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CITY OF ORONO * 2 0 1 x - 0 1 1 0 0 <br /> 2750 KELLEY PARKWAY DATE ISSUED: 09/12/2016 <br /> ORONO,MN 55356- <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 $ 10,000.00 <br /> NOTE: SEPARATE PERMITS REQUIRED: PLUMBING,MECHANICAL,ELECTRICAL(STATE) <br /> BASEMENT BATHROOM&WET BAR <br /> APPLICANT PERMIT FEE SCHEDULE 201.32 <br /> LECY BROS HOMES STATE SURCHARGE(VALUATION) 5.00 <br /> 15012 HWY 7 TOTAL 206.32 <br /> MINNETONKA,MN 55345- Payment(s) <br /> (952)944-9499 CHECK 46076 206.32 <br /> Minnesota State License#:BUIL-20325555 <br /> OWNER <br /> ADAMS,DONALD&SHEILA <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 with the State Building Code.This permit may be <br /> revok d at any time for due cause. <br /> A plicant ertnitee Signature I Date Issued By Signature Date <br />