELOCATION TO 4555 BAYSIDE RD <br /> SEPTIC AREA-NO SAC DUE <br /> APPLICANT DEMOLITION - PRINCIPAL STRUCTURE 75.00 <br /> STATE SURCHARGE DEMO 5.00 <br /> DENALI CUSTOM HOMES, INC. DEMOLITION-ACCESSORY STRUCTURE 50.00 <br /> 18283 MINNETONKA BLVD. TOTAL 130.00 <br /> DEEPHAVEN,MN 55391- <br /> (952)476-2679 Payment(s) <br /> Minnesota State License#: BUIL-20175394 CHECK 11300 80.00 <br /> CHECK 11507 50.00 <br /> OWNER <br /> DOUBECK,TIM&MARY <br /> 4565 BAYSIDE RD <br /> MAPLE PLAIN, MN 55359- <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 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 w th the State Building Code.This permit may be � <br /> revoked at any time for due; use. <br /> � _� `_�,.,., <br /> ------ ,py', i�(� 1.��.�.-�_� 5 �l �l � IS <br /> Ap t i e Sign ture Date Issued By Signature Date <br />