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CITY OF ORONO PERMIT NO.: 2009-00414 <br /> 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- �ATE ISSUED: 08/06/2009 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 785 FERNDALE RD N <br /> PIN : 36-118-23-11-0012 <br /> LEGAL DESC : REG. LAND SURVEY NO. 1031 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : ACCESSORY STRUCTURE <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : UNDEFINED � PDoL BC-L/GD//�l�r" <br /> ACTIVITY : 437-NONRESIDENTIAL&NONHOUSEKEEPIN <br /> VALUATION : $ 20,000.00 <br /> NOTE: SEPERATE PERMITS REQUIRED:EL�CTRICAL(STATE) <br /> ADV. PLAN REVIEW COLLECTED ON PERMIT 2009-00413$220.51 <br /> APPLICANT <br /> PERM' 339.25 <br /> JR, M[CHELLE&THOMAS CULLUM ST° 10.00 <br /> 785 FERNDALE RD N <br /> WAYZATA, MN 55391 349.25 <br /> ;�_•;.;�� <br /> ��:. ,- <br /> '.-' �a =-1-�-� �.:,t: �.�-,. <br /> a I.., — <br /> �i.1�6 Yv_4 . � . , . . . <br /> OWNER <br /> JR, MICHELLE&THOMAS CULLUM <br /> 785 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 ;;;j.:; <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 c':�i�}�: <br /> not grant permission for additional or related work which requires separate �:r •' <br /> permits. All provisions of laws and ordinances governing this type of work <br /> shall be compied with whether or not specitied herein.This permi[will �a <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 /> ,'`� �::: r�-,-: <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 ti e for du cause. <br /> ���� ���� � � � �'� <br /> Applicant Permitee Signature Date / / <br /> Issue y nature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTI-iER THAN DESCRIBED ABOVE. <br />