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CITY OF ORONO * z 0 1 z - B 0 5 7 1 * <br /> . 2750 KELLEY PARKWAY DATE ISSUED: 07/23/2012 <br /> ' ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 455 SUSSEX LA <br /> PIN : 04-117-23-32-0011 <br /> LEGAL DESC : FOX BEND <br /> : LOT 005 BLOCK 001 <br /> PERMIT TYPE : ADDITION/REMODEL/REPAIR <br /> City ,�f Or�or�o <br /> PROPERTY TYPE : RESIDENTIAL �75U Kelley Parkway <br /> CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR Orono MN 55356 g52-24g-4f,� <br /> ACTIVITY : 434-RESIDENTIAL Receipt Na: 3.447273 Jul 23, 201� <br /> VALUATION : $ 20,000.00 <br /> NOTE: OTHER INSPECTION: PROVIDE PILING REPORT Robert Willis Constru�tion, LLC <br /> IN KIND DECK REPLACEMENT Previaus Balar�ce; ,p� <br /> Peraits <br /> 2012-00571 455 5ussex La 339,25 <br /> 101-32510 <br /> Building PerOits <br /> Rer�its <br /> 2ti1P-00571 455 5ussex La iG.00� <br /> !{71-208G2 <br /> �ue to govts-5tate <br /> Total: � 3�g,� <br /> Check �M�---=__ <br /> Check No: 1514 34g,� <br /> Payor: <br /> Robert Willis Construction, LLC <br /> Total Applied: 349,� <br /> Change Tendered: N--,p�j <br /> s)7!c3/201� 10:04AM ==_______ <br /> APPLICAI�TT pERMIT FEE SCHEDULE 339.25 <br /> ROBERT WILLIS CONSTRUCTION LLC STATE SURCHARGE(VALUATION) 10.00 <br /> 11401 COUNTY RD 3 <br /> SUITE 2 TOTAL 349.25 <br /> HOPKINS, MN 55343- <br /> (612)323-5036 <br /> Minnesota State License#: 205761 11 <br /> OWNER <br /> CRAWFORD, BRUCE&CAROL <br /> 455 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 ro <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 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 /> request in conformance with the State Building Code.This permit may be <br /> r ed for due cause. L�f!' <br /> � �l 3 �I� ��-�--�--r ��-��-�-�► � 7 ;a� --ia- <br /> Ap ]icar ermitee Signature� Date Issued By Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />