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CITY OF ORONO PERMIT NO.: 2011-00271 <br /> „ -'� 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- DATE IssuEn: 05/13/2011 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ; ADDRESS : 1795 SHADYWOOD RD <br /> " PIN ; 17-117-23-21-0008 <br /> � LEGAL DESC : REG.LAND SURVEY NO.0702 <br /> ' : LOT 000 BLOCK 000 <br /> PERMIT TYPE : ZONING PERMIT <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : SHED< 120 SQ FT <br /> APPLICANT STRUCTURE PERMIT 50.00 <br /> BETZ BUILDERS INC. ENGINEERING REVIEW COSTS <br /> 300 CRESTVIEW AVE. TOTAL 50.00 <br /> LONG LAKE,MN 55356 <br /> (612)221-2963 <br /> OWNER <br /> DIERCKS,MICHAELA <br /> 1795 SHADYWOOD RD <br /> P.O. BOX 81(NAVARRE <br /> WAYZATA,MN <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 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 180 days of the date of issuance,or if consuuction is <br /> suspended for a period of 180 days at any time after work has commenced. <br /> The ap ' ant is responsible for assuring all required inspections aze <br /> requ e in conformance with the State Bui ding Code.This permit may be <br /> rev d t any time for/1... ause. <br /> / / �/�� / / <br /> _Applicant Permitee Signature Date Issued y Signature Date <br /> � <br /> � SEPARATE PERMITS REQUIRED FOR WORK OT ER THAN DESCRIBED ABOVE. <br />