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CITY OF ORONO * z 0 1 7 — 0 0 7 1 z * <br /> � � 2750 KELLEY PARKWAY DATE ISSUED: 06/29/2017 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 2765 PHEASANT RD <br /> P[N : 21-117-23-23-0025 <br /> LEGAL DESC : PHEASANT LAWN <br /> : LOT O10 BLOCK 000 <br /> PERMIT TYPE : MINOR ALTERATIONS <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : DOORS <br /> ACTIVITY : O/S BUILDING-UNDEFINED <br /> VALUATION : $ 3,850.00 <br /> NOTE: REPLACE(1)PATIO DOOR <br /> APPLICANT PERMIT FEE SCHEDULE 108.38 <br /> PELLA NORTHLAND STATE SURCHARGE(VALUATION) 1.93 <br /> 15300 25TH AVE N. -SUITE# ]00 MAIL-IN FEE 2.00 <br /> PLYMOUTH, MN 55447- TOTAL 112.31 <br /> (952)345-6047 Payment(s) <br /> Minnesota State License#: BUIL-BC645090 CHECK 78300 112.31 <br /> OWNER <br /> BAKKE, STEPHEN <br /> 2765 PHEASANT RD <br /> EXCELSIOR,MN 55331- <br /> AGREEMENT A1vD 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 additiona)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 l80 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 /> i <br /> L I �b �'C) � l�� ll7 <br /> Applicant Permitee Signature Date Issued By S gnature Date <br />