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• CITY OF ORONO * 2 0 1 5 — 0 0 4 8 0 * <br /> � 2750 KELLEY PARKWAY DATE ISSUED: OS/0]/2015 <br /> ` ORONO, MN 55356- <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 3640 JACOBS MILL RD <br /> PIN : 32-118-23-24-0010 <br /> LEGAL DESC : JACOBS MILL <br /> : LOT 004 BLOCK 001 <br /> PERMIT TYPE : ZONING PERMIT <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : STRUCTURE PERMIT <br /> NOTE: (DRIVEWAY PILLARS) <br /> APPLICANT STRUCTURE PERMIT 50.00 <br /> TOTAL 50.00 <br /> HOFFMAN,KEITH&MARY Payment(s) <br /> 3640 JACOBS MILL RD CHECK 8495 50.00 <br /> LONG LAKE,MN 55356- <br /> OWNER <br /> HOFFMAN,KEITH&MARY <br /> 3640 JACOBS MILL RD <br /> LONG LAKE,MN 55356- <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 dces <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 whether or not specified herein.This permit will <br /> expire and become null and void if conswction 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 /> 'I'he applicant is responsible for assuring all required inspections aze <br /> requested in conformance with the State Building Code.This permit may be <br /> revoked at any time for due cause. `�%'" <br /> � � l I�-�'� '�-i � i <br /> Applicant Permitee Sigr►ature Date Issued By Signature Date <br />