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, , CITY OF ORONO * 2 0 1 7 - PJ 0 7 5 0 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 08/OU2017 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 2090 SHORELINE DR <br /> PIN : 15-117-23-23-0001 <br /> LEGAL DESC : UNPLATTED 15 117 23 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : NEW STRUCTURE <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTIOIY TYPE : ,SINGLE FAMILY <br /> ACTIVITY : 101-SINGLE FAMILY HOUSES,DETACHED <br /> VALUATION : $ 650,000.00 <br /> NOTE: SEPARATE PERMITS REQUIRED:PLUMBING,MECHANICAL,FIREPLACE,WATER CONNECTION,SEWER CONNECTION, <br /> ELECTRICAL(STATE) <br /> NOTE:PLEASE SEE AND INITIAL NEW BUILDER ACKNOWLEDGEMENT FORM <br /> APPLICANT PERMIT FEE SCHEDULE 4,417.42 <br /> STATE SURCHARGE(VALUATION) 325.00 <br /> G.S. MEICHELS CONST. S.A.C. 2,485.00 <br /> 4715 13TH AVE S <br /> MINNEAPOLIS,MN 55407- TOTAL 7,227.42 <br /> (612)210-2286 Payment(s) <br /> Minnesota State License#:BUIL-CR006457 CREDIT CARD 5225 7,227.42 <br /> OWNER <br /> HEAD, MARTHA <br /> 1616 W.22ND STREET <br /> MINNEAPOLIS,MN 55405- <br /> AGREEMENT AND SWORIY 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 1 SO days of the date of issuance,or if construction is <br /> suspended for a period of I80 days at any time after work has commenced. <br /> The applicant is responsible for assuring all required inspections are <br /> requested istconformance with the State Building Code.This permit may be <br /> revoke any time for due cause. <br /> i" <br /> �'r"/ '�;� J' / � l � �U �i G C ��7 <br /> Applicant ermitee ignature Date Issued ignature Date � <br />