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- - CITY OF ORONO PERMIT NO.: 2009-00911 <br /> 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- DATE ISSUED: OV06/2010 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 3205 CRYSTAL BAY RD <br /> PIN : 17-117-23-41-0011 <br /> LEGAL DESC : TOWNSITE OF LANGDON PARK <br /> : LOT 001 BLOCK 002 <br /> PERMIT TYPE : ADDITION/REMODEL/REPAIR <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ADDN /REMODEL/REPAIR <br /> ACTIVITY : 434-RESIDENTIAL <br /> VALUATION : $ 175,000.00 <br /> NOTE: SEPERATE PERM[TS REQUIRED: YLUMBING,MECHANICAL, FIREPLACE. ELEC"I'RICAL(STATE) <br /> ADV. PLAN REVIEW PD 12/21/09 2009-00910$979.39 <br /> -COLOR CODED SURVEY/HARDCOVER REMOVAL PLAN TO BE FOLLOWED L �� <br /> -COMPLIANCG PRIOR TO C.O.VERIFIGD W/AS-BUIL'1'SURVEY �1� <br /> APPLICANT PERMIT FEE SCHEDULE 1,506.75 <br /> ANDERSON, RICHARD STATE SURCHARGE(VALUATION) 87.50 <br /> 3205 CRYSTAL BAY RD TOTAL 1,594.25 <br /> WAYZATA, MN 55391- <br /> OWNER <br /> ANDERSON, R[CHARD <br /> 3205 CRYSTAL BAY RD <br /> WAYZATA, MN 55391- <br /> AGREEMENT AND SWORN STATEMENT <br /> "I�he work ibr which this pennit is issued shall be periormed according to <br /> thc approved plans and specifications,applicable City approvals,and thc <br /> State F3uilding Code. "l�his permit is for only�the work dcscribed and does <br /> not grant permission for additional or rclated work which requires separatc <br /> permits. All provisions of la��s and ordinances govcrning this type ol�work <br /> shall be compied with whether or not speciticd herein.This permit will <br /> expire and become null and void if construction authorized is not <br /> commenced within I 80 da��s 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 arc <br /> requested in conformance with the State Building Code.This permit may be <br /> revoked at any time for due cause. � �� <br /> '�-�a.�C��SJ�`�'`� � � i C' � i ( i1 " ' ��� / i �v i�7L�/l� <br /> A plicant Permitee Signature Date �� �� G��C� �� � <br /> Issue By Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />