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CITY OF ORONO 1' I I 11 <br /> 2750 KELLEY PARKWAY * 2 1 8 - 0 0 <br /> DATE ISSUED: 04/10/2018 <br /> ORONO,MN 55356- <br /> (952)249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 4051 HIGHWOOD RD <br /> PIN : 07-117-23-44-0076 <br /> LEGAL DESC : REG.LAND SURVEY NO. 1420 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : ADDITION/REMODEL/REPAIR <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR <br /> ACTIVITY : 434-RESIDENTIAL <br /> VALUATION : $ 13,758.00 <br /> NOTE: POLY OVER EARTH IN CRAWLSPACE <br /> APPLICANT PERMIT FEE SCHEDULE 263.28 <br /> COMPLETE BASEMENT SYSTEMS PLAN REVIEW 171.13 <br /> 54004 LEN DRIVE STATE SURCHARGE(VALUATION) 6.88 <br /> MANKATO,MN 56001- TOTAL 441.29 <br /> (507)387-0500 Payment(s) <br /> Minnesota State License#:BUIL-143377 CREDIT CARD 5821 441.29 <br /> OWNER <br /> ROUSE,WILLIAM&ANITA <br /> 4051 HIGHWOOD ROAD <br /> MOUND,MN 55364 <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 /> IWI1(e) Wit) / /0, <br /> Date Date <br /> Applicant Permitee Signature Issued By '� ature <br />