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' ` CITY OF ORONO rERMiT No.: 2o1i-oio33 <br /> 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- DATE ISSUED: 09/28/2011 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 725 FERNDALE RD N <br /> PIN : 36-118-23-12-0002 <br /> LEGAL DESC : UNPLATTED 36 118 23 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : ADDITION/REMODEL/REPAIR <br /> PROPERTY TYPE : RESIDENT[AL <br /> CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR <br /> ACTIVITY : 434-RESIDENTIAL <br /> VALUATION : $ 150,000.00 <br /> NOTE: SEPERATE PERMITS REQUIRED: PLUM[31NG,MECHANICAL,ELECTRICAL(STATE) <br /> * AS-BUILT SURVEY SHOULD ALS REFLECT EXISTING AND SECONDARY SEPTIC TREATMENT SITES. (INITIAL) <br /> ��� <br /> APPLICANT PERMIT FEE SCHEDULE 1,356.75 <br /> MEADOWCREEK BU[LDING CORP STATE SURCHARGE(VALUAT[ON) 75.00 <br /> 6955 BAKER AVE NW <br /> BUFFALO, MN 55313- TOTAL 1,431.75 <br /> (612)616-2252 PA[D W[TH CC# 1687 <br /> Minnesota State License#: 20573604 <br /> OWNER <br /> SOWADA, MICHEAL& MARGARET <br /> 725 FERNDALE RD N <br /> WAYZATA, MN 55391 <br /> AGREEMENT AND SWORN STATEMENT <br /> l�he�vork for which this permit is issued shall be performed according to <br /> the approved plans and specitications,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 speci�ied hercin."I'his permit will <br /> expire and become null and void if construction authorized is not <br /> commenced ti�ithin I 80 days of the date of issuance,or if construction is <br /> suspended for a period of I 80 days at any time atter work has commenced. <br /> The applicant is responsible for assuring all rcquired inspections are <br /> requested in conformance with the State I3uilding Code.This permit may be <br /> revoked at any time for due causc. <br /> �c , � , , - 9� � ���/ <br /> Appl' ant itee Signature Date Issue y Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />