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� • CITY OF ORONO * 2 0 1 7 - 0 0 5 1 5 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 06/19/2017 <br /> ORONO,MN 55356- <br /> (952)249-4600 FAX: (952)249-4616 <br /> ADDRESS : 4380 SIXTH AVE N <br /> PIN : 31-118-23-12-0018 <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 : $ 115,000.00 <br /> NOTE: SEPARATE PERMITS REQUIRED: PLUMBING,MECHANICAL, ELECTRICAL(STATE) <br /> ADDITION/REMODEL <br /> APPLICANT PERMIT FEE SCHEDULE 1,204.42 <br /> STATE SURCHARGE(VALUATION) 57.50 <br /> UNITED BUILDING CONTRACTORS <br /> 11162 ABERDEEN ST NE TOTAL 1,261.92 <br /> #B Payment(s) <br /> BLAINE,MN 55449- CHECK 5501 1,261.92 <br /> (763)45&0892 <br /> Minnesota State License#:BUIL-BC631205 <br /> OWNER <br /> MICHAEL DEMENGE&KURTIS WOLBECK <br /> 14226 NEBULA ST NE <br /> CIRCLE PINES,MN 55014- <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 Ciry 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 sepazate <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 the State Building Code.This permit may be <br /> revoked at any time for due cause. <br /> . <br /> �� �?� /7 <br /> App►icant Permitee ignature Date Issued B ignature Date <br />