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iII <br /> •w II <br /> CITY OF ORONO �II P1 11 3 I II <br /> * 20 1 7 - 0 0 2 9 3 <br /> 2750 KELLEARKWAY DATE ISSUED: 04/11/2017 <br /> ORONO, 55356- <br /> (952)249-4600 FAX (952)249-4616 <br /> ADDRESS : 425 OLD CRYSTAL BAY RD S <br /> PIN : 04-117-23-31-0001 <br /> LEGAL DESC : AUDITOR'S SUBD.NO.230 <br /> : LOT 020 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 /> 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 BACKFII4JING. <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. CHECK <br /> TO MAKE SURE THIS PERMIT HAS BEEN PULLED BEFORE ISSUING HIS PERMIT. <br /> APPLICANT DEMOLITION-PRINCIPAL STRUCTURE 75.00 <br /> STATE SURCHARGE DEMO 1.00 <br /> BURNS EXCAVATING,INC. DEMOLITION-ACCESSORY STRUCTURE 50.00 <br /> 3470 CO.RD 21 <br /> MAYER,MN 55360- TOTAL 126.00 <br /> (612)685-4303 Payment(s) <br /> Minnesota State License#: SW-1888 CHECK 28319 126.00 <br /> OWNER <br /> KVALSETH,JAHN&CHRISTINE <br /> 13650 ASHCROFT ROAD <br /> SAVAGE,MN 55378- <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 <br /> revoked at any time for due cause. <br /> 141 <br /> Applicant Permitee Signature Date Issued Signature Date <br />