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CITY OF ORONO * z 0 1 5 — 0 1 2 7 1 * <br /> ' 2750 KELLEY PARKWAY DATE ISSUED: 12/16/2015 <br /> ' ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 4565 BAYSIDE RD <br /> PIN : 06-117-23-21-0010 <br /> LEGAL DESC : BAYSIDE BERRY FARM <br /> : LOT 2 BLOCK 1 <br /> PERMIT TYPE : ACCESSORY STRUCTURE <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : BARN <br /> ACTIVITY : 328-0THER NONRESIDENTIAL BUILDINGS <br /> VALUATION : $ 58,900.00 <br /> NOTE: SEPARATE PERMITS REQUIRED: ELECTRICAL(STATE) <br /> (POLE BUILDING) <br /> SEE ACKOWLEDGEMENT FORM <br /> APPLICANT PERMIT FEE SCHEDULE 786.84 <br /> STATE SURCHARGE(VALUATION) 29.45 <br /> DENALI CUSTOM HOMES, INC. TOTAL 816.29 <br /> 18283 MINNETONKA BLVD. Payment(s) <br /> DEEPHAVEN, MN 55391- CHECK 11875 816.29 <br /> (952)476-2679 <br /> Minnesota State License#: BUIL-20175394 <br /> OWNER <br /> DOUBECK, TIM& MARY <br /> 4565 BAYSIDE RD <br /> MAPLE PLAIN,MN 55359- <br /> AGREEMEIYT AND SWORN STATEMENT <br /> The work for which this permit is issued shall be performed according to <br /> the approved plans and specifications,applicable Ciry 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 goveming 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 l80 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. �J <br /> '� ----_ -_�_ j��j % '1 � •.��'��(,; ��-� /b � <br /> n� <br /> Appl ant Permitee ignature Date Issued By Signature Date <br />