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CITYOFORONO * z � 18 - r� � mz9 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: OU12/2018 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 2780 SHADYWOOD RD <br /> PIN : 21-117-23-24-0041 <br /> LEGAL DESC : REG. LAND SURVEYNO. 1196 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : ADDITION/REMODEL/REPAIR <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR <br /> VALUATION : $ 20,000.00 <br /> NOTE: SEPARATE PERMITS REQUIRED: PLUMBING,MECHANICAL, ELECTRICAL(STATE) <br /> KITCHEN AND BATH REMODEL <br /> APPLICANT PERMIT FEE SCHEDULE 356.22 <br /> STATE SURCHARGE(VALU?,TION) 10.00 <br /> PLEKKENPOL BUILDERS 'COTAL 366.22 <br /> 470 W 78TH ST Payment(s) <br /> BLOOMINGTON,MN 55420- <br /> (952)888-2225 CREDIT CARD 6152 366.22 <br /> Minnesota State License#: BUIL-BCD01797 <br /> OWNER <br /> CARTER, RICHARD&JEANNE <br /> 2780 SHADYWOOD RD <br /> EXCELSIOR, MN 55331- <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 onty 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 construction is <br /> suspended for a period of 180 days at any time afrer work has commenced. <br /> The applican[is responsible for assuring all required inspections are <br /> requested in conformance with the Stat Building Code.This permit may be <br /> revoked at any ' e for due u e. <br /> i <br /> '_ ' - % � l� i l i� <br /> Appl' ant Permite gnatu Date Issu y Signature Date <br />