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CITY OF ORONO * Z 0 1 6 - 0 0 8 5 4 * <br /> ' 2750 KELLEY PARKWAY DATE ISSUED: OS/16/2016 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 1240 ARBOR ST <br /> PIN : ]0-117-23-31-0099 <br /> LEGAL DESC : MAXWELLS ADDN CRYSTAL BAY LAKE <br /> : LOT 000 BLOCK 001 <br /> PERMIT TYPE : NEW STRUCTURE <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : SINGLE FAMILY <br /> ACTIVITY : 101-SINGLE FAMILY HOUSES,DETACHED <br /> VALUATION : $ 276,730.00 <br /> NOTE: SEPARATE PERMITS REQUIRED: PLUMBING,MECHANICAL,FIREPLACE, SEWER CONNECTION,WELL(STATE), <br /> ELECTRICAL(STATE) <br /> NOTE:PLEASE SEE AND INITIAL NEW BUILDER ACKNOWLEDGEMENT FORM <br /> APPLICANT PERM[T FEE SCHEDULE 2,225.02 <br /> PLAN REVIEW 397.21 <br /> DRUK,TIMOTHY&JULIE STATE SURCHARGE(VALUATION) 138.37 <br /> 4308 I 15TH STREET SE <br /> DELANO, MN 55328- S.A.C. 2,485.00 <br /> TOTAL 5,245.60 <br /> Payment(s) <br /> CHECK 1020 5,245.60 <br /> OWNER <br /> DRUK,TIMOTHY&JULIE <br /> 4308 115TH STREET SE <br /> DELANO, MN 55328- <br /> AGREEMENT AND SWORN STATEMENT <br /> "l�he work Yor which this permit is issued shall be performed according ro <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 specitied 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 for a period of 180 days at any time 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 au e. <br /> ^----"__ <br /> ' � / /(o/ %!� <br /> Applicant Perm e Signature Date Issued Signature Date <br />