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CITY OF ORONO PERMIT NO.: 2009-00644 <br /> . 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- DATE ISSUED: 10/23/2009 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 175 CRYSTAL CREEK RD <br /> PIN : 33-ll 8-23-33-0006 <br /> LEGAL DESC : CRYSTAL CREEK <br /> : LOT 005 BLOCK 001 <br /> PERMIT TYPE : ADDIT[ON/REMODEL/REPAIR <br /> PROPERTY TYPE : RES[DENTIAL <br /> CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR <br /> ACTIVITY : 434-RESIDENTIAL <br /> VALUATION : $ 23,500.00 <br /> NOTE: SEPERATE PFRMITS REQUIRGD: FIREPLACE,ELECTRICAL(STA'1'E) <br /> ADDITION OF A PORCH <br /> ADV.PLAN REVIEW PD PERMIT 2009-00645$258.86 <br /> ESCROW TIED TO BLDG PERMIT 2009-00715$2500.00 PD ]0-16-09 <br /> APPLICANT PERMIT FEE SCHEDULE 398.25 <br /> INTEGRITY DESIGN&CONSTRUCTION INC STATE SURCHARGE(VALUATION) 11.75 <br /> 21140 HONEYCOMB PATH TOTAL 410.00 <br /> LAKEVILLE, MN 55044- <br /> (952)985-5004 PA[D WITH CC# 9899 <br /> Minnesota State License#: 20004064 <br /> OWNER <br /> ENGEBRETON, ANDREW&SALLY <br /> 175 CRYSTAL CREEK RD <br /> LONG LAKE, MN 55356 <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 type of work <br /> shall be compied with whether or not specified herein.This permit will <br /> expire and become null and void if consVuction authorized is no[ <br /> commenced within I 80 days of the date of issuance,or if construction is <br /> su�nded for a period of 180 days at any time after work has commenced. <br /> The applicant is responsible for assuring ali required inspections are <br /> reque�ted in conformance with the State Building Code.This permit may be <br /> re�okGd at an�ti ue cause. <br /> ' ' U / 2 3 �(�G1 ��.�J /C�l 23> O <br /> Ap�iP�can Permitee i nature Date u e d B y S i g n a t u r e D a t e <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCR[BED ABOVE. <br />