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" CITY OF ORONO PERMIT NO.: 2011-01182 <br /> ` 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- DATE ISSUED: 10/13/2011 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 3510 BAYSIDE RD <br /> PIN : OS-117-23-13-0016 <br /> LEGAL DESC : AUDITOR'S SUBD.NO.203 <br /> : LOT 000 BLOCK 000 <br /> PERM[T TYPE : ACCESSORY STRUCTURE <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : POOL- IN GROUND <br /> ACTIVITY : 329-STRUCTURES OTHER THAN BUILDINGS <br /> VALUATION : $ 15,000.00 <br /> NOTE: *AS-BUILT SURVGY REQUIRED PRIOR TO ESCROW RELEASE <br /> * ADMINIS`�RATNG APPROVAL PER 78-1279 <br /> AllV. PLAN RGVIEW$172.58 YD 10/4/I 1 2011-01181 <br /> ESCROW$2500.00 PAID 10/12/11 BY GRGGG LARSEN CK 2187 <br /> APPLICANT PERMIT FEE SCHEDULE 265.50 <br /> PERFORMANCE POOL&SPA STATE SURCHARGE(VALUATION) 7.50 <br /> 1890 WOODDALE DRIVE TOTAL 273.00 <br /> WOODBURY, MN 55125 <br /> (651)731-3440 <br /> OWNER <br /> LARSEN, GREGG & STEPHANIE <br /> 3510 BAYSIDE RD <br /> LONG LAKE, MN 55356- <br /> AGREEMENT AND SWORN STATEMENT <br /> "I he work tor which this permit is issued sha(1 be performed according[o <br /> the approved plans and specitications,applicable City approvals,and the <br /> State E3uilding Code. This permit is for only the work described and does <br /> not grant permission for additional or rclated work which requires separate <br /> pennits. All provisions of laws and ordinances governing this type of work <br /> shall be compied wilh whether or not specitied herein.This permit will <br /> expire and become null and void if construction authorized is not <br /> commenced within l80 days of the date of issuance,or if construction is <br /> suspended for a period of l80 days at any time after work has commenced. <br /> The appl responsible for assuring all required inspections are <br /> re ed in co Yonnance with the State Building Code.This permit may be <br /> re ed at i time for due cause. <br /> � I � �� /D � l� � �/ <br /> Applicant Permitee S gn ure Date Issued Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />