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? ' ' CITY OF ORONO PERMIT NO.: 2010-01092 <br /> 2750 KELLEY PARKWAY <br /> � ORONO, MN 55356- DATE ISSUED: 12/02/2010 <br /> ; <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 1125 MILLSTON RD <br /> PIN : 10-117-23-14-0006 <br /> LEGAL DESC : MILLSTON <br /> : LOT 001 BLOCK 001 <br /> PERMIT TYPE : ADDITION/REMODEL/REPAIR <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRiJCTION TYPE : ADDN/REMODEL/REPAIR <br /> ACTIVITY : 434-RESIDENTIAL <br /> VALUATION : $ 60,000.00 <br /> NOTE: SEPERATE PERMITS REQUIRED: ELECTRICAL(STATE) <br /> MISCELLANEOUS FEE IS FOR WORK STARTED WITHOUT PERMIT <br /> APPLICANT pERMIT FEE SCHEDULE 756.75 <br /> TOM POTTER CONSTRUCTION INC. PLAN REVIEW 491.89 <br /> 6531 DEVONSHIRE DR. <br /> CHANHASSEN,MN 55317 STATE SURCHARGE(VALUATION) 30.00 <br /> O MISC FEE 756J5 <br /> Minnesota State License#: 20130144 TOTAL 2,035.39 <br /> OWNER <br /> BURWELL,MR.&MRS. RODNEY P <br /> 7901 XERXES AVE S <br /> MINNEAPOLIS,MN 55431- <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 desc�ibed 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 responsible for assuring all required inspections aze <br /> requested' onformance ith the State Building Code.This permit may be <br /> rev t y time for d <br /> � Z l Z l a �� ) lD�l /O <br /> _Applicant Permitee Signature Date Is d By Signature Date <br /> � SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br /> I <br />