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. - ' CITY OF ORONO PERMIT NO.: 200&00441 <br /> , 2750 KELLEY PARKWAY <br /> •� ORONO, MN 55356- �ATE �ss[1En: OU14/2009 <br /> ` � 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 2640 FOX ST <br /> P[N : 04-117-23-42-0008 <br /> LEGAL DESC : REG. LAND SURVEY NO. 1249 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : NEW STRUCTURE <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : SINGLE FAMILY <br /> ACTIVITY : 101-5[NGLE FAMILY HOUSES, DETACHED <br /> VALUATION : $ 800,000.00 <br /> NOTE: SI:PGRATE PERMITS REQU[RED: PLUMI3ING, MECHANICAL, SGPTIC, NIREPLACE, <br /> LAWN IRRIGATION, WELL(STA'CE),ELEC"CR[CAI,(STATE) <br /> SEPTIC AREA-NO SAC <br /> APPLICANT PERM[T FEE SCHEDULE 4,956.75 <br /> STONEWOOD DESIGN BUILD PLAN REVIEW 3,221.89 <br /> 7404 WAYZATA BLVD <br /> M[NNEAPOLIS, MN 55426- STATE SURCHARGE(VALUATION) 400.00 <br /> (952)697-5075 TOTAL 8,578.64 <br /> Minnesota State License#: 20534541 <br /> OWNER <br /> WESTL[NG, TOM <br /> 2640 FOX ST <br /> WAYZATA, MN 55391- <br /> AGREEMENT AND SWORN STATEMENT <br /> 7�he 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. 'I'his permit is for only the work described and does <br /> not grant pennission for additional or related work which requires separate <br /> permits. All provisions of la�vs and ordinances governing this type of work <br /> shall be compied with whether or not specified herein.This permit will <br /> expirc 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 /> revok�d at a ty�i�e for ue cause. G���� <br /> _� . <br /> ,. / - l�( - C°� <br /> ��, <br /> ��"�.�_ ,� �1�����,,���o.�L_��i�lo� �L�--'��� U�'�'1C� � 1 (l0 / / <br /> Applicant Permitee Signature Date Issued By Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />