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CITY OF ORONO I I I 1111111111111111 III I I III III IIII <br /> 2750 KELLEY PARKWAY * 2 1 S - 0 PJ 2 1 5 <br /> DATE ISSUED: 05/07/2012 <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 : $ 1,571.00 <br /> NOTE: SEPERATE PERMITS REQUIRED: PLUMBING,MECHANICAL,FIREPLACE,ELECTRICAL(STATE) <br /> 2 PROJECTS-DECK&STIRS/ENTRY <br /> NOTE:BUILDING SEWER LINE IS`�Zi t4 D IN THE AREA OF THE 16'X 16'DECK. <br /> SEE ATTACHED SEPTIC AS-BUILT INITIAL <br /> APPLICANT PERMIT FEE SCHEDULE 60.75 <br /> PETERSON,RONALD STATE SURCHARGE(VALUATION) 0.79 <br /> 4700 WEST BRANCH RD <br /> MOUND,MN 55364 TOTAL 61.54 <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 /> ked at ' e f r due cause. <br /> 5 / / I / / <br /> Nxit / <br /> Applicant Permitee Signature Date Issue:y Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />