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' ' � CITY OF ORONO * 2 0 1 5 - 0 0 8 2 6 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 07/09/2015 <br /> ORONO, MN 55356- <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 4225 SIXTH AVE N <br /> PIN : 31-118-23-12-0012 <br /> LEGAL DESC : UNPLATTED 31 118 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 : $ 9,718.06 <br /> NOTE: SEPARATE PERMITS REQUIRED: PLUMBING,MECHANICAL <br /> FIRE REPAIR <br /> APPLICANT PERMIT FEE SCHEDULE 201.36 <br /> LINDSTROM CLEANING&CONSTRUCTION PLAN REVIEW 130.88 <br /> 9621 l OTH AVE N STATE SURCHARGE(VALUATION) 4.86 <br /> PLYMOUTH, MN 55441- TOTAL 337.10 <br /> (763)544-8761 Payment(s) <br /> Minnesota State License#: cont-1087 CHECK 321679 337.10 <br /> OWNER <br /> DAHLSTROM,JESSE <br /> 4225 SIXTH AVE N <br /> LONG LAKE,MN 55356- <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for which this permi[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 no[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 wi[h the State Building Code.This permit may be <br /> revoked at time for due cause. � <br /> �� ' _ n c� <br /> L� �---� �7 j- � � � -��1�--(� � l ! l� <br /> Applican� itee Signature Date Issued By i ature Date <br />