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CITY OF ORONO * Z 0 1 5 - 0 1 2 3 2 * <br /> � ' 2750 KELLEY PARKWAY DATE ISSUED: 12/04/2015 <br /> ORONO, MN 55356- <br /> 952 249-4600 FAX: 952 249-4616 � <br /> ADDRESS : 3349 CRYSTAL BAY RD <br /> PIN : 17-117-23-41-0023 ,�i(J' <br /> LEGAL DESC : WALLACES ADDN TO VIL OF MTKA B � <br /> : LOT 010 BLOCK 000 <br /> PERMIT TYPE : ADDITION/REMODEL/REPAIR <br /> PROPERTY TYPE : RESIDENT[AL ` <br /> CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR � <br /> ACT[VITY : 434-RESIDENTIAL � <br /> VALUATION : $ 90,000.00 � <br /> NOTE: SEPARATE PERMITS REQUIRED: PLUMBING, MECHANICAL,ELECTRICAL(STATE) <br /> ADDITION/REMODEL <br /> � <br /> � <br /> Q � <br /> APPLICANT PERMIT FEE SCHEDULE 1,031.04 <br /> STATE SURCHARGE(VALUATION) 45.00 <br /> S. J. FISHER CONSTRUCTION <br /> 70 FLORENCE DRIVE TOTAL 1,076.04 <br /> TONKA BAY, MN 55331- Payment(s) <br /> (952)474-6976 CHECK 5419 1,076.04 <br /> Minnesota State License#: BUIL-BC626515 <br /> OWNER <br /> LENSING,JULIE <br /> 3349 CRYSTAL BAY RD <br /> WAYZATA, MN 55391- <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 rela[ed work which requices separate <br /> permits. All provisions of laws and ordinances goveming this type of work <br /> shall be wmpied with whether or no[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 cons[ruction is <br /> suspended for a period of 180 days at any[ime 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 /> � f S ���� /�l `� i /S <br /> App ant Permitee Signature Dat Issued Signature Date <br />