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• CITYOFORONO * 20 14 - PJ0903 * <br /> � 2750 KELLEY PARKWAY DATE ISSUED: 08/15/2014 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> AllDRESS : 3510 BAYSIDE RD <br /> PIN : OS-117-23-13-0016 <br /> LEGAL DESC : AUDITOR'S SUBD. NO. 203 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : MINOR ALTERATIONS <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : SIDING <br /> ACTIVITY : O/S BUILDING - UNDEFINED <br /> VALUA"TION : $ 5,000.00 <br /> APYLICANT PERM[T FEE SCHEDULE 118.00 <br /> STATE SURCHARGE (VALUATION) 2.50 <br /> LARSEN, GREGG & STEPHANIE <br /> 3510 BAYS[DE RD TOTAL 120.50 <br /> LONG LAKE, MN 55356- Payment(s) <br /> CHECK 17011 120.50 <br /> OWNER <br /> I_ARSEN, GREGG & S"I'EPHANIE <br /> 3510 BAYS[DE RD <br /> I.ONG LAKE, MN 55356- <br /> AGREEMENT AND SWORN STATEMENT <br /> 'i'he work for which this permit is issued shall be perfornled accordine to <br /> the approved plans and specifications,applicable City approvals,and the <br /> State Building Code. 'I'his permit is for only the work described and does <br /> not,rant permission for additional or related work which requires separate <br /> permits. All provisions of laws and ordinunces governing this typc of work <br /> shall be compied with whether or not spcciticd hcrein.'I'his pernlit wiil <br /> expire and become null and void ifconstruction authorized is not <br /> commenced within 180 days of the date of issuance,or if construction is <br /> suspended tbr a period of 180 days at any time after work has commeneed. <br /> I�he applicant is responsible lor assuring all required inspections are <br /> requcsted in conformance with Ihe State Quilding Code."�his permit ma��be <br /> revoked at•ny time for due cause. <br /> �'�) '�� / / <br /> i1p I� � Permitee Signature Uate [ssued By nature Date <br />