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CITY OF ORONO * 2 0 1 4 - 0 0 2 3 S * <br /> � 2750 KELLF,Y PARKWAY DATE ISSUED: 04/04/2014 <br /> , ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS ` : 2620 FOX ST <br /> PIN : 04-117-23-42-0010 <br /> LEGAL DESC : REG. LAND SURVEY NO. 1249 <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 : $ 7,500.00 <br /> NOTE: SEPARATE PERM[TS REQUIRED: PLUMBING,MECHANICAL,ELECTRICAL(STATE) <br /> I3ATI IROOM REMODEL ��l�,,,.( <br /> � t.� <br /> APPLICANT PERM[T FEE SCHEDULE 162.25 <br /> PLAN REVIEW 105.46 <br /> JAFFRAY, MR. & MRS. STATE SURCHARGE(VALUATION) 3.75 <br /> 2620 FOX S"]' <br /> WAYZATA, MN 55391- TOTAL 271.46 <br /> Payment(s) <br /> CHECK 6080 271.46 <br /> OWNER <br /> JAFFRAY, MR. & MRS. <br /> 2620 FOX ST <br /> WAYZATA, MN 55391- <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for which this permit is issued shall be performed according to <br /> the approved plans and specitications,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 goveming 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 no[ <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 aze <br /> requested in conformance with the State B mg Code.This permit may bc <br /> revoked at ari,�y tirt}e�or due cause. <br /> . � / %Z� <br /> �, `(—�I-:�1�1 ,�` :f � � �'��c ;s�7 � � <br /> Applicant Permitee Signature Date Issued By Signature Date <br />