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CITY-OF ORONO PERMIT <br /> b <br /> Permit Number:275(; Kelley Parkway- PO Box 66 PermP08142 <br /> Crystal Bay, Minnesota 55323 Permit Type: Addition/Remodel/Repair <br /> (952) 249-4600 Date Issued: 11/30/2004 <br /> SITE ADDRESS: 4535 North Shore Dr <br /> Mound,MN 55364 <br /> PID: 07-117-23-31-0007 <br /> DESCRIPTION: UBC occupancy R3 <br /> Proposed Use: Residential Construction Type VN <br /> Permit Class: Building Census Code 434 <br /> Permit Type: Addition/Remodel/Repair Permit Sub-type(s): Addn/RemodeVRepair <br /> DETAILS: <br /> Approved per resolution#: <br /> Separate permits required: Electrical(state) <br /> NOTICES/REMARKS: <br /> FEE SUMMARY: Permit Fee: $ 54.00 Valuation: $ 1,500.00 <br /> Plan Review Fee: $ 35.08 <br /> State Surcharge Fee: $ 1.25 <br /> TOTAL FEE: $ 9033 <br /> APPLICANT: Owner/Self OWNER: Roger&Elaine Haydock <br /> MN 4535 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 CODE REQUIREMENTS. <br /> APPLICANT PEIWITEE SIGNATURE ISSftD BY SIGNATURE <br /> Conies: 1-File(Sienitures Rewired).1-Annlicant,1-Monthlv Reports, 1-Assessing, 1-Finance Page 1 <br />