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. , CITY OF ORONO * Z 0 1 4 — fd 1 3 1 8 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 1ll24/2014 <br /> ORONO,MN 55356- <br /> 952) 249-4600 FAX: (952 249-4616 <br /> ADDRESS : 3669 NORTH SHORE DR <br /> PIN : 08-117-23-34-0051 <br /> LEGAL DESC : CRYSTAL BEACH <br /> : LOT 003 BLOCK 000 <br /> PERMIT TYPE : ADDITION/REMODEL/REPAIR <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRiJCTION TYPE : ADDN/REMODEL/REPAIR <br /> ACTIVITY : 434-RESIDENTIAL <br /> VALUATION : $ 14,961.80 <br /> NOTE: SEPARATE ENCAPSULATION <br /> APPLICANT PERMIT FEE SCHEDULE 265.50 <br /> PLAN REVIEW 172.58 <br /> COMPLETE BASEMENT SYSTEMS STATE SURCHARGE(VALUATION) 7.48 <br /> 54004 LOREN DRIVE <br /> MANKATO,MN 56001- TOTAL 445.56 <br /> (507)387-0500 Payment(s) <br /> Minnesota State License#: BUIL-143377 CREDIT CARD 9982 445.56 <br /> OWNER <br /> ETAL, WARREN BERG <br /> 3669 NORTH SHORE DR <br /> WAYZATA,MN 55391- <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. All provisions of laws and ordinances governing this type of work <br /> shall be compied with whether or not specified herein.This pertnit 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 /> � /� / Ci��'�'v,�- � � � z�/� <br /> Applicant Permitee Signature Dat Issued y Signature Date <br />