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CITY OF ORONO * z 0 1 5 - 0 1 1 9 s * <br /> ' 2750 KELLEY PARKWAY DATE ISSUED: 11/06/2015 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 10 MYRTLEWOOD RD <br /> PIN : 36-118-23-33-0009 <br /> LEGAL DESC : MYRTLEWOOD <br /> : LOT 001 BLOCK 001 <br /> PERMIT TYPE : NEW STRUCTURE <br /> PROPERTY TYPE : RESIDENTIAL <br /> COIVSTRUCTIOIY TYPE : SINGLE FAMILY <br /> ACTIVITY : 101-SINGLE FAMILY HOUSES, DETACHED <br /> VALUATION : $ 1,400,000.00 <br /> NOTE: SEPARATE PERMITS REQUIRED: PLUMBING,MECHANICAL,FIREPLACE,WATER CONNECT[ON,SEWER CONNECT[ON, <br /> ELECTR[CAL(STATE) <br /> NOTE:PLEASE SEE AND INITIAL NEW BUILDER ACKNOWLEDGEMENT FORM <br /> APPLICANT PERMIT FEE SCHEDULE 7,934.59 <br /> STATE SURCHARGE(VALUAT[ON) 660.00 <br /> CHAMBERLAIN FINE CUSTOM HOMES S.A.C. 2,485.00 <br /> 1 1578 CHAMBERLA[N CT <br /> EDEN PRAIR[E, MN 55344- TOTAL 11,079.59 <br /> (952)649-7653 Payment(s) <br /> Minnesota State License#: BUIL-BC661410 CHECK 5309 I 1,079.59 <br /> OW1vER <br /> Chamberlain Capital LLC <br /> 11578 CHAMBERLAIN CT <br /> EDEN PRA[RIE, MN 55344- <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for which this permit is issued shall be performed according[o <br /> the approved plans and specitications,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 responsible for assuring all required inspections are <br /> requested in conformance with the State Building Code.This permit may be �}•�� <br /> revoked at any time for due cause. �- <br /> �� ,�) ---- <br /> / . .-- <br /> f/./���C_[".t \_ �� \�—�—'�4� � I� 1�� �,� <br /> Applicant Permitee Signature Date Issued By Signatu Date <br />