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CITY OF ORONO PERMIT NO.: 2009-00348 <br /> 2750 KELLEY PARKWAY <br /> ORONO,MN 55356- DATE ISSUED: 06/29/2009 <br /> (952) 249-4600 FAX: (952)249-4616 <br /> ADDRESS : 795 OLD CRYSTAL BAY RD N <br /> PIN : 28-118-23-34-0003 <br /> LEGAL DESC : UNPLATTED 28 118 23 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : ADDITION/REMODEL/REPAIR <br /> PROPERTY TYPE : INSTITUTIONAL-SCHOOL <br /> CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR <br /> ACTIVITY : 326-SCHOOLS AND OTHER EDUCATIONAL <br /> VALUATION : $ 7,000.00 <br /> NOTE: SHOWER ADDITION IN EXISTING SPACE. <br /> WORK REQUIRES ADDITIONAL PERMITS: PLUMBING PERMIT REQUIRED. <br /> APPLICANT PERMIT FEE SCHEDULE 147.50 <br /> M.CARSON CONSTRUCTION STATE SURCHARGE(VALUATION) 3.50 <br /> 3311 VALE CIRCLE SW <br /> PRIOR LAKE,MN 55372- TOTAL 151.00 <br /> (952)226-2699 <br /> Minnesota State License#:20264722 <br /> OWNER <br /> 278,ORONO SCHOOL DIST NO. <br /> 795 OLD CRYSTAL BAY RD N <br /> LONG LAKE,MN 55356- <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 /> requested in conformance with the State Building Code.This permit may be <br /> revoked at any tirry or du cause. <br /> AzIOV 4IP' a4.40./A- <br /> • <br /> Applicant Permitee Signature Date Iss/By Signature Date .&9 <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />