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� <br /> � j CITY OF ORONO * 2 PJ 1 4 - 0 1 3 6 5 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 11/25/2014 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 1685 CONCORDIA ST <br /> PIN : 17-1 17-2.i-22-0022 <br /> LEGAL DESC : COFFEES ADDN TO SHADY WOOD LAK <br /> : LOT 016 E3LOCK 000 <br /> PERMIT TYPE : TREE REMOVAL WITHIN 0-75' <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYNE : TREE REMOVAL WITHIN 0-75 <br /> APPLICANT <br /> TOTAL <br /> PALM, MR. & MRS. TOM Payment(s) <br /> 1685 CONCORDIA ST <br /> WAYZATA, MN 55391- <br /> OWNER <br /> PALM, MR. & MRS. TOM <br /> 1685 CONCORDIA ST <br /> WAYZATA, MN 55391- <br /> AGREEMENT AND SWORN STATEMENT <br /> I he work for which this permit is issued shall be per(ormed according to <br /> the approved plans and specitications,applicable Cit��approvals,and the <br /> State Building Code. This permit is for only the work described and does <br /> not grant pennission for additional or related�vork���hich reyuires separate <br /> permits. All provisions of laws and ordinances governing this type of work <br /> shall be compied with�vhether or not specified herein."I�his permit will <br /> expire and become null and void if construction authorized is not <br /> commenced within I 80 days of the da[e of issuance,or if construction is <br /> suspended for a period of 180 da}'s at anp time afrer work has commenced. <br /> The applicant is responsible Yor assuring all required inspections are <br /> requested in conformance with the State[3uilding Code.This permit may be <br /> rcvukcd at any time for due cause. <br /> / / <br /> Applicant Permitee Signature Date Issued 13y Signature Dat� <br />