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CITY OF ORONO * 2 0 1 6 — 0 0 7 0 5 * <br /> �� 2750 KELLEY PARKWAY DATE ISSUED: 06/24/2016 <br /> t ORONO,MN 55356- <br /> (952)249-4600 FAX: (952)249-4616 <br /> ADDRESS : 3188 NORTH SHORE DR <br /> PIN : 09-117-23-32-0011 <br /> LEGAL DESC : CRYSTAL BAY PARK <br /> : LOT 000 BLOCK 004 <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. INSPECTIONS DONE BEFORE BACKFILLING. <br /> DEMO PRINCIPAL& 1 ACCESSORY STURCTURE <br /> 04/07/16-PER ROGER PEITSO,BUILDING OFFICIAL. SAC GRANDFATHERED IN H/U PROJECT#1785 04/10/68 AND HONIE BUILT IN <br /> 1952. <br /> APPLICANT DEMOLITION-PRINCIPAL STRUCTURE 75.00 <br /> STATE SURCHARGE DEMO 1.00 <br /> TMS COMPANIES DEMOLITION-ACCESSORY STRUCTURE 50.00 <br /> 5990 MEADOWLARK LN <br /> PRIOR LAKE,MN 55372- TOTAL 126.00 <br /> (612)414-5700 Payment(s) <br /> CHECK 4483 126.00 <br /> OWNER <br /> RUCINSKI,MICHEAL&HOLLY <br /> 3188 NORTH SHORE DR <br /> WAYZATA,MN 55391- <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 construction suthorized is not <br /> commenced within 180 days of the da of issuance,or if construction is <br /> suspended for a period of 180 da s at time after work has commenced. <br /> The applicant is responsi e for surin required inspections aze <br /> requested in conf anc ith te uilding Code.This permit may be <br /> revoked at any f e for c u ` �/� 'n <br /> ���r� <br /> �`1 �o� �.�.�-�� � i z U� ! � <br /> Applican ermitee Si ature ate Issued By Signature Date <br />