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CITY OF ORONO PERMIT NO.: 2010-01141 <br /> 2750 KELLEY PARKWAY <br /> - ORONO, MN 55356- �ATE ISSUED: 1 U19/2010 <br /> � 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 3095 NORTH SHORE DR <br /> PIN : 09-117-23-32-0014 <br /> LEGAL DESC : REG. LAND SURVEY NO. 0670 <br /> : LOT 000 BLOCK 000 <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 /> l. FOUNDATIONS/ALL DEMO DEBRIS TO 13E REMOVED FROM GROUND&DISPOSED OF OFF SITE,PER PCA REGULATIONS. <br /> 2. WELLS MUST BE ABANDON�D. <br /> 3. INSPECTIONS DONE BEFORE BACKFILLING. <br /> � <br /> APPLICANT DEMOLITION - PRINCIPAL STRUCTURE 75.00 <br /> WESLEY BERDICKSON <br /> 6705 HIGHWAY 12 STATE SURCHARGE DEMO 5.00 <br /> MAPLE PLAIN, MN DEMOLITION -ACCESSORY STRUCTURE 50.00 <br /> (763)479-1107 TOTAL 130.00 <br /> PAID W[TH CASH 130.00 <br /> OWNER <br /> COLE, RANDY <br /> 2959 LAKESHORE AVE <br /> MEDINA, 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 specitications,applicable City approvals,and the <br /> State[3uilding Code. This permil is for only the work described and does <br /> not grant permission for additional or related work which requires separatc <br /> permits. All provisions of laws and ordinances governing this type of wark <br /> shall be compicd 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 or 180 days at any time after work has commenced. <br /> The applicant is responsible tor assuring all required inspections are <br /> requested in c formance�h the Stat uilding Code.This pennit may be � <br /> r�vqJSed,�t an time t�_ cause. . / <br /> ' �� / _ >_- v� / ���l —� <br /> .._ �- 1 ��r— � L.d cl�--i L'S�'7� i � <br /> ..t�p licant Per�' e ignature Date Issued E3y Signat e Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />