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�` CITY OF ORONO * 2 0 1 6 — 0 0 7 1 B * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 06/22/2016 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 4225 FOREST LAKE DR <br /> PIN : 07-117-23-12-0025 <br /> LEGAL DESC : FOREST ARMS COUNTRY CLUB ADDN <br /> : LOT 003 BLOCK 003 <br /> PERMIT TYPE : MINOR ALTERATIONS <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : UNDEFINED <br /> ACTIVITY : O/S BUILDING-UNDEFINED <br /> VALUATION : $ 11,000.00 <br /> NOTE: EXTER[OR STONE WORK PROJECT <br /> APPLICANT PERMIT FEE SCHEDULE 216.81 <br /> STATE SURCHARGE(VALUATION) 5.50 <br /> CONDOR F[REPLACE& STONE CO. MAIL-IN FEE 2.00 <br /> 8282 ARTHUR ST NE <br /> SPRING LAKE PARK, MN 55432 TOTAL 224.31 <br /> (763)786-2341 Payment(s) <br /> CREDIT CARD 6743 224.31 <br /> OWNER <br /> ANDERSON,KENNETH <br /> 4225 FOREST LAKE DR <br /> MOLJND,MN 55364- <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for which this permit is issued shall be performed according ro <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 time for due cause. <br /> l <br /> ,� 1 �,;�j � c <{ �:�_�.�` � <�._ � �_ c. c_��=,�t� ��� , �z z , �c�, <br /> Applicant Permitee Signature Date Issued By Signature Date <br />