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` ` CITY OF ORONO * z 0 1 4 - 0 1 1 6 0 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 10/24/2014 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 2915 SOMERSET LA <br /> PIN : 04-117-23-24-0019 <br /> LEGAL DESC : OLD CRYSTAL BAY ROAD 2ND ADDN <br /> : LOT 002 BLOCK 004 <br /> PERMIT TYPE : ADDITION /REMODEL/REPAIR <br /> PROPERTY TYPE : RESIDENTIAL /f� ��� � <br /> CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR � � ��� <br /> VALUATION : $ 18,400.00 <br /> NOTG: S6PARA"I I;YF,RMITS REQUIRED: ELECTRICAL(STATE) <br /> RF,MODGL <br /> APPLICANT PERM�T PEE SCHEDULE 324.50 <br /> PLAN REVIEW 210.93 <br /> HERITAGE BUILDERS STATE SURCHARGE(VALUATION) 9.20 <br /> 9953 NAT}iAN LN N TOTAL 544.63 <br /> MAPLE GROVE, MN 55369- <br /> (952)927-6595 Payment(s) <br /> CHF,CK 002740 544.63 <br /> OWNER <br /> BORDSON, BRENT&NANCY <br /> 2915 SOMERSET LA <br /> LONG LAKE, MN 55356- <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 E�uilding Code. This permit is for only the work described and does <br /> not grant permission for additional or related work which requires separa[e <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 ti�r a period of 180 days at any time after work has commenced. <br /> "I�hc 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 /> � �� Z ! �� /Z /� <br /> Applicant Permitee Signature ate Issued y Signature Date <br />