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I CITY OF ORONO <br /> . 2750 KELLEY PARKWAY * 2 0 1 2 - 0 PJ 0 7 2 * <br /> � DATE ISSUED: 03/22/2012 <br /> ORONO,MN 55356- <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 2690 RAINEY RD <br /> PIN : 04-117-23-43-0016 <br /> LEGAL DESC : TREES TO BE <br /> : LOT 003 BLOCK 002 <br /> PERMIT TYPE' : ADDITION/REMODEL/REPAIR <br /> PROPERTY TI�PE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR <br />� ACTIVITY : 434-RESIDENTIAL <br /> VALUATION : $ 90,000.00 <br /> NOTE: SEPERATE PERMITS REQUIRED: PLUMBING,AND ELECTRICAL(STATE) <br /> SEE CITY ENGINEER LETTER DATED 02/10/2012 <br /> APPLICANT pERMIT FEE SCHEDULE 981.75 <br /> C.T.CONSTRUCTION STATE SURCHARGE(VALUATION) 45.00 <br /> P O BOX 46182 TOTAL 1,026.75 <br /> EDEN PRAIRIE,MN 55346- <br /> (612)327-7843 PAID WITH CC# 5153 <br /> Minnesota State License#: BC588723 <br /> OWNER <br /> SMITH,JASON&JODY <br /> 2690 RAINEY RD <br /> WAYZATA,MN 55391- <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for which this permit is issued shall be p¢rformed 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 gant permission for additional or related work which requires separate <br /> pernuts. All provisions of laws and ordinances governing this rype of work <br /> shall be compied with whether or not specified herain.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 bf 180 days at any time after work has commenced. <br /> The applicant is res onsible for assuring all required inspections aze <br /> requested,.�n nfo auec wi �the St de.This permit may be n <br /> revo at y ' Y ause. �- <br /> ^ � � � U�--- �/ �� � � <br /> A 1' t Perm e gnature Date Iss By Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />