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„ CITY OF ORONO PERMIT NO.: 2011-00195 <br /> 2750 KELLEY PARKWAY <br /> ORONO,MN 55356- DATE ISSUED: OS/12/2011 <br /> � 952 249-4600 FAX: 952 249-4616 <br /> � ADDR � : 3120 SUSSEX RD <br /> � PIN : 04-117-23-32-0009 <br /> LEGA DIES : FOX BEND <br /> : LOT 003 BLOCK 001 <br /> PERMI fiY : ADDITION/REMODEL/REPAIR <br /> PROPE 'CY PE : RESIDENTIAL <br /> CONS UC ON TYPE : ADDN/REMODEL/REPAIR <br /> ACTI T!Y : 434-RESIDENTIAL <br /> VALU TXO : $ 116,000.00 <br /> NOTE: �7PE TE PERMITS REQUIRED: PLUMBING,MECHANICAL,FIREPLACE,ELECTRICAL(STATE) <br /> FINISH OIWE LEVEL AND CONVERT DECK TO SCREEN PORCH <br /> ADV.P A�I IEW$749.29 PD 4/1/I 1 2011-00194 <br /> i APPLICANT pERMIT FEE SCHEDULE 1,152.75 <br /> L.C ER O. STATE SURCHARGE(VALUATION) 58.00 <br /> 5500 L ICO DRIVE#180 <br /> EDIN ,1'�IN 5436- MISC FEE 0.00 <br /> (952)9 Sr84 TOTAL 1,210.75 <br /> Minne t�St e License#: 0002064 PAID WITH CC# 1423 <br /> OWNER <br /> ANDE $O BRETT& STEPHANIE <br /> 3120 S �SE RD <br /> LONG L1�K MN 55356- <br /> C'rR MENT AND SWORN STATEMENT <br /> The wo k�'or ch this permit is issued shall be performed according to <br /> the app ovled p s and specifications,applicable City approvals,and the <br /> State B il�ing de. This permit is for only the work described and does <br /> not gr t erm ion for additional or related work which requires sepazate <br /> permits II pr isions of laws and ordinances goveming this type of work <br /> shall b c mpi with whether or not specified herein.This permit will <br /> expire bec e null and void if construction authorized is not <br /> comme c d w' in 180 days of the date of issuance,or if construction is <br /> suspen e for iod of 180 d at an ime after work has commenced. <br /> The ap li ponsib or assu � g all required inspections aze <br /> request orm with tate Building Code.This permit may be <br /> 're ok e r d ause. � <br /> , / L—f- G I 1 �/ /� � <br /> . li P Sig ature Date Iss By Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />