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. � , CITY OF ORONO * 2 0 1 6 - 0 0 5 4 9 * <br /> • 2750 KELLEY PARKWAY DATE ISSUED: 05/24/2016 <br /> ORONO,MN 55356- <br /> (952)249-4600 FAX: (952)249-4616 <br /> ADDRE5S : 4175 NORTH SHORE DR <br /> PIN : 07-117-23-44-0093 <br /> LEGAL DESC : HIGHWOOD LAKE MTKA <br /> : LOT MB BLOCK MB <br /> PERMIT TYPE : ADDITION/REMODEL/REPAIR <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR <br /> ACTIVITY : 434-RESIDENTIAL <br /> VAI,.UATION : $ 1,500.00 <br /> NOTE: HAND EXCAVATE AND INSTALL PEEL AND STICK WATER PROOFING <br /> APPLICANT PERMIT FEE SCHEDULE 60.35 <br /> PLAN REVIEW 39.23 <br /> JESSE TREBIL(SAFE BASEMENTS) STATE SURCHARGE(VALUATION) 0.75 <br /> 60335 US HWY 12 <br /> LITCHFIELD,MN 56387- MAIL-IN FEE 2.00 <br /> (320)9748729 TOTAL 102.33 <br /> Minnesota State License#:BiJIL-20446489 Payment(s) <br /> CREDIT CARD 3188 10233 <br /> OWNER <br /> GOODFELLOW,MARI <br /> 4175 NORTH SHORE DR <br /> MOLJND,MN 55364- <br /> AGREEMENT AND SWORI�T 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 pertnit 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 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 inspecrions aze <br /> requested in conformance with the State Building Code.This permit may be <br /> revoked at any time for due cause. <br /> 1 � <br /> � � � �/� <br /> Applicant Permitee Signature Date Issu Signature Date <br />