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� <br /> ' CITY OF ORONO * z p� 1 8 - 0 0 z 2 z * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 03/12/2018 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 1480 SIXTH AVE N <br /> PIN : 26-118-23-32-0008 <br /> LEGAL DESC : DOUGLAS ESTATES <br /> : LOT 001 BLOCK 001 <br /> PERMIT TYPE : ADDITION/REMODEL/REPAIR <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR <br /> ACTIVITY : 434-RESIDENT(AL <br /> VALUATION : $ 30,000.00 <br /> NOTE: SEPARATE PERMITS REQUIRED: PLUMBING,MECHANICAL,ELECTRICAL(STATE) <br /> MASTER BATH REMODEL <br /> � <br /> APPLICANT PERMIT FEE SCHEDULE 490.12 <br /> PLAN REVIEW 318.58 <br /> BUILDERS BY DESIGN STATE SURCHARGE(VALUATION) 15.00 <br /> 21185 VIKING BLVD. <br /> WYOMING,MN 55092- TOTAL 823.70 <br /> Minnesota State License#: BUIL-20026555 Payment(s) <br /> CHECK 8453 823.70 <br /> OWNER <br /> GULBRANDSON, DAN&ER[CKA <br /> 1480 SIXTH AVE N <br /> LONG LAKE, MN 55356- <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for which this permit is issued shall be perfornied according to <br /> the approved plans and specifications,applicable City approvals,and the <br /> State Building Code. This permi[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 /> .. . ��___------ -�- ,Z �� r@� .3 � ra � �� <br /> Applicant,P�ermitee Signature Date Issued Signature Date <br />