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ITY PERMIT <br /> C �.� O RO N O Permit Number: <br /> 2750 Kelley Parkway - PO Box 66 P06351 <br /> Crystal B�y, Minnesota 55323 Permit Type: NeW sm��r�e <br /> (952) 249-4600 Date Issued: 6�6�2003 <br /> SITE ADDRESS: 3720 Jacobs Mill Rd <br /> L.ong Lake,MN 55356 <br /> PID: 32-118-23-24-0008 <br /> DESCRIPTION: UBC Occupancy R3 <br /> Construction Type VN <br /> Proposed Use: Residential <br /> Permit Class: Building Census Code 101 <br /> Permit Type: New Structure Pernut Sub-type(s): New Home-Single Family <br /> DETAILS: <br /> Approved per resolution#: <br /> Separate permits required: riumoing iviecnanicai �eptic rirepiace imgarion 'vveii�siaiej Eiecincai�siaiej <br /> NOTICES/REMARKS: <br /> L�_._a:_ A____ <br /> vvY�av a i��.0 <br /> FEE SUMMARY: Pernut Fee: $ 2,617.75 Valuation: $ 390,000.00 <br /> Plan Review Fee: $ 1,701.63 <br /> State Surcharge Fee: $ 195.50 <br /> TOTAL FEE: $ 4,514.88 <br /> APPLICANT: Owner/Self OWNER: Greg Carlson <br /> MN 521 Willow Dr.N.#203 <br /> Long Lake, MN 55356 <br /> THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED <br /> AND AGREES TO DO ALL WORK IN STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF <br /> MINNESOTA BUILDING CODE REQUIREMENTS. <br /> � <br /> , <br /> � � �� " � ��' ' ' i ���--� 1 <br /> APP C T PERMITEE SIGNATURE ISSUED BY SIGNATURE <br /> Copies: 1-File(Si�nitures Repuired), 1-Anplicant, 1-Monthlv Reports, 1-Assessin�, 1-Finance Page 1 <br />