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PERMIT <br /> CITY OF ORONO Permit Number: <br /> 275U Kelley Parkway - PO Box 66 P07545 s , <br /> Crystal Bay, Minnesota 55323 Permit Type: ada�rio�xemodevxepa�r <br /> (952) 249-4600 Date Issued: 6�9�2ooa <br /> SITE ADDRESS: 4064 North Shore Dr <br /> Mound,MN 55364 <br /> PID: 07-117-23-44-0085 <br /> DESCRIPTION: UBC Occupancy R3 <br /> Construction Type VN <br /> Proposed Use: <br /> Permit Class: Building Census Code 434 <br /> Permit Type: Addition/RemodeURepair Permit Sub-type(s): Addn/Remodel/Repair <br /> DETAILS: <br /> Approved per resolution#: <br /> Separate pernuts required: riumoing iviec;nanicai r,ieciricai�sraie� <br /> NOTICES/REMARKS: <br /> "-=— -"-`---� ---'n.--- ----�-'-- �-- �--�---- �----- -�---. _�� � <br /> :�»::.c:.c..c.a..:::::::::c, "'_' ��:::��::::.� � .,...�cc� »....., <br /> FEE SUMMARY: PermitFee: $ 251.25 <br /> Valuation: $ 15,000.00 <br /> Plan Review Fee: $ 163.28 <br /> State Surcharge Fee: $ 8.00 <br /> TOTAL FEE: $ 422.53 <br /> APPLICANT: Owner/Self OWNER: Dan Phipps&Janet Obrigewitsch <br /> � 4064 North Shore Dr <br /> Mound,MN 55364 <br /> THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED <br /> AND AGREES TO DO ALL WORK IN STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF <br /> MINNESOTA BUILDING C E REQUIREMENTS. <br /> �..--__ ! <br /> I <br /> _�;, : �;(f� � (� ��� /'� ��� <br /> APPLICANTPERMI SIGNATURE 1SSUEDBYSIGNATURE <br /> Copies: 1-File(SiQnitures ReAuired), 1-Apnlicant, 1-Monthlv Reports. 1-Assessine, 1-Finance Page 1 <br />