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CITY OF ORONO PERMIT NO.: 2011-00880 <br /> 2750 KELLEY PARKWAY <br /> f ORONO, MN 55356- �ATE IssuEn: 08/18/2011 <br /> + 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 930 COX FARM RD <br /> PIN : 27-118-23-33-0013 <br /> LEGAL DESC : SHADOWOOD FARM <br /> : LOT O10 BLOCK 001 <br /> PERMIT TYPE : ADDiTION/REMODEL/REPAIR <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR <br /> ACTI V ITY : 434-RESI DENTIAL <br /> VALUATION : $ 400,000.00 <br /> NOTE: SGPGRATE PERMITS REQUIRED: PLUMBING,MECHANICAL, FIREPLAGE,ELECTRICAL(STATE) <br /> ADV. PLAN RF,VIEW PD 2011-0086�$1856.89 8/15/11 <br /> APPLICANT PERMIT FEE SCHEDULE 2,856.75 <br /> VIKING CONSTRUCTION,INC. STATE SURCHARGE(VALUATION) 200.00 <br /> 871 JEFFERSON AVE. TOTAL 3,056.75 <br /> ST. PAUL, MN 55102- <br /> (651)222-3065 PAID WITH CC# 0251 <br /> Minnesota State License#: 20332522 <br /> OWNER <br /> KILLINGSTAD, MR.& MRS. <br /> 930 COX FARM RD <br /> LONG LAKE, MN 55356 <br /> AGREEMENT AND SWORN STATEMENT <br /> Thc 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 pemlission for additional or rclated work which rcquires 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 tbr a period of 180 days at any time after work has commenced. <br /> The applicant is responsible for assaring all required inspections are <br /> requested in conformance wilh Cfie State Building Code.This permit may be <br /> revoked-ai-a�y-tim�for due cause. , <br /> ,� i/J i.; �" , <br /> __�b�''� c-�_ '�-' �/,-� �'� l <br /> Applicant Per�mitee_Sig urc Date Issued By ' ature <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABO <br />