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I <br /> CITY OF ORONO �' 1' <br /> * 20 1 4 - 0 1 3E13 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 01/09/2015 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952)249-4616 <br /> ADDRESS : 625 FERNDALE RD N <br /> PIN : 36-118-23-11-0021 <br /> LEGAL DESC : UNPLATTED 36 118 23 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : ADDITION/REMODEL/REPAIR <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR <br /> ACTIVITY : 434-RESIDENTIAL <br /> VALUATION : $ 250,000.00 <br /> NOTE: INTERIOR REMODEL <br /> SEPARATE PERMITS REQUIRED: PLUMBING,MECHANICAL,FIREPLACE,ELECTRICAL(STATE) <br /> Applicant&owner acknowledge the City's 35' setback from wetlands per City code 78-16$ <br /> Construction of addition w/o confirmed wetland boundary is at your own risk. Initial: /7/ <br /> WetWnc delineation must be submitted and approved by the MCWD prior to escrow release. Initial: <br /> As built survey&as built hardcover cals required for escrow release. Initial: k‘,./9 <br /> APPLICANT PERMIT FEE SCHEDULE 2,054.59 <br /> PLAN REVIEW 63.59 <br /> LECY BROS HOMES STATE SURCHARGE(VALUATION) 125.00 <br /> 15012 HWY 7 TOTAL 2,243.18 <br /> MINNETONKA,MN 55345- <br /> (952)944-9499 Payment(s) <br /> Minnesota State License#: BUIL-20325555 CHECK 40593 2,243.18 <br /> OWNER <br /> GLAD,CARSON&KAROLIEN <br /> 625 FERNDALE RD N <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 /> /A/1 <br /> Applicant Permitee ignature to Issued By Si riature Date <br />