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CITY OF ORONO 11111 It rI II! Till r I' <br /> 2750 KELLEY PARKWAY * 20 1 4 - 0 1 3 7 6 <br /> DATE ISSUED: 12/29/2014 <br /> ORONO, MN 55356- <br /> (952)249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 450 OLD LONG LAKE RD <br /> PIN : 36-118-23-34-0014 <br /> LEGAL DESC : SUMMIT STATION <br /> : LOT 007 BLOCK 001 <br /> PERMIT TYPE : ADDITION/REMODEL/REPAIR <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR <br /> ACTIVITY : 434-RESIDENTIAL <br /> VALUATION : $ 250,000.00 <br /> NOTE: SEPARATE PERMITS REQUIRED: MECHANICAL,ELECTRICAL(STATE) <br /> (SMALL ADDITION WITH SMALL ATTACHED DECK) <br /> APPLICANT PERMIT FEE SCHEDULE 1,956.75 <br /> STATE SURCHARGE(VALUATION) 125.00 <br /> SCHWARZ BUILDERS INC. TOTAL 2,081.75 <br /> 240 MINNETONKA AVE S, SUITE 2 <br /> WAYZATA, MN 55391 Payment(s) <br /> (952)476-6768 CREDIT CARD 1993 2,081.75 <br /> Minnesota State License#: BUIL-BC003922 <br /> OWNER <br /> POLICINSKI,CHRISTOPHER&ANNE <br /> 450 OLD LONG LAKE RD <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 assurin_all required inspections are <br /> requested in conformance with e % - ui ding Code.This permit may be <br /> revoked at any ti - or due c.f <br /> / 4 / bc11)1! 2 /g / I <br /> Applicant Permitee Signature Date Issue By Signature Date <br />