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M . <br /> CITY OF ORONO * z 0 1 s — 0 0 1 7 2 * <br /> 2'750 KELLEY PARKWAY DATE ISSUED: 07/OU2016 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 3960 BAYSIDE RD <br /> PIN : OS-117-23-22-0015 <br /> LEGAL DESC : AUDITOR'S SUBD.NO.203 <br /> : LOT MB BLOCK MB <br /> PERMIT TYPE : NEW STRUCTURE <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : SINGLE FAMILY <br /> ACTIVITY : 101-SINGLE FAMILY HOUSES,DETACHED <br /> VALUATION : $ 611,206.00 <br /> NOTE: SEPARATE PERMITS REQUIRED:PLUMBING,MECHANICAL,FIREPLACE,WELL(STATE),ELECTRICAL(STATE) <br /> NOTE:PLEASE SEE AND IN[TIAL NEW BUILDER ACKNOWLEDGEMENT FORM <br /> APPLICANT PERMIT FEE SCHEDULE 4,217.92 <br /> PLAN REVIEW 1,201.20 <br /> MODERN CONSTRUCTION OF MINNESOTA STATE SURCHARGE(VALUATION) 305.60 <br /> 621 MAIN ST NW <br /> ELK RNER,MN 55330- TOTAL 5,724.72 <br /> (763)200-6376 Payment(s) <br /> Minnesota State License#: BUIL-BC648528 CREDIT CARD 2369 5,724.72 <br /> OWNER <br /> LOVELESS, CHRISTOPHER&KATIE <br /> 3960 BAYSIDE RD <br /> MAPLE PLAIN, MN 55359- <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 construction authorized is not <br /> commenced within 180 days of the date of issuance,or if construction is <br /> suspended fr�a period of 180 days at any time afrer work has commenced. <br /> The applica�t is responsible for assuring all required inspections are <br /> requested if�conformance wit�the State Building Code.This permit may be <br /> revoked ay`any[ime fo�due,c�use. <br /> � . <br /> � � ���J;� `�� ^J' � � � / <br /> pli¢an ermit ig ure Date Issued Signature Date <br /> i <br /> ; <br /> i <br /> v <br />