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, CITY OF ORONO * z 0 1 6 - 0 0 0 9 Z * <br /> 2750 KELLEY PARKWAY DATE ISSUED: OU28/2016 <br /> � ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 1270 BRIAR ST <br /> PIN : 10-117-23-31-0038 <br /> LEGAL DESC : CRYSTAL BAY MINNETONKA <br /> : LOT O10 BLOCK 002 <br /> PERMIT TYPE : ADDITION/REMODEL/REPAIR <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR <br /> ACTIVITY : 434-RESIDENTIAL <br /> VALUATION : $ 804.00 <br /> NOTE: BLOWING INSULATION IN WALLS. <br /> NOTE: PROVIDE INSULATION CERTIFICATE FROM INSTALLER AT FINAL INSPECTION. <br /> APPLICANT PERMIT FEE SCHEDULE 39.89 <br /> STATE SURCHARGE(VALUATION) 0.40 <br /> CRAFTMASTERS REMODELING MAIL-IN FEE 2.00 <br /> 2495 MAPLEWOOD DR#314 <br /> MAPLEWOOD, MN 55109- TOTAL 42.29 <br /> (651)757-4100 Payment(s) <br /> Minnesota State License#: BUIL-BC627243 CREDIT CARD 8204 42.29 <br /> OWNER <br /> RANGE,JOHN <br /> 1270 BRIAR ST <br /> WAYZATA,MN 55391- <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 /> revoked at any time for due cause. <br /> ► <br /> � -e l �Z�� / <br /> Applicant Permitee Signature Date Issued B ignature Date <br />