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� CITY OF ORONO PERM[T NO.: 20�2-00006 <br /> � 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- DATE ISSUEn: OU04/2012 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 2178 SHADYWOOD RD <br /> PIN : 17-117-23-42-0009 <br /> LEGAL DESC : WILEYS PARK LAKE MTKA <br /> � : LOT 017 BLOCK 001 <br /> PERMIT TYPE : ADDITION/REMODEL/REPA[R <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR <br /> ACTIVITY : 434-RESIDENTIAL <br /> VALUATION : $ 17,000.00 <br /> NOTE: SEPERATE PERMITS REQUIRED: PLUMBING,MECHANICAL,ELECTRICAL(STATE) <br /> BA"I'I IROOM REMODEL <br /> APPLICANT PERMIT FEE SCHEDULE 295.00 <br /> EDGEWORK BUILDERS INC PLAN REVIEW 191.75 <br /> 7250 HAZELTINE BLVD <br /> EXCELSIOR, MN 55331- STATE SURCHARGE(VALUATION) 8.50 <br /> (612)328-0944 TOTAL 495.25 <br /> Minnesota State License#: 3681 PAID WITH CC# 3222 <br /> OWNER <br /> ANDERSON, MR. & MRS. CURTIS <br /> 2178 SHADYWOOD RD <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 whether or not specitied herein.This permit will <br /> expire and become null and void if construction authorized is not <br /> commenced wi[hin 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 ace <br /> requested in conformance with the State Building Code.This permit may be � <br /> revoked at any time for due cause. /� ! <br /> l l �`(�—� � \'� Y'�C C L � l _ (f - r,:� <br /> / f <br /> Applicant Permitee Signature Date Issued By Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />