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I <br /> , , , CITY OF ORONO _ <br /> � 2750 KELLEY PARKWAY * 2 0 1 6 0 6 4 0 * <br /> DATE ISSUED: OtJ/OU2016 <br /> ` ORONO,MN 55356- <br /> (952)249-4600 FAX: (952)249-4616 <br /> ADDRESS . , 1255 I�C�I�SON ST[�r�r�c�d '�-r, �L� k--��-1'1 �'1J� <br /> PIN : 02-117-23-31-0027 <br /> LEGAL DESC : MINNETONKA BLUFFS <br /> : LOT 000 BLOCK O15 �'� <br /> PERMIT TYPE : NEW STRUCTURE I <br /> PROPERTY TYPE : RESIDENTIAL � <br /> i <br /> CONSTRUCTION TYPE : SINGLE FAMILY <br /> ACTIVITY : 101-SINGLE FAMILY HOUSES,DETACHED <br /> VALUATION : $ 355,000.00 <br /> NOTE: SEPARATE PERMITS REQUIRED:PLUMBING,MECHANICAL,SEWER CONNECTION,WELL(STATE),ELECTRICAL(S ATE) <br /> NOTE:PLEASE SEE AND INITIAL N$W BUILDER ACKNOWLEDGEMENT FORM I <br /> SAC PAID#6703 06/14/1982-$425.00 <br /> APPLICANT PERMIT FEE SCHEDULE 2,716.4� <br /> STATE SURCHARGE(VALUATION) 177.SQ <br /> ZEHNDER HOMES INC TOTAL 2,893.9�, <br /> 4400 BLUEBELL TRAIL S Payment(s) <br /> MEDINA,MN 55340- CREDIT CARD 6074 2,893.92�'�, <br /> Minnesota State License#:BUIL-BC582356 <br /> OWNER <br /> 'i <br /> DETTLOFF,HB JC I <br /> 1001 TWELVE OAKS CENTER DR#10 I ii <br /> WAYZATA,MN 55391- i <br /> �I <br /> �I <br /> AGREEMENT AND SWORN STA�TEMENT <br /> The wark for which this permit is issued shall be perfarmed according to <br /> the approved plans and specifications,applicable City approvals,and the <br /> State Building Code. 1'his permit is for only the work described and does � <br /> not grant permission for additional or related work whi h requires sepazate <br /> permits. All provisions of laws and ordinances governi g this type of work <br /> shall be compied with whether or not specified herein. his permit will <br /> expire and become null and void if construction author� ed is not �I <br /> commenced within 180 days of the date of issuance,or i construction is <br /> suspended for a period of 180 days at any time after wo has commenced. <br /> The applicant is responsible for assuring all required ins ections are <br /> requested in conformance with the State Building Code.�'his permit may be . 'i <br /> revoked at any time for due cause. n J� <br /> ._._._-- . __...__ �'(�• <br /> �� � � � / �� ��-�� � � / / �� �I <br /> ` I <br /> Applicant Permitee Sign re Date Issued By Signature Date <br /> I <br /> I <br />