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iiiiiiiiiiiiiiiiiiiiiillillilillim <br /> CITY OF ORONO * 2014 - 01079 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 09/23/2014 <br /> ORONO,MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS 1000 WILLOW DR S <br /> PIN 10-117-23-21-0004 <br /> LEGAL DESC UNPLATTED 10 117 23 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE DEMOLITION <br /> PROPERTY TYPE RESIDENTIAL <br /> CONSTRUCTION TYPE DEMO-ACCESSORY STRUCTURE <br /> ACTIVITY 649-ALL OTHER BUILDING&STRUCTURES <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 OF GARAGE&SIDING OFF HOUSE. OK'D BY LYLE. <br /> APPLICANT DEMOLITION-ACCESSORY STRUCTURE 50.00 <br /> HOMES BY LEGACY STATE SURCHARGE DEMO 5.00 <br /> 6145 LAKE VIRGINIA DR TOTAL 55.00 <br /> P O BOX 245 <br /> Payment(s) <br /> EXCELSIOR,MN 55331- CREDIT CARD 9115 55.00 <br /> (612)270-6214 <br /> Minnesota State License#: BUIL-BC667652 <br /> OWNER <br /> KLOMBIES,LINDSAY&ANNA <br /> 1000 WILLOW DR S <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 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 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 are <br /> requested in conf ce with the State Building Code.This permit may be <br /> revoked at a for due cau <br /> r <br /> plicant P itee Signature Date Issued 4Signature Date <br />