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' ^ CITY OF ORONO PERMIT NO.: 2oos-oo4�s <br /> 2750 KELLEY PARKWAY <br /> ORONO,MN 55356- DATE IssuEn: 12/02/2008 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 395 SUSSEX LA <br /> PIN : 04-117-23-24-0007 <br /> LEGAL DESC : FOX BEND <br /> : LOT 006 BLOCK 001 <br /> PERMIT TYPE : ACCESSORY STRUCTURE <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : GAZEBO <br /> ACTIVITY : 329-STRUCTURES OTHER THAN BUILDINGS <br /> VALUATION : $ 79,800.00 <br /> NOTE: SEPERATE PERMITS REQUIRED:ELECTRICAL(STATE)AND FIREPLACE(MASONRY)PERMIT <br /> GAZEBO <br /> APPLICANT pERMIT FEE SCHEDULE 906.75 <br /> MANTIS DESIGN&BUILD PLAN REVIEW 589.39 <br /> 465 NEWTON AVE S <br /> MINNEAPOLIS,MN 55405- STATE SURCHARGE(VALUATION) 39.90 <br /> (612)377-0123 TOTAL 1,536.04 <br /> Minnesota State License#:20470400 <br /> OWNER <br /> CAMPBELL,JON&SUSAN <br /> 395 SUSSEX 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 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 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 after work has commenced. <br /> The applicant is responsible for assuring all required inspections aze <br /> requested in conformance with the State Building Code.T ' permit may be <br /> revok any time for due cause. <br /> pplicant Permitee Signature ! /Da� / `� �--- ��l D �/ U � <br /> Issu By Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />