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� ' CITY OF ORONO * z 0 1 4 II- 0 0 4 z B * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 06/1U2014 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 565 LEAF ST <br /> PIN : OS-117-23-41-0028 <br /> LEGAL DESC : FOX HOLLOW <br /> : LOT 003 BLOCK 001 <br /> PERMIT TYPE : ZONING PERMIT <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : LAND ALTERATION(0-500 CU YDS) <br /> NOTE: LAND ALTERAT[ON PERMIT AND RETAINING WALL <br /> DOUBLE FEE FOR AFTER THE FACT PERMIT <br /> APPLICANT MINOR LAND ALTERATION 50.00 <br /> RETAINING WALL<4' S0.00 <br /> GOODWIN,BEN&HEATHER <br /> 565 LEAF ST MISC FEE 100.00 <br /> LONG LAKE,MN 55356- TOTAL 200.00 <br /> Payment(s) <br /> CHECK 1730 200.00 <br /> OWNER <br /> GOODWIN,BEN&HEATHER <br /> 565 LEAF ST <br /> LONG LAKE,MN 55356- <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for which this permit is issued shall be perforrned according to <br /> the approved plans and specifications,applicable Ciry 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 rype 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 wnformance with the State Building Code.This permit may be <br /> revoked at any time for due cause. <br /> �'��t'.�2C.�,�� l6/ / �1 L�t.Q-/� � // � / <br /> Applicant Permitee Signature D te Issue By Signature Date <br />