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CITY OF ORONO 111111111 I URI I I � I I * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 12/01/2017 <br /> ORONO,MN 55356- <br /> (952)249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 1065 FERNDALE RD W <br /> PIN : 02-117-23-43-0021 <br /> LEGAL DESC : REG.LAND SURVEY NO. 1372 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : ADDITION/REMODEL/REPAIR <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR <br /> ACTIVITY : 434-RESIDENTIAL <br /> VALUATION : $ 4,000.00 <br /> NOTE: SEPARATE INSPECTION REQUIRED FOR WINDOWS. INITIAL: <br /> APPLICANT PERMIT FEE SCHEDULE 108.38 <br /> PLAN REVIEW 70.45 <br /> HHC INC STATE SURCHARGE(VALUATION) 2.00 <br /> 11100 W RIVER ROAD <br /> CHAMPLIN,MN 55316- TOTAL 180.83 <br /> (763)422-8958 Payment(s) <br /> Minnesota State License#:BUIL-BC452069 CHECK 1597 180.83 <br /> OWNER <br /> DETOR,ELIZABETH&LUCAS <br /> 1065 FERNDALE RD W <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 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 inspections are <br /> req ested in conformance with the State Building Code.This permit may be <br /> re ed at any ime for due cause. <br /> —17 /0,0 <br /> Applican rtnitee Signature Date Issued By, ignature Date <br />