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i CITY OF ORONO * 2 PJ 1 7 — 0 0 9 3 4 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: osio9�2��,�d, <br /> ORONO, MN 55356- '`�" _ - `w i��:a_,% <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 980 HERITAGE LA <br /> PIN : 10-117-23-11-0004 <br /> LEGAL DESC : iJNPLATTED 10 117 23 <br /> : LOT 2 BLOCK 1 <br /> PERMIT TYPE : ZONING PERMIT <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : TREE REMOVAL WITHIN 0-75 <br /> APPLICANT TREE REMOVAL 0.00 <br /> TOTAL 0.00 <br /> TOM POTTER CONSTRUCTION INC. <br /> 6531 DEVONSHIRE DR. <br /> CHANHASSEN, MN 55317 <br /> �) <br /> Minnesota State License#: BUIL-BC130144 <br /> OWNER <br /> IRWIN JACOBS REV TRUST <br /> 1700 SHORELINE DR <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 whe[her or no[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 conformance with the State Building Code.This permit may be <br /> revoked at any time for due cause. <br /> ��-Y�i/�-�(it (G� I /l�l/ " i —�/ � � l / l � / <br /> Applicant Permitee Signature Date Issued B ignature Date <br />