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, . CITY O ORONO * 2 0 1 7 - 0 0 1 1 2 * <br /> 2750 KELL Y PARKWAY DATE ISSUED: 02/13/2017 <br /> ORONO MN 55356- <br /> (952)249-4600 F : (952)249-4616 <br /> ADDRESS : 2500 SHADYWOOD RD <br /> PIN : 20-117-23-11-0034 <br /> LEGAL DESC : REG.LAND SURVEY NO. 163'0 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : ADDITION/REMODEL/REPAIR <br /> PROPERTY TYPE : COMMERCIAL-BUSINESS <br /> CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR <br /> ACTIVITY : 437-NONRESIDENTIAL&NaNHOUSEKEEPIN <br /> VALUATION : $ 20,000.00 <br /> NOTE: SEPARATE PERMITS REQUIRED: PLUMBING,MECHANI�AL,ELECTRICAL(STATE) <br /> INERIOR REMODEL FOR SUITES#410 AND#420 I <br /> APPLICANT pERMIT FEE SCHEDULE 356.22 <br /> Ugorets 8098 LLC STATE SURCHARGE(VALUATION) 10.00 <br /> 410 11TH AVE S TOTAL 366.22 <br /> HOPKINS,MN 55343- Payment(s) <br /> (952)769-7249 CHECK 1601 366.22 <br /> OWNER <br /> Ugorets 8098 LLC <br /> 410 11TH AVE S <br /> HOPKINS,MN 55343- <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for which this pertnit 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 dces <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 hereia This permit will <br /> expire and become null and void if construction suthorized 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 alI 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 /> (� � ��-�-- a/►3/� �°-��� �-� �3 � �� <br /> Applicant Permitee Signature Date Issued B ignature Date <br />