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PERMIT <br /> CITY OF ORONO Permit Number: <br /> 2750 Kelley Parkway- PO Box 66 P07132 <br /> Crystal Bay, Minnesota 55323 Permit Type: Addition/Remodel/Repair <br /> (952) 249-4600 Date Issued: 1/13/2004 <br /> SITE ADDRESS: 150 North Shore Dr W <br /> Maple Plain,MN 55359 <br /> PID: 06-117-23-22-0023 <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/Remodel/Repair <br /> DETAILS: <br /> Approved per resolution#: <br /> Separate permits required: Plumbing Mechanical Electrical(staie� <br /> NOTICES/REMARKS: <br /> FEE SUMMARY: Permit Fee: $ 181.25 Valuation: $ 10,000.00 <br /> Plan Review Fee: $ 117.78 <br /> State Surcharge Fee: $ 5.50 <br /> TOTAL FEE: $304.53 <br /> APPLICANT: Owner/Self OWNER: Steven&Julie Dzubay <br /> MN 150 North Shore Dr W <br /> Maple Plain MN 55359 <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 /> 'X_ --/) _':�0 <br /> APPLICANT PE ITEE SIGNATURE— <br /> IGNATURE ISSUED BY SIGNATURE <br /> Conies: 1-File(Sienittwes Required), 1-Avnlicant,1-Monthly Reuorts, 1-Assessing,1-Finance Page 1 <br />