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, � <br /> CITY OF ORONO * 2 0 1 3 — 0 0 4 4 5 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 06/12/2013 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 4395 NORTH SHORE DR <br /> PIN : 07-117-23-43-0018 <br /> LEGAL DESC : SAGA HILL REVISED <br /> : LOT 000 BLOCK 018 <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. FOUNDA"1'IONS/ALL DEMO DEBRIS TO SE REMOVED FROM GROUND&DISPOSED OF OFP SITE,PER PCA REGULATIONS. <br /> 2. WELLS MUS"I'BE ABANDONED. <br /> 3. INSPECTIONS DONF,BEFORE BACKFILLING. <br /> NOTE: A 24-48 HOUR NOTICE IS REQU[RED FOR ALL INSPECTIONS. CALL(952)249-4600. <br /> SEWER MUST BE DISCONTINUED AT THE CI"1'Y SERVICE BY QUALIFIED CONTRACTOR BEFORE DEMO PERMIT IS ISSUED. <br /> CHECK TO MAKE SURE THIS PERMIT HAS BEEN PULLED BGFORE [SSUING THIS PERMIT. <br /> APPL[CANT DEMOLITION -PRINCIPAL STRUCTURE 75.00 <br /> BURNS EXCAVATING, INC. STATE SURCHARGE DEMO 5.00 <br /> 3470 CO. RD 21 <br /> MAYER, MN 55360- TOTAL 80.00 <br /> (612)685-4303 <br /> Minnesota State License#: 1888 <br /> OWNER <br /> CORNESS, JOHN& BARBARA <br /> 4395 NORTH SHORE DR <br /> MOLTND, MN 55364- <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 Building Code. This permit is Yor 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 whe[her or not speciYied 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 Yor 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 /> � l �Zi �� ��� � l/� l l.3 <br /> Applicant Permitee Signature Date Issue y Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />