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t , CITY OF ORONO * z 0 1 z - 0 0 5 z 7 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 06/20/2012 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 495 OXFORD RD <br /> PIN : OS-117-23-41-0011 <br /> LEGAL DESC : STIELOWS ADDN <br /> : LOT 003 BLOCK 001 <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 /> 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. <br /> CHECK TO MAKE SURE THIS PERMIT HAS BEEN PULLED BEFORE ISSUING THIS PERMIT. <br /> APPLICANT DEMOL[TION-PRINCIPAL STRUCTURE 75.00 <br /> MARK BEND[CKSON, INC. STATE SURCHARGE DEMO 5.00 <br /> 1501 HUNTER DR <br /> WAYZATA, MN 55391- MISC FEE 0.00 <br /> (612)695-8072 TOTAL 80.00 <br /> OWNER <br /> SAMPLE, MIKE&ANNE <br /> 1449 BAY RIDGE RD <br /> WAYZATA, MN 55391- <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for which this permit is issued shall be performed according[o <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 /> 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 r a period of 180 days at any time after work has commenced. <br /> The applic ht is responsible suring all required inspections are <br /> request d conformance w th t e State Building Code.This permit may be <br /> revoke a any time fqr due c u e. <br /> i <br /> �G � �/ �Z C) / �?C,1�Z_ / / <br /> pplican Vermitee Signatu Date Issue By ' nature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED A VE. <br />