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. � <br /> CITY OF ORONO PERMIT NO.: 2009-00635 <br /> 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- �ATE IssuEn: 10/OS/2009 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 965 EDGEWOOD HILLS RD <br /> PIN : 02-117-23-14-0001 <br /> LEGAL DESC : REG. LAND SURVEY NO. 1098 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : ADDITION/REMODEL/REPAIR <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ADDN/REMODEL/REPA[R <br /> ACTIVITY : 434-RESIDENTIAL <br /> VALUATION : $ 263,000.00 <br /> NOTE: SEPERATE PERMITS REQUIRED: PLUMBING,MECHANICAL,ELECTRICAL(STATE) <br /> PERM[T#2009-00634 -ADVANCED PLAN REVIEW -PD$1332.59 <br /> PERM[T#2009-00636 - ESCROW- PD$2500.00 <br /> OTHER INSPECTION NOTED IS FOR A POURED WALL INSPECTION <br /> APPLICANT PERMIT FEE SCHEDULE 2,034.75 <br /> JAMES PATSCH CONST INC. STATE SURCHARGE(VALUATION) 131.50 <br /> 3427 HUMBOLT AVENUE S <br /> MINNEAPOLIS, MN 55408 MISC FEE 0.00 <br /> (612)527-01 ll TOTAL 2,166.25 <br /> Minnesota State License#: 4290 <br /> OWNER <br /> CUSICK, MR. & MRS. THOMAS <br /> 965 EDGEWOOD HILLS RD <br /> WAYZATA, MN 55391 <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for which this permit is issued shall bc 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 whe[her or not specified herein."Chis permit will <br /> expire and become null and void if construction au[horized 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 aRer 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 du ause. <br /> `� �O�.s � � y?�t'.GG� � cr s � v y <br /> Applicant Per tee Signature Date I � d By Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />