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CITY OF ORONO PERMIT NO.: 2009-00496 <br /> 2750 KELLEY PARKWAY <br /> � ; ORONO, MN 55356- �ATE �SSUED: 08/25/2009 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 980 FERNDALE RD W <br /> PIN : 02-117-23-44-0019 <br /> LEGAL DESC : COUNTRY CLUB ESTATES <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : ADDITION/REMODEL/REPAIR <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR <br /> ACTIVITY : 434-RESIDENTIAL <br /> VALUATION : $ 60,000.00 <br /> NOTE: SGPERATG PERMITS REQUIRED: PLUMBING,MGCHANICAL,FIREPLACE,ELECTRICAL(STATF;) <br /> ADVANCED PLAN REVIEW COLLECTED ON PERMIT 2009-00495 S/17/09$491.89 <br /> APPLICANT PERMIT FEE SCHEDULE 756.75 <br /> SAFAR,JACK <br /> 980 FERNDALE RD W PLAN REV[EW 0.00 <br /> WAYZATA, MN 55391- STATE SURCHARGE(VALUATION) 30.00 <br /> TOTAL 786.75 <br /> OWNER <br /> SAFAR,JACK& PAMELA <br /> 980 FERNDALE RD W <br /> WAYZATA, MN 55391- <br /> AGREEMENT AIVD 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 Buiiding Code. This permit is for only[he work described and does <br /> no[grant permission for additional or related work which requires separate <br /> permits. All provisions of laws and ordinances governing this[ype 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 no[ <br /> commenced within 180 days of the date of issuance,or if construction is <br /> suspended for a period of 180 ays at any time after work has commenced. <br /> The applicant is responsibl .or assuring all required inspections are <br /> requested in con anc ith the State Building Code.This permit may be <br /> revoked at an im for ue cause. �\ <br /> / / �� �� l'� <br /> L <br /> Applicant P m e ignature � Date ued By Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WO OTHER THAN DESCRIBED ABOVE. <br />