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� . CITY OF ORONO * 2 0 1 5 - 0 0 S 4 8 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 07/27/2015 <br /> ORONO, MN 55356- <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 2655 COUNTRYSIDE DR W <br /> PIN : 04-117-23-13-0006 <br /> LEGAL DESC : OLD CRYSTAL BAY ROAD ADDN <br /> : LOT 006 BLOCK 003 <br /> PERMIT TYPE : ZONING PERMIT <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : RETAINING WALL<4 FEET <br /> NOTE: RETAINING WALL AND MAJOR[,AND ALTERATION <br /> APPLICANT RETAIN[NG WALL<4' S0.00 <br /> ENGINEERING REVIEW COSTS <br /> IMPACT DESIGN GROUP MAJOR LAND ALTERATION 50.00 <br /> P.O.BOX 48645 <br /> MINNEAPOLIS, MN 55433- TOTAL 100.00 <br /> Payment(s) <br /> CREDIT CARD 7220 100.00 <br /> OWNER <br /> VOSSEN, MICHAEL&KATHLEEN <br /> 2655 COUNTRYSIDE DR W <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 sepazate <br /> permi[s. All provisions of laws and ordinances goveming this type of work <br /> shall be compied with whether or no[specified herein.This permi[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 /> � `� i o77i/5 <br /> Applicant Permitee Signature Date [ss d Signature Date <br />