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CITY OF ORONO * 2012 - 00339 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 06/13/2012 <br /> ORONO,MN 55356- <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS 4115 WATERTOWN RD <br /> PIN 31-118-23-41-0014 <br /> LEGAL DESC MAPLE PLACE 2ND ADDN <br /> LOT 002 BLOCK 001 <br /> PERMIT TYPE ADDITION/REMODEL/REPAIR <br /> PROPERTY TYPE RESIDENTIAL <br /> CONSTRUCTION TYPE ADDN/REMODEL/REPAIR <br /> ACTIVITY 434-RESIDENTIAL <br /> VALUATION $ 368,000.00 <br /> NOTE: SEPARATE PERMITS REQUIRED: PLUMBING,MECHANICAL,AND ELECTRICAL(STATE) <br /> ADV PLAN REVIEW COLLECTED 4/30/12 PERMIT 2012-00338$1732.09 <br /> * AS BUILT SURVEY MUST BE SUBMITTED AND APPROVED PRIOR TO RELEASE OF BUILDING PERMIT ESCROW. <br /> * WETLAND BUFFER IMPROVEMENT PLAN MUST BE APPROVED AND WETLAND BUFFER ESCROW AGREEMENT SIGNED AND <br /> $5000 ESCROW SUBMITTED BEFORE BLDG PERMIT ESCROW REFUNDED. <br /> APPLICANT PERMIT FEE SCHEDULE 2,664.75 <br /> SAWHORSE INC. <br /> 4740 42ND AVE N. STATE SURCHARGE(VALUATION) 184.00 ROBBINSDALE,MN 55422 TOTAL 2,848.75 <br /> (763)533-0352 <br /> Minnesota State License#:2382 <br /> OWNER <br /> DYER,MICHEAL&JILL <br /> 4115 WATERTOWN RD <br /> MAPLE PLAIN,MN 55359 <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 becoa null and void if construction authorized is not <br /> commenced wit 'n 180 days Athe date of issuance,or if construction is <br /> suspended or a eriod of 180 days at any time after work has commenced. <br /> The appy t is sponsible for assuring all required inspections are <br /> request in co rmance with the State Building Code.This permit may be <br /> revoke at i or due cause. <br /> 0/ -17�/ Iz / <br /> pl t Permitee Signature Date Issued By Si ature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />