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CITY OF ORONO * Z 0 1 6 - 0 1 4 9 4 * <br /> , 2750 KELLEY PARKWAY DATE ISSUED: OU1U2017 <br /> ORONO, MN 55356- <br /> ' (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 2800 SHADYWOOD RD <br /> PIN : 21-117-23-13-0023 <br /> LEGAL DESC : REG. LAND SURVEY NO. 1196 <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 /> 1. FOUNDAT[ONS/ALL DEMO DEBRIS TO BE REMOVED FROM GROUND&D[SPOSED 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 /> SAC GRANDFATHERED IN,PERMIT#3082 5/2/72 <br /> SEWER MUST BE DISCONTINUED AT THE CITY SERVICE BY QUAL[F[ED CONTRACTOR BEFORE DEMO PERMIT IS ISSUED. CHECK <br /> TO MAKE SURE THIS PERMIT HAS BEEN PULLED BEFORE ISSUING THIS PERMIT. <br /> APPLICANT DEMOLITION-PRINCIPAL STRUCTURE 75.00 <br /> STATE SURCHARGE DEMO 1.00 <br /> CREEK HILL CUSTOM HOMES DEMOLITION-ACCESSORY STRUCTURE 50.00 <br /> 15235 65TH PL N <br /> MAPLE GROVE, MN 55311- TOTAL 126.00 <br /> (763) 553-0325 Payment(s) <br /> Minnesota State License#: BUIL-20415174 CREDIT CARD 8936 126.00 <br /> OWNER <br /> BERGH, HANS& SHARON <br /> 2800 SHADYWOOD RD <br /> EXCELSIOR, MN 55331- <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 Ihe <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 l80 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 /> n � <br /> ,f�� ;� ,�� ` l _ /� "/ �"' �', c. ' .�� �� � `�� �: / � �/ � / � <br /> � i . ti - � <br /> Applican�ermita��Signature Date [ssued By Signatu e Date <br />