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. , CITY OF ORONO * 2 0 1 4 — 0 (d 6 5 6 * <br /> 2750 KF,LLEY PARKWAY DATE ISSUED: 07/03/2014 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 2560 KEI.I,Y AVE <br /> PIN : 20-117-23-11-0007 <br /> LEGAL DESC : REG. LAND SURVEY NO. 0088 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : DEMOLITION <br /> PROPERTY TYPE . R�tt6�AF�6-- I'�cj`-t �<-l � � l cc ` <br /> CONSTRUCTION TYPF. : DEMO- PRINCIPAL STRUCTURE <br /> lo�� ��1 p��� 8�-e� <br /> NO'1'L: DEMO(1)PRINCINAL S�RUC"I�URE AND(1)�10ESSORY BUILDING <br /> APPLICANT DEMOLITION - PRINCIPAL STRUCTURE 75.00 <br /> STATE SURCHARGE DEMO 5.00 <br /> TAYLOR WEST DEMOLITION-ACCESSORY STRUCTURE 50.00 <br /> P O BOX 190 <br /> CIRCLE PINES, MN 55014- TOTAL 130.00 <br /> (612)248-3132 Payment(s) <br /> CHECK 5424 130.00 <br /> OWNER <br /> INTN'L MINISTERIAL PELLOWSHIP <br /> 2560 KELLY AVE <br /> EXCELSIOR, MN 55331- <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for which this permit is issued shali be perli�rmed according to <br /> the approved plans and specitications,applicable Citp approvals,and the <br /> State[�uildino Code. l�his permit is for only the work described and does <br /> not grant permission for additional or rclated 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 speciYied herein.'I�his pennit will <br /> expirc 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 alter work has commenced. <br /> I'he applicant is responsible for assuring all required inspections are <br /> requested in conformance with the State Building Code.This permit may be <br /> revoked at any time for due cause. <br /> -''l <br /> '� �?�-�-� �.3�/ 7 �/ <br /> , . <br /> Applicant � mitee Signaturo 1�atc Issu� l3y Signature Date <br />