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� � <br /> CITY OF ORONO * Z 0 1 6 - 0 0 1 5 7 * <br /> � 2750 KELLEY PARKWAY DATE ISSUE�: 04/06/2016 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 787 BOULDER DR <br /> PIN : 33-118-23-11-0132 <br /> LEGAL DESC : STONEBAY <br /> : LOT 7&8 BLOCK 1 <br /> PERMIT TYPE : NEW STRUCTURE <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCT[ON TYPE : TOWNHOME <br /> ACTNTTY : 102-SINGLE FAMILY HOUSES,ATTACHED <br /> VALUATION : $ 620,000.00 <br /> NOTE: SEPERATE PERMITS REQUIRED:PLUMBING,MECHANICAL,FIREPLACE,WATER&SEWER CONNECTION,ELECTRICAL <br /> (STATE) <br /> PLEASE INITIAL BUILDERS ACKNOWLEDGEMENT FORM(ATTACHED) <br /> APPLICANT PERMIT FEE SCHEDULE 4,259.92 <br /> STATE SURCHARGE(VALUATION) 310.00 <br /> WOODDALE BUILDERS INC. S.A.C. 2,485.00 <br /> 6117 BLUE CR DR <br /> MINNETONKA, MN 55343- TOTAL 7,054.92 <br /> (952)345-0543 Payment(s) <br /> Minnesota State License#: BUIL-BC002926 CHECK 84821 7,054.92 <br /> OWNER <br /> Wooddale Builders <br /> 6117 BLUE CIR DR <br /> MINNETONKA, MN 55343- <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for which this permit is issued shall be performed according to <br /> the approved plans and specifications,applicable City 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 governing this rype 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 180 days of the date of issuance,or if construction is <br /> suspended for a period of 180 days at any time afrer 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. � <br /> ._ ':... ,�� ��� !�C� �--�c, � �o � ,� <br /> Applicant Per�gnature Date�� Issued y S' ature Date <br />