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.� CITY OF ORONO PERMIT NO.: 2009-00869 <br /> 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- DATE ISSUEn: 12/2ll2009 <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 1265 SHORELINE DR <br /> PIN : 02-117-23-34-0010 <br /> LEGAL DESC : REG. LAND SURVEY NO. 1123 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : ADDITION/REMODEL/REPAIR <br /> PROPERTY TYPE : RES[DENTIAL <br /> CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR <br /> ACTIVITY : 434-RESIDENTIAL <br /> VALUATIOI�T : $ 100,000.00 <br /> NOTE: SEPERATE PERM[TS REQUIRED: MECHANICAL,FIREPLACE,ELECTRICAL(STA'CE) <br /> PROVIDE SOILS REPORT AT OR PRIOR TO FOOTING INSPECTION <br /> APPLICANT PERMIT FEE SCHEDULE 1,056.75 <br /> LAKE COUNTRY BUILDERS,LTD STATE SURCHARGE(VALUATION) 50.00 <br /> 339 2ND STREET <br /> EXCELSIOR, MN 55331 TOTAL 1,106.75 <br /> (952)474-7121 <br /> Minnesota State License#: 20349679 <br /> OWNER <br /> MCCABE, ROGER <br /> 1265 SHOREL[NE DR <br /> WAYZATA,MN 55391- <br /> AGREEMENT AND SWORN STATEMEIVT <br /> Thc 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 l80 days of[he 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 /> revo� y t or ue cause. <br /> ��i � i.�d ��;�vtL�-r� i i <br /> A ' ant Permitee Signature Date Issued By Si ture Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER T AN DESCRIBED ABO . <br />