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PERMIT <br /> CITY OF ORONO PERMIT TYPE: <br /> 2750 Kelley Parkway- P.O. Box 66 WILDING <br /> Crystal Bay, Minnesota 55323 Permit Number: <br /> Date Issued: `'}`'�`"`€ `'`"� <br /> (612)473-7357 06/2S/q6 <br /> SITE ADDRESS: <br /> 1930 WEST FARM RD <br /> LSV <br /> P . 1. . ,u . ; '?7-118-23-4:::-0021 <br /> DESCRIPTION: <br /> I NGEC€t_iND POOL <br /> Building Perrnit. Type SF-ACC STRUCTURE <br /> Building Work Type POOL <br /> Census Code 329 NONBLDG STRUCT . <br /> REMARKS: <br /> SEPARATE STATE PERMIT REQUIRED FOR ELECTRICAL . <br /> FEE SUMMARY: <br /> VAL SAT ION $1.3 ,000 <br /> Base Fee, $199. 75 <br /> Plan Review139. 84 <br /> Surcharge $,s aa� <br /> Total Few $336 .09 <br /> CONTRACTOR: - Applicant - OWNER: <br /> CUSTOM POOLS INC 19332255 PETERSON BOB <br /> 601 E EXCELSIOR AVE 19:7-* WE:-;T FARM RD <br /> H€:'FF:IN°S: MN 55:34:3 ORONO MN ss_:46 <br /> (612) 93:3-32 ,5 (E'12)47F,- 5C.ci <br /> THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS <br /> SPECIFIED AND AGREES TO DO i ALL WORK IN 'STRICT COMPLIANCE WITH ALL CITY OF <br /> L_ ORONO ORDINANCES AND STATE OF MINNESOTA BUILDING CODE REQUIREMENTS. j <br /> __. _ (; C'. 2a,`i <br /> APPLICANT/PERMITEE SIGNATURE ISSUED BY:SIGNATURE <br />