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� CITY OF ORONO * 2 0 1 7 - 0 0 4 7 3 * <br /> 2750 KELLEY PARKWAY DATE ISSiJED: OS/22/2017 <br /> ORONO,MN 55356- <br /> (952)249-4600 FAX: (952)249-4616 <br /> ADDRESS : 825 FOREST ARMS LA <br /> PIIY : 07-117-23-12-0011 <br /> LEGAL DESC : FOREST ARMS <br /> : LOT 003 BLOCK 002 <br /> PERMIT TYPE : ADDITION/REMODEL/REPAIR <br /> PROPERTY TYPE : RESIDENTIAL <br /> COI�TSTRUCTION TYPE : ADDN/REMODEL/REPAIR <br /> ACTIVITY : 434-RESIDENTIAL <br /> VALUATION : $ 120,000.00 <br /> NOTE: SEPARATE PERMITS REQUIRED: PLUMBING,MECHANICAL,FIREPLACE,ELECTRICAL(STATE) <br /> SECOND STORY ADDITION <br /> APPLICANT PERMIT FEE SCHEDULE 1,235.92 <br /> STATE SURCHARGE(VALUATION) 60.00 <br /> NIEMELA CONSTRUCTION INC. <br /> 5765 QUAM AVE NE TOTAL 1,295.92 <br /> OTSEGO,MN 55330- Payment(s) <br /> (612)532-7956 CHECK 1011 1,295.92 <br /> Minnesota State License#: BUIL-BC602194 <br /> OWNER <br /> BRANDENBURG,NATHAN&BETH <br /> 825 FOREST ARMS LA <br /> MOUND,MN 55364- <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for which this pertnit 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 separate <br /> permits. All provisions of laws and ordinances goveming 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 r nsible for assuring all required inspections are <br /> requested in co o ance with the State Building Code.This perrrtit may be <br /> revoked at or due cause. <br /> r � � '�f'"� <br /> V �f ^ <br /> � �Z Zo1�" C�C�-�-� /"�_.2�.5� � / Z Z/ l � <br /> plicant Permitee gttatti�e ate Issued By Signature Date <br />