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� . � . CITY OF ORONO * z � 1 Z - 0 P1 9 7 6 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 10/17/2012 <br /> ORONO, MN 55356- <br /> ' (952) 249-4600 FAX: (952) 249-4616 <br /> AL�►IRESS : 3350 FOX ST <br /> PIN : OS-117-23-44-0008 <br /> LEGAL DESC : FULLERTON ESTATES <br /> : LOT 004 BLOCK 001 <br /> PERMIT TYPE : ACCESSORY STRUCTURE <br /> PROPERTY TYPE : RES[DENTIAL <br /> CONSTRUCTION TYPE : ENTRANCE MONUMENTS <br /> ACTIVITY : O/S BUILD[NG-UNDEFINED <br /> VALUATION : $ 10,000.00 <br /> NO'I'L: ADV PLAN RGVIEW PD 2012-00975$12d.64 <br /> F.N"I'RANCE MONUMENTS <br /> APPLICANT <br /> PERMIT FEE SCHEDULE 191.75 <br /> STEINER& KOPPELMAN STATE SURCHARGE(VALUAT[ON) 5.00 <br /> 18340 MINNETONKA BLVD <br /> DEEPHAVEN, MN 55391- TOTAL 196.75 <br /> (612)473-5435 PAID WITH CC# 1072 <br /> Minnesota State License#: 3721 <br /> OWNER <br /> BIGOS,NANCY <br /> 3350 FOX ST <br /> LONG LAKE, MN 55356- <br /> AGREEMENT AND 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 Building Code. 'I'his 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�ti ith whether or not specified 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 cons[ruction is <br /> suspended for a period of 180 days at any time after work has commenced. <br /> The applicant is-esponsible fo�uring all required inspections are <br /> requested�tn con rmane ith th'e State Building Code.This pem�it may be <br /> revok�d at any � e due c � � � <br /> ; � / <br /> , /-, � -� <br /> �----�:"" '� � ;� � �7 � � �_ �-� C%'�/1--����'� i i��', _ � <br /> pplicant Permitee Signature Date Issued By Signature Date <br /> SEPARATE PERMITS REQU[RED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />