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.� <br /> -�� � CITY OF ORONO * 2 0 1 6 - 0 0 Z 8 9 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: OS/OS/2016 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 4220 CHIPPEWA LA <br /> PIN : 31-118-23-42-0012 <br /> LEGAL DESC : CHIPPEWA 2ND ADDN <br /> : LOT 001 BLOCK 001 <br /> PERMIT TYPE : NEW STRUCTURE <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : SINGLE FAMILY <br /> ACTIVITY : ]O1-SINGLE FAMILY HOUSES,DETACHED <br /> VALUATION : $ 621,617.00 <br /> NOTE: SEPARATE PERMITS REQUIRED:PLUMBING,MECHAN[CAL,SEPTIC,FIREPLACE,WELL(STATE),ELECTRICAL(STATE) <br /> NOTE:PLEASE SEE AND INITIAL NEW BUILDER ACKNOWLEDGEMENT FORM <br /> APPLICANT PERMIT FEE SCHEDULE 4,270.42 <br /> PLAN REVIEW 153.56 <br /> M&M HOME CONTRACTORS STATE SURCHARGE(VALUATION) 310.81 <br /> 205 WINKLER TRL <br /> PO BOX 90 TOTAL 4,734.79 <br /> COLOGNE, MN 55322- Payment(s) <br /> (612)797-3720 CHECK 8792 4,734.79 <br /> Minnesota State License#: BUIL-BC560376 <br /> OWNER <br /> DBG, LLC <br /> SCHRODER, SUSAN <br /> 4725 WEST LANE <br /> MINNETRISTA, MN 55364- <br /> AGREEMENT AIYD SWORIv 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 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 180 days of the date of issuauce,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 fo ca e. - <br /> /�� I <br /> �, ,, <br /> �� S � � �� �/� <br /> Applica ermit$�Sig re Dat Issued Signature Date <br />