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� <br /> � CITY OF ORONO * Z 0 1 6 - 0 0 2 4 2 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 03/15/2016 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 2345 BLAINE AVE <br /> PIN : 17-117-23-34-0011 <br /> LEGAL DESC : TOWNSITE OF LANGDON PARK <br /> : LOT 005 BLOCK 009 <br /> PERMIT TYPE : ADDITION/REMODEL/REPAIR <br /> PROPERTY TYPE : COMMERCIAL- BUSINESS <br /> CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR <br /> ACTIVITY : 437-NONRESIDENTIAL&NONHOUSEKEEPIN <br /> VALUATION : $ 15,000.00 <br /> NOTE: ANTENNA REPLACEMENT <br /> APPLICANT PERMIT FEE SCHEDULE 278.7'7 <br /> PLAN REVIEW 181.27 <br /> BLACK&VEATCH CORPORATION STATE SURCHARGE(VALUATION) 7.50 <br /> 7600 S COUNTY LINE RD <br /> SUITE 1 TOTAL 467.54 <br /> BURR RIDGE, IL 60527- Payment(s) <br /> (913)458-1200 CHECK 42412661 467.54 <br /> OWNER <br /> (WELL NO. 3 PUMPHOUSE), CITY OF ORONO <br /> 2345 BLAINE AVE <br /> PO BOX 66 <br /> CRYSTAL BAY,MN 55323- <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 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 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. <br /> � �� /5 , /� <br /> Applicant Permitee Signature Date Issued By Signature Date <br />