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, CITY OF ORONO * Z 0 1 3 — 0 0 8 9 5 * <br /> � 2750 KELLEY PARKWAY �pTE�ssuEn: 09/11/2013 <br /> � ORONO, MN 55356- <br /> � (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 1700 SHORELINE DR <br /> PIN : 10-117-23-14-0014 <br /> LEGAL DESC : UNPLATTED 10 117 23 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : ADDITION/REMODEL/REPAIR <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR <br /> ACTIVITY : 434-RESIDENTIAL <br /> VALUATION : $ 75,000.00 <br /> NO"I'E: SEPARATF,PERMITS REQUIRED: PLUMBING,ELECTRICAL(STATE) <br /> MASTER BATE 1 REMODEL <br /> APPLICANT <br /> HNH HOMES PERMIT FEE SCHEDULE 86925 <br /> 13911 RIDGEDALE DRIVE#406D STATE SURCHARGE(VALUATION) 37.50 <br /> MINNETONKA, MN 55345- TOTAL 906.75 <br /> (952)288-3746 PAID WITH CC# 6746 <br /> Minnesota State License#: 654037 <br /> OWNER <br /> ETAL, [RWIN JACOBS <br /> 1700 SHORELINE DR <br /> WAYZATA, MN 55391- <br /> AGREEMENT A1vD 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 /> no[grant permission for additional or related work which requires separate <br /> permits. All provisions oY laws and ordinances goveming 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 applicant is responsible for assuring all required inspections are <br /> requested in conformance with the S[ate Building Code.This permit may be <br /> revoked at any time for due cause. �� �.,%�.'' <br /> � �. �� // � � � ��,,,�_;. r���L�_-�..�-2 � :> � ,� _ <br /> Ap icant Permi e Sign ure Date Issued By Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />