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CITY OF ORONO PERMIT NO.: 2009-00907 <br /> 2750 KELLEY PARKWAY <br /> ORONO,MN 55356- DATE ISSUED: 01/08/2010 <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 200 WAYZATA BLVD W <br /> PIN : 36-118-23-43-0001 <br /> LEGAL DESC : UNPLATTED 36 118 23 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : ADDITION/REMODEL/REPAIR <br /> PROPERTY TYPE : COMMERCIAL-BUSINESS <br /> CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR <br /> ACTIVITY : 328-OTHER NONRESIDENTIAL BUILDINGS <br /> VALUATION : $ 15,000.00 <br /> NOTE: ADVANCED PLAN REVIEW WAS PAID FOR THIS PERMIT ON 12/21/09 ON PERMIT#2009-00906 IN THE AMOUNT OF$172.58, <br /> BASED ON PERMIT VALUATION OF$15,000. <br /> THIS PERMIT IS FOR A TEMPORARY ADDITION AT 430 OLD LONG LAKE RD. <br /> SEPARATE PERMIT FOR ELECTRICAL IS REQUIRED. ELECTRICAL PERMITS ARE ISSUED THROUGH THE STATE OF MN. <br /> i <br /> APPLICANT <br /> PERMIT FEE SCHEDULE 265.50 <br /> Wayzata Country Club STATE SURCHARGE(VALUATION) 7.50 <br /> 200 WAYZATA BLVD W <br /> WAYZATA, MN 55391- TOTAL 273.00 <br /> OWNER <br /> Wayzata Country Club <br /> 200 WAYZATA BLVD W <br /> WAYZATA,MN 55391- <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 /> per is All provisions of laws and ordinances governing this type of work <br /> sh I b4 compied with whether or not specified herein.This permit will <br /> e ire hnd become null and void if construction authorized is not <br /> c mmenc d within days of the date of issuance,or if construction is <br /> suspende for a per od of 80 days at any time after work has commenced. <br /> The appli ant is res on ib for assuring all required inspections are <br /> reggeste 'n confor e 't the tate Building Code.This permit may be <br /> rev¢ked a any tinAf e.ca e. <br /> 7 / E; / ,-,zq /6 oe 671/1_,-x.- / / 7 /07z)./ ) <br /> Applicant Permitee Signature Date Iss :y ignature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK I HER THAN DESCRIBED ABOVE. <br />