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� . , . <br /> CITY OF ORONO * 2 0 1 6 - 0 0 6 4 9 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 06/06/2016 <br /> ORONO,MN 5535Cr <br /> (952)249-4600 FAX: (952)249-4616 <br /> ADDRESS : 2195 SHADYWOOD RD <br /> PIN : 17-117-23-43-0135 <br /> LEGAL DESC : WILEYS PARK LAKE MTKA <br /> : LOT 007 BLOCK 002 <br /> PERMIT TYPE : ADDITION/REMODEL/REPAIR <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR <br /> ACTIVITY : 434-RESIDENTIAL <br /> VALUATION : $ 3,700.00 <br /> NOTE: REPAIR CHIMNEY CROWN <br /> APPLICANT PERMIT FEE SCHEDULE 108.38 <br /> PATRICK D DONAHUE STATE SURCHARGE(VALUATION) 1.85 <br /> 505 FIRST AVE NE TOTAL 110.23 <br /> MINNEAPOLIS,MN 55413- Payment(s) <br /> (612)763-1803 CASH 110.23 <br /> OWNER <br /> ANDERSON,JOHN <br /> 2195 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 dces <br /> not grant permission for additional or related work which requ'ves 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 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 th tate Building Code.This permit may be <br /> revoked at any time ue cau e. <br /> � � ' �(/ / (l/ / 6 <br /> Applicant Permitee Signature Date Issue ignature Date <br />