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e „ <br /> CITY OF ORONO * z 0 1 4 - 0 0 0 8 B * <br /> 2750 KELLEY PARKWAY DATE ISSUED: OZ/07/2014 <br /> ORONO, MN 55356- <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 380 LEAF ST <br /> PIN : 04-117-23-23-0027 <br /> LEGAL DESC : AUDITOR'S SUBD.NO.230 <br /> : LOT 026 BLOCK 000 <br /> PERMIT TYPE : ADDITION/REMODEL/REPAIR <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR <br /> ACTIVITY : 434-RESIDENTIAL <br /> VALLTATION : $ 15,000.00 <br /> NOTE: SEPARATE PERMITS REQUIRED: PLUMBING,MECHANICAL,ELECTRICAL(STATE) <br /> 2ND FLOOR REMODEL <br /> APPLICANT PERMIT FEE SCHEDULE 265.50 <br /> PLAN REVIEW 172.58 <br /> THOMAS BREN HOMES STATE SURCHARGE(VALUATION) 7.50 <br /> 2073 WAYZATA BLVD. W.#50 <br /> WAYZATA,MN 55391 TOTAL 445.58 <br /> (952)475-6777 Payment(s) <br /> Minnesota State License#: BUIL-BC128144 CHECK 14350 445.58 <br /> OWNER <br /> BURKE,FORREST&RENEE <br /> 380 LEAF 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. This permit is for only the work described and does <br /> not grant permission for additional or related work which requires sepazate <br /> permits. All provisions of laws and ordinances governing 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 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 aze <br /> requested in conformance with the State Building Code.This permit may be <br /> revoked at any time for due cause. <br /> �- ? / i/ <br /> Applicant Pe ee Signature te Issu By Signature Date <br />