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CITY OF ORONO * 2 0 1 5 - 0 0 6 3 3 * <br /> -- 2750 KELLEY PARKWAY DATE ISSUED: 06✓03/2015 <br /> . ORONO,MN 55356- <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 4175 NORTH SHORE DR <br /> PIN : 07-117-23-44-0093 <br /> LEGAL DESC : HIGHWOOD LAKE MTKA <br /> : LOT MB BLOCK MB <br /> PERMTT TYPE : ADDITION/REMODEL/REPAIR <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR <br /> ACTIVITY : 434-RESIDENTIAL <br /> VALUATION : $ 2,350.00 <br /> NOTE: SEPARATE PERMITS REQUIRED: PLUMBING,I�CHANICAL,FIREPLACE,ELECTRICAL(STATE) <br /> (EXTERIOR RADON SYSTEII� <br /> APPLICANT PERNIIT FEE SCHEDLTLE 92.93 <br /> PLAN REVIEW 60.40 <br /> COMPLETE BASEMENT SYSTEMS STATE SURCHARGE(VALUATIOI� 1.18 <br /> 54004 LOREN DRIVE <br /> MANKATO,MN 56001- TOTAL 154.51 <br /> (50'n 387-0500 Payment(s) <br /> Minnesota State License#:BUIL-143377 CREDIT CARD 5821 154.51 <br /> OWNER <br /> SAVAGE,ANNE B&WILLIAM C <br /> 4175 NORTH SHORE DR <br /> MOLJND,MN 55364 <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for which this pennit is issued shall be performed according to <br /> the approved plans and specifications,applicable City approvals,and the <br /> State Building Code. 1'his permit is for only the work described and dces <br /> not grant permission for addidonal or related work which requires separate <br /> pemuts. All provisions of laws and ordinances governing this type of work <br /> shall be wmpied with whether or not specified herein.This permit will <br /> eacpire and become null and void if construction suthorized 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 confom►ance with the State Building Code.This permit may be <br /> revoked at any time for due cause. <br /> ' � o � � lQ � I� � �.S— <br /> , <br /> Applicant Permitee ignature Date Issued Sign Date <br />