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CITY OF ORONO * z 0 1 5 - 0 0 9 2 8 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 08/17/2015 <br /> ' ORONO, MN 55356- <br /> 952 249-4600 FAX: 952) 249-4616 <br /> ADDRESS : 4205 NORTH SHORE DR <br /> PIN : 07-117-23-43-0004 <br /> LEGAL DESC : ORCHARD BEACH <br /> : LOT 002 BLOCK 000 <br /> PERMIT TYPE : ADDITION/REMODEL/REPAIR <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR <br /> ACTIVITY : 434-RESIDENTIAL <br /> VALUATION : $ 36,000.00 <br /> NOTE: SEPARATE PERMITS REQUIRED:FIREPLACE <br /> SCREEN IN AREA UNDERNEATH DECK <br /> NOTE:PRIOR TO RELEASE O�SCROW MONEY AN AS-BU[LT SURVEY AND HARD COVER CALCULATIONS MUST BE SUBMITTED <br /> AND APPROVED. INIT[AL: , <br /> ��c <br /> APPLICANT PERMIT FEE SCHEDULE 557.84 <br /> STATE SURCHARGE(VALUATION) 18.00 <br /> SCOTT STIFTER SAWDUST CONSTRUCTION TOTAL 575.84 <br /> 1455 OXFORD AVE Payment(s) <br /> DELANO,MN 55328- CHECK 6366 575.84 <br /> (952)913-2451 <br /> Minnesota State License#: BUIL-155848 <br /> OWNER <br /> KOEHLER,TIMOTHY&DANIELLE <br /> 4205 NORTH SHORE DR <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 E3uilding 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 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 applican[is responS�ble for assuring all required inspections aze <br /> request,P�l in conform�nc�with the State Building Code.This permit may be 7 <br /> revoked'at any time f r e cause. �C�` � <br /> __�_. ��`�..�_ � � � <br /> �� ��__._ -�`�.`� �-�`�-`l � .��`�� � , ��, 1 .� <br /> Appli a Permitee Signature Date [ssued By Signature Date <br />