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CITY OF ORONO PERMIT NO.: 2009-00111 <br /> , 2750 KELLEY PARKWAY <br /> ' ORONO,MN 55356- DATE IssuED: 03/25/2009 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 3186 NORTH SHORE DR <br /> PIN : 09-117-23-32-0010 <br /> LEGAL DESC : CRYSTAL BAY PARK <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. 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 BACKFILLING. <br /> APPLICANT DEMOLITION-PRINCIPAL STRUCTURE 75.00 <br /> NEDDERMEYER,GLEN STATE SURCHARGE DEMO 0.50 <br /> 709 MINNETONKA HIGHLAND LA <br /> LONG LAKE,MN 55356- MISC FEE 0.00 <br /> TOTAL 75.50 <br /> OWNER <br /> NEDDERMEYER,GLEN <br /> 709 MINNETONKA HIGHLAND LA <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 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 /> shali 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 aze <br /> requested in conformance with the State Building Code.This permit may be <br /> revoked at any time for due cause. <br /> � � / / �7�`�'� / / <br /> A plicant Permitee Signature Date Issued By ' nature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED VE. <br />