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, • CITY OF ORONO <br /> 2750 KELLEY PARKWAY * 2 0 1 6 - PJ 1 P1 5 9 * <br /> DATE ISSUED: 09/26/2016 <br /> ORONO,MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 4640 NORTH ARM DR W <br /> PIN : 06-117-23-23-0005 <br /> LEGAL DESC : LJNPLATTED 06 117 23 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : ADDITION/REMODEL/REPAIR <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR <br /> ACTIVITY : 434-RESIDENTIAL <br /> VALUATION : $ 28,000.00 <br /> NOTE: SEPARATE PERMITS REQUIRED: PLUMBING,MECHANICAL,ELECTRICAL(STATE) <br /> NOTE: PRIOR TO RELEASE OF ESCROW M EY D SOILS MUST BE ESTABLISHED WITH VEGETATION AND A FINAL <br /> INSPECTION COMPLETED. INITIAL: <br /> APPLICANT PERMIT FEE SCHEDULE 467.54 <br /> STATE SURCHARGE(VALUATION) 14.00 <br /> A.M.BURNEY EXTERIORS,INC. TOTAL 481.54 <br /> 14367 78TH STREET NE Payment(s) <br /> OTSEGO,MN 55330- CREDIT CARD 1399 481.54 <br /> (952)836-8938 <br /> Minnesota State License#: BUIL-BC635734 <br /> OWNER <br /> IVERSON,DANIEL&LINDA <br /> 4640 NORTH ARM DR W <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 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. Ail 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 are <br /> requested in conformance with the State Building Code.This permit may be <br /> revoked at any time for due cause. <br /> / / <br /> A ic t ermitee Signature Date ssued ignature Date <br />