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' ` CITY OF ORONO * Z 0 1 3 - 0 0 8 4 3 * <br /> • ' � � 2750 KELLEY PARKWAY DATE ISSUED: 10/i U2013 <br /> ORONO,MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 2760 SHADYWOOD RD <br /> PIN : 21-117-23-24-0040 <br /> LEGAL DESC : REG.LAND SURVEY NO. 1196 <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 : $ 100,000.00 <br /> NOTE: SEPARATE PERMITS REQUIRED: PLUMBING,MECHANICAL, ELECTRICAL(STATE) <br /> KITCHEN ADDITION AND DECK <br /> NOTE: ESCROW WILL BE REFUNDED AFTER AS-BUILT SURVEY AND HARDCOVER CALCULATIONS ARE SUBMITTED <br /> AND APPROVED. INITIAL: <br /> APPLICANT pERMIT FEE SCHEDULE 1,056.75 <br /> CREATIVE BUILDERS INC. STATE SURCHARGE(VALUATION) 50.00 <br /> 5958 FENNING AVE SE <br /> DELANO,MN 55328- TOTAL 1,106.75 <br /> (952)955-3062 <br /> Minnesota State License#: BC037260 <br /> OWNER <br /> ENGLER,JEFF <br /> 3330 MARTHA LANE <br /> MINNETONKA,MN 55345- <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 Ciry 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 sepazate <br /> permits. All provisions of laws and ordinances goveming 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 respo s'ble for assuring all required inspections aze <br /> requeste o e with the State Building Code.This permit may be <br /> revoked at any t� e due cause. <br /> o � 1 c � t� �a ,�� ,� <br /> Applicant Pe itee Signature Date Issue y �gnature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK O ER THAN DESCRIBED ABOVE. <br />