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. ' CITY OFORONO 1111111IIH1111II 11111111111111111111111 <br /> * 20 1 6 - 00 1 1 7 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 06/06/2016 <br /> ORONO,MN 55356- <br /> (952)249-4600 FAX: (952)249-4616 <br /> ADDRESS : 470 ORCHARD PARK RD <br /> PIN : 1000166 <br /> LEGAL DESC : ORCHARD FARMS <br /> : LOT 1 BLOCK 1 _ <br /> PERMIT TYPE : NEW STRUCTURE <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : SINGLE FAMILY <br /> ACTIVITY : 101-SINGLE FAMILY HOUSES,DETACHED <br /> VALUATION : $ 900,000.00 <br /> NOTE: SEPARATE PERMITS REQUIRED:PLUMBING,MECHANICAL,SEPTIC,FIREPLACE,WELL(STATE),ELECTRICAL(STATE) <br /> NOTE:PLEASE SEE AND INITIAL NEW BUILDER ACKNOWLEDGEMENT FORM <br /> APPLICANT PERMIT FEE SCHEDULE 5,729.92 <br /> MSI CUSTOM HOMES,LLC STATE SURCHARGE(VALUATION) 450.00 <br /> 15101 STONE RIDGE TRACE TOTAL 6,179.92 <br /> WAYZATA,MN 55391- <br /> Payment(s) <br /> (612)867-5955 CHECK 3096 6,179.92 <br /> Minnesota State License#:BUIL-BC639727 <br /> OWNER <br /> MULHERAN&JON S,PATRICK <br /> 460 ORCHARD P RD C �,Il" <br /> LONG LAKE, 55356- �aV`� � <br /> V <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 /> requeste inn ,, ance with the State Building Code.This permit may be <br /> revoke. lii,due cause. <br /> Ak -r 6 / :h <br /> Applic..• ermitee Signature Date Issued B ignature Date <br />