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CITY OF ORONO I 111111111111 11 I II 111001,11IH <br /> * 2 0 1 5 - 0 1 2 9 4 <br /> 2750 KELLEY PARKWAY DATE ISSUED: 10/23/2015 <br /> ORONO,MN 55356- <br /> (952)249-4600 FAX: (952)249-4616 <br /> ADDRESS : 575 OXFORD RD <br /> PIN : 05-117-23-41-0029 <br /> LEGAL DESC : KLITZKE ADDN <br /> : LOT 002 BLOCK 001 <br /> PERMIT TYPE : ADDITION/REMODEL/REPAIR <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR <br /> ACTIVITY : 434-RESIDENTIAL <br /> VALUATION $ 24,500.00 <br /> NOTE: ADD FRONT PORCH ROOF TO EXISTING HOME,DECK ALREADY PRESENT <br /> NOTE:PRIOR TO RELEASE OF ESCROW MONEY AN AS-BUILT SURVEY AND HARDCOVER CALCULATIONS MUST BE SUBMITTED <br /> AND APPRQVFD. <br /> INITIAL: j <br /> APPLICANT PERMIT FEE SCHEDULE 433.71 <br /> STATE SURCHARGE(VALUATION) 12.25 <br /> ARBOR HAUS TOTAL 445.96 <br /> P 0 BOX 338 <br /> Payment(s) <br /> EXCELSIOR,MN 55331- <br /> (952)917-9130 CHECK 5155 445.96 <br /> Minnesota State License#:BUIL-BC678563 <br /> OWNER <br /> WAMBOLD,SEAN&MELISSA <br /> 575 OXFORD RD <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 OK)requested in conformance with the State Building Code.This permit may be <br /> revoked at any time for due ca e. <br /> IgZif f 73� O A <br /> Applicant Permitee Si.1:ture Date Issued By Signature Date <br />