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t t <br /> CITY OF ORONO ® 1 1 - 0 a M <br /> 2750 KELLEY PARKWAY DATE ISSUED: 08/17/2017 <br /> ORONO,MN 55356- <br /> 952)249-4600 FAX: (952)2494616 <br /> ADDRESS 1020 TONKAWA RD <br /> PIN 08-117-23-13-0014 <br /> LEGAL DESC REG.LAND SURVEY NO.0617 <br /> LOT 000 BLOCK 000 <br /> PERMIT TYPE NEW STRUCTURE <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : SINGLE FAMILY <br /> ACTIVITY : 101-SINGLE FAMILY HOUSES,DETACHED <br /> VALUATION : $ 1,525,000.00 <br /> NOTE: SEPARATE PERMITS REQUIRED:PLUMBING,MECHANICAL,FIREPLACE, SEWER CONNECTION,WELL(STATE), <br /> ELECTRICAL(STATE) <br /> NOTE:PLEASE SEE AND INITIAL NEW BUILDER ACKNOWLEDGEMENT FORM <br /> APPLICANT PERMIT FEE SCHEDULE 8,459.92 <br /> STATE SURCHARGE(VALUATION) 710.00 <br /> STONEWOOD,LLC <br /> 153 E LAKE STREET Payment(s) <br /> TOTAL 9,169.92 <br /> WAYZATA,MN 55391- <br /> (612)462-4000 CHECK 14930 9,169.92 <br /> Minnesota State License#:BUIL-BC594315 <br /> OWNER <br /> BURKE,FORREST <br /> 380 LEAF ST <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 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 tir or due cause. <br /> Applicant Permitee Signature Date Issued B ignature Date <br />