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� CITY OF ORONO * z 0 1 2 - PJ 0 7 5 0 * <br /> � � 2750 KELLEY PARKWAY DATE ISSUED: 08/02/2012 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 1180 LOMA LINDA AVE <br /> PIN : 08-117-23-23-0002 <br /> LEGAL DESC : UNPLATTED 08 1 17 23 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : ADDITION/REMODEL/REPA(R <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR <br /> ACTIVITY : 434-RESIDENTIAL <br /> VALUATION : $ 10,000.00 <br /> NOTE: RGPA[R GARAGE FLOOR <br /> APPLICANT PERMIT FEE SCHEDULE 191.75 <br /> STRUCTURES UNLIMITED, INC. STATE SURCHARGE(VALUATION) 5.00 <br /> 5425 CLAYTON DR[VE <br /> MAPLE PLA[N, MN 55359 MISC FEE 0.00 <br /> �� TOTAL 196.75 <br /> Minnesota State License#: BC173396 PAID WITH CC# 4520 <br /> OWNER <br /> BURNS, MATTHEW <br /> 1180 LOMA LINDA AVE <br /> MOUND, MN 55364 <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 thc <br /> State Building Code. This permit is for only the work described and does <br /> not grant permission for additional or�elated work which requires separate <br /> permits. All provi ' s of laws and ordinances goveming this type of work <br /> shall be compied it�whether or not specified herein.This permit will <br /> expire and beco e null and void if construction authori �not <br /> commenced with n 180 days of the date of issu ,or if construction is <br /> suspended for a raod of 180 day t a e after work has commenced. <br /> The applicant is r ponsible for surmg all required inspections are <br /> requested in conf rmance w' the State Building Code.This permit may be <br /> revoked at any t e for d}r�cause. <br /> / / � � <br /> A p�can P itee Signature Date Issued y S' ature te <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER HAN DESCR[BED ABO . <br />