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CITY OF ORONO * z 0 1 5 - 0 0 7 5 1 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 06/16/2015 <br /> , ORONO, MN 55356- <br /> � (952 249-4600 FAX: 952) 249-4616 <br /> ADDRESS : 1291 BRIAR ST <br /> PIN : 10-117-23-31-0043 <br /> LEGAL DESC : CRYSTAL BAY MINNETONKA <br /> : LOT 000 BLOCK 003 <br /> PERMIT TYPE : ADD[TION/REMODEL/REPA[R <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR <br /> ACTIVITY : 434-RESIDENTIAL <br /> VALUATION : $ 5,000.00 <br /> NOTE: SEPARATE PERMITS REQUIRED: PLUMBING,MECHANICAL,ELECTRICAL(STATE) <br /> ADD A BATHROOM TO SECOND LEVEL <br /> APPLICANT PERMIT FEE SCHEDULE 123.91 <br /> PLAN REVIEW 80.54 <br /> ROSE CREEK BUILDERS LLC STATE SURCHARGE(VALUATION) 2.50 <br /> P O BOX 68 <br /> LORETTO, MN 55357- TOTAL 206.95 <br /> (763)717-8000 Payment(s) <br /> Minnesota State License#: BUIL-BC629805 CREDIT CARD 4087 206.95 <br /> OWNER <br /> KELLETT, KEVIN CURLEY&W <br /> P.O. BOX 41 <br /> CRYSTAL BAY,MN 55323- <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 goveming 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 construc[ion 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[he State Building Code.This permit may be <br /> revoked at any ti due cause. ���!) <br /> � <br /> 4r j��5- -^ �� � �-�_j��� �' � � (r� (� <br /> Applicant Permitee Sign re Date Issued By Signatu Date <br />