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# 4 CITY OF ORONO <br /> * z0 17 — PJ 1098 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 09/20/2017 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 2500 SHADYWOOD RD <br /> PIN : 20-117-23-11-0034 <br /> LEGAL DESC : REG. LAND SURVEY NO. 1630 <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&NONHOUSEKEEPIN <br /> VALUATION : $ 20,000.00 <br /> NOTE: SEPARATE PERMIT REQUIRED: MECHANICAL,ELECTRICAL(STATE) <br /> APPLICANT PERMIT FEE SCHEDULE 356.22 <br /> PLAN REVIEW 231.54 <br /> Ugorets 8098 LLC STATE SURCHARGE(VALUATION) 10.00 <br /> 410 11TH AVE S <br /> HOPKINS,MN 55343- TOTAL 597.76 <br /> (952)769-7249 Payment(s) <br /> CHECK 1701 597.76 <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 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 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 construc[ion is <br /> suspended for a period of 180 days at any time afrer 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 /> � � , � Z � �0��ft , ) (' <br /> -�,� ; � 'J � � �'�. �"�c � �' , � l�L l� � <br /> ` � ,: <br /> Applicant P rmitee Signature te ssued By gnature Date <br />