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CITY OF ORONO PERMIT NO.: 2010-01176 <br /> 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- DATE ISSUED: 12/29/2010 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS 200 TRUFFULA TR <br /> PIN 33-118-23-44-0039 <br /> LEGAL DESC MEADOW WOOD POND <br /> LOT 005 BLOCK 001 <br /> PERMIT TYPE ADDITION/REMODEL/REPAIR <br /> PROPERTY TYPE RESIDENTIAL <br /> CONSTRUCTION TYPE ADDN/REMODEL/REPAIR <br /> ACTIVITY : 434-RESIDENTIAL <br /> VALUATION $ 40,000.00 <br /> NOTE: SEPERATE PERMITS REQUIRED: PLUMBING,MECHANICAL,FIREPLACE,ELECTRICAL(STATE) <br /> ADDITION ,t <br /> INSTALL SILT FENCE WHERE NEEDED L,fJ <br /> ADVANCE PLAN REVIEW FEE PD$474.26 ON PERMIT 2010-01175 <br /> APPLICANT PERMIT FEE SCHEDULE 574.25 <br /> LECY BROS CONSTRUCTION STATE SURCHARGE(VALUATION) 20.00 <br /> 15012 HWY 7 TOTAL 594.25 <br /> MINNETONKA,MN 55345 <br /> (952)746-3783 <br /> Minnesota State License#: 20325555 <br /> OWNER <br /> ADAMS,MR.&MRS. <br /> 200 TRUFFULA TR <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 ' the State Building Code.This permit may be <br /> roke at any time for e 5,du <br /> C&kte- U. <br /> ! l Ali 40 <br /> Applicant Permitee Signature Date IsAU By Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />