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CITY OF ORONO * 2 0 1 4 - 0 1 0 8 1 * <br /> " 2750 KELLEY PARKWAY pATE [ssu��: 09/23/2014 <br /> � ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 128 CHEVY CHASE DR <br /> PIN : 36-118-23-41-0041 <br /> LEGAL DESC : HILL O'WAY MANOR <br /> : LOT 007 BLOCK 002 <br /> PERMIT TYPE : MINOR ALTERA"I�IONS <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : WINDOWS <br /> ACTIVITY : O/S BUILDING - UNDEFINED <br /> VALUATION : $ 30,000.00 <br /> APPLICANT PERMIT FEE SCHEDULE 466.75 <br /> NELSON, TODD&JANA STATE SURCHARGE(VALUATION) 15.00 <br /> 128 CHEVY CHASE DR TOTAL 481J5 <br /> WAYZATA, MN 55391- Payment(s) <br /> CREDIT CARD 0189 481.75 <br /> OWNER <br /> NELSON, TODD&JANA <br /> 128 CHEVY CHASE DR <br /> WAYZATA, MN 55391- <br /> AGREEMENT AIYD SWORN STATEMENT <br /> The work for which this permit is issued shall be perfonned according to <br /> the approved plans and specifications,applieable City approvals,and the <br /> State Building Cbde. 'I'his permit is for only the work described and does <br /> not grant permission for additional or related work which requires separate <br /> permits. AII 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 /> suspendcd for a period of 1 AO days at any time after work has commenced. <br /> The applicant is responsible for assuring all required inspections arc <br /> requested in conformance with the State Building Coda This permit may be <br /> revoked at any time,ker due cause. . ��/J7 <br /> /�' �f `ti/ <br /> C: � ��� �~�C:i�� n � <br /> � y Z� y �-� ,��, s� <br /> A licant Per ilee Signature Dat lssucd By Signature Date <br />