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� { CITY OF ORONO * Z 0 1 3 - PJ 0 9 1 2 * 2750 KELLEY PARKWAY DATE ISSUED: 09/06/2013 ORONO, MN 55356- (952) 249-4600 FAX: (952) 249-4616 ADDRESS : 127 CHEVY CHASE DR PIN : 36-118-23-41-0019 LEGAL DESC : HILL O'WAY MANOR : LOT 014 BLOCK 001 PERMIT TYPE : ADDITION/REMODEL/REPAIR PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR ACTIVITY : 434-RESIDENTIAL VALUATION : $ 10,000.00 NO"TE: DECK REPAIR-REPLACE DECKING AND RAILS-STAIR REPA[R APPLICANT PERMIT FEE SCHEDULE 191.75 D. JONES CONSTRUCTION. LLC STATE SURCHARGE(VALUATION) 5.00 5434 WILLISTON ROAD MINNEAPOLIS, MN 55345- TOTAL 196.75 (952)452-2612 PAID WITH CC# 6864 Minnesota State License#: BC636390 OWNER JACOBSEN,JEFFREY& ELIZABETH 127 CHEVY CHASE DR WAYZATA, MN 55391- AGREEMENT AND SWORN STATEMENT The work for which this permit is issued shall be performed according to the approved plans and specifications,applicable City approvals,and the State Building Code. This permit is for only[he work described and does not grant permission for additional or rela[ed work which requires separate permits. All provisions of laws and ordinances governing this type of work shall be compied with whether or not specitied hereia This permit will expire and become null and void if construction authorized is not commenced within I 80 days of the date of issuance,or i1�construction is suspended for a period of 180 days at any time afrer work has commenced. The applicant is responsible for assuring all required inspections are requested in conformance with the State[�uilding Code.This permit may be revoked at any time f r due cause. �� y, � ,L��3 �, �o � !� Applicant Permitee Signature Date Issue By Signature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.