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Fill 11111 1111111 <br /> CITY OF!ORONO * 20 1 7 - 0 1 026 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 10/06/2017 <br /> ORONO,MN 55356- <br /> (952)249-4600 FAX (952)249-4616 <br /> ADDRESS : 425 OLD CRYSTAL BAY RD S <br /> PIN : 04-117-23-31-0001 <br /> LEGAL DESC : AUDITOR'S SUBD.NO.230 <br /> : LOT 020 BLOCK 000 <br /> PERMIT TYPE : NEW STRUCTURE <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : SINGLE FAMILY <br /> ACTIVITY : 101-SINGLE FAMILY HOUSES,DETACHED <br /> VALUATION : $ 1,200,000.00 <br /> NOTE: SEPARATE PERMITS REQUIRED:PLUMBING,MECHANICAL,SEPTIC,FIREPLACE, ELECTRICAL(STATE) <br /> NOTE:PLEASE SEE AND INITIAL NEW BUILDER ACKNOWLEDGEMENT FORM <br /> APPLICANT PERMIT FEE SCHEDULE 7,094.92 <br /> STATE SURCHARGE(VALUATION) 580.00 <br /> HENDEL HOMES <br /> TOTAL 7,674.92 <br /> 15250 WAYZATA BLVD. <br /> SUITE 108 'ayment(s) <br /> WAYZATA,MN 55391- REDIT CARD 8091 7,674.92 <br /> (612)998-2167 <br /> Minnesota State License#:BUIL-BC192308 <br /> OWNER <br /> KVALSETH,JAHN&CHRISTINE <br /> 13650 ASHCROFT ROAD <br /> SAVAGE,MN 55378- <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 time for due cause. <br /> /0Za___ it) / 6; / 7 <br /> i J <br /> Applicant a itee Signa a I Issued y Signature Date <br /> I <br />