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. - CITY OF ORONO� * z 0 1 3 - 0 0 0 6 6 * <br /> 2750 KELLEY PARKWAY �ATE tss[1��: 02/12/2013 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 4495 BAYSIDE RD <br /> PIN : 06-117-23-21-0004 <br /> LEGAL DESC : UNPLATTED 06 I l7 23 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : ADDITION/REMODEL/REPAIR <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR <br /> ACTIVITY : 434-RESIDENTIAL <br /> VALUATION : $ 17,500.00 <br /> NOTE: SEPERATG PERMITS REQU[RFD: PLUMBING, MECI IANICAL,FIRGPLACG, GLECTIZICAL(STATG) <br /> P[NISH BASEMEN'I� <br /> APPLICANT PERMIT FEE SCHEDULE 309.75 <br /> KATHERINE TAYLOR HOMES, INC. STATE SURCHARGE(VALUATION) 8.75 <br /> 120 RAILWAY STREET W <br /> PO BOX 35 PLAN REVIEW 201.34 <br /> LORETTO, MN 55357 TOTAL 519.84 <br /> (763)479-0301 <br /> Minnesota State License#: 4738 <br /> OWNER <br /> Katherine Taylor Homes, Inc. <br /> P.O. BOX 35 <br /> LORETTO, MN 55357- <br /> AGREEMENT AND SWORN STATEMENT <br /> I'hc work for which this permit is issued shall be performed according to <br /> the approved plans and specitications,applicable City approvals,and the <br /> State Building Code. 'I�his permit is for only the work described and docs <br /> not grant pennission for additional or related work which requires separalc <br /> permits. All provisions of laws and ordinances goveming this type of work <br /> shall be compied wilh 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 /> revoke t any time for due cause. <br /> a �/a � / 2 a�/ � � 13 <br /> pplicant Permitee,ignature Daie ssu B��Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />