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CITY OF ORONO 111111111 I I 1 1111011i <br /> * 20 1 8 - 00 1 59 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 02/13/2018 <br /> ORONO, MN 55356- <br /> (952)249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 905 FERNDALE RD W <br /> PIN : 02-117-23-44-0032 <br /> LEGAL DESC : AUDITOR'S SUBD.NO. 184 <br /> : LOT MB BLOCK MB <br /> PERMIT TYPE : ZONING PERMIT <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : LAND ALTERATION(0-500 CU YDS) <br /> APPLICANT MINOR LAND ALTERATION 50.00 <br /> TOTAL 50.00 <br /> BLACK BEAR BUILDERS <br /> Payment(s) <br /> 13333 179TH CIRCLE NW CHECK 3032 50.00 <br /> ELK RIVER,MN 55330- <br /> (952)249-0972 <br /> Minnesota State License#: BUIL-BC639692 <br /> OWNER <br /> BROOKS,JOHN&JOAN <br /> 905 FERNDALE RD W <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 goveming 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 conformance with the State Building Code.This permit may be <br /> revoked at any time for due cause. <br /> / 1�3 <br /> Applicant Permitee Signature Date Issuy Signature Date <br />