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, CITY OF ORONO PERMIT IVO.: 2010-00147 <br /> 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- �ATE ISsuEn: 03/22/2010 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 2695 COUNTRYSIDE DR W <br /> PIN : 04-117-23-13-0005 <br /> LEGAL DESC : OLD CRYSTAL BAY ROAD ADDN <br /> : LOT 005 BLOCK 003 <br /> PERMIT TYPE : ADDITION/REMODEL/REPA[R <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ADDN /REMODEL/REPAIR <br /> ACTIVITY : 434-RESIDENTIAL <br /> VALUATION : $ 15,000.00 <br /> NOTE: SEPERATE PGRMITS REQU[RED: PLUMBING) <br /> INTERIOR BATHROOM REMODEL-NO STRUC"I�URAL CHANGES <br /> APPLICANT <br /> PERMIT FEE SCHEDULE 265.50 <br /> WATER STREET HOMES LLC STATE SURCHARGE(VALUATION) 7.50 <br /> 305 MINNETONKA AVE S TOTAL 273.00 <br /> WAYZATA, MN 55�91- <br /> (952)474-6160 <br /> Minnesota State License#: 20390906 <br /> OWNER <br /> PETERSON, DON <br /> 2695 COUNTRYSIDE DR W <br /> LONG LAKE, MN 55356- <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for which this permit is issucd shall be performed according to � <br /> the approved plans and specifications,applicable City approvals,and the <br /> State Buiiding 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 /> shail be compied with whether or not specitied 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 lor assuring all required inspections are <br /> requested in conformance with the State Building Code."I�his permit may be <br /> revoked at time for cause. <br /> r 3j ` Z� �n � � <br /> Applicant Permitee Signature Date Issued By Signalure Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />