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111111111111111111111111 <br /> CITY OF ORONO * 2 1012 - 0095 1 <br /> 2750 KELLEY PARKWAY DATE ISSUED: 02/27/2013 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 4700 WEST BRANCH RD <br /> PIN : 06-117-23-33-0004 <br /> LEGAL DESC : UNPLATTED 06 117 23 <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 : $ 1,800.00 <br /> NOTE: SEPERATE PERMITS REQUIRED: <br /> REPLACE ATTACHED DECK <br /> PAID ADV PLAN REVIEW FEE$43.71 CK 9/24/12 2012-00950 <br /> * AS-BUILT SURVEY TO INCLUDE WO'. PERMIT#2012-00367. ESCROW WILL BE REFUNDED AFTER SUBMITTAL <br /> AND APPROVAL OF AS-BUILT SURVEY. ` (INITIAL) <br /> APPLICANT PERMIT FEE SCHEDULE 67.25 <br /> PETERSON,RONALD STATE SURCHARGE(VALUATION) 0.90 <br /> 4700 WEST BRANCH RD <br /> MOUND,MN 55364 TOTAL 68.15 <br /> OWNER <br /> PETERSON,RONALD <br /> 4700 WEST BRANCH RD <br /> MOUND,MN 55364 <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 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 /> ed a time for due cause. /‘X7 / /.8 ipp 02 <br /> Applicant Permitee Signature Date <br /> Is By y Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />