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{ � CITY OF ORONO PERMIT NO.: 2011-01039 <br /> ` 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- �ATE IssuED: 12/15/2011 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 2620 FOX ST <br /> PIN : 04-117-23-42-0010 <br /> LEGAL DESC : REG. LAND SURVEY NO. 1249 <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 : $ 10,000.00 <br /> NOTE: SEPERATE PERMITS REQUIRED: PLUMBING,MECHANICAL,ELECTRICAL(STATE) <br /> APPLICANT PERMIT FEE SCHEDULE 191.75 <br /> JAFFRAY,MR.& MRS. PLAN REVIEW 124.64 <br /> 2620 FOX ST <br /> WAYZATA, MN 55391 STATE SURCHARGE(VALUATION) 5.00 <br /> MISC FEE 0.00 <br /> TOTAL 321.39 <br /> OWNER <br /> JAFFRAY, MR. &MRS. <br /> 2620 FOX ST <br /> WAYZATA, MN 55391 <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for which this permit is issued shall be perlormed 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 no[ <br /> commenced within 180 days of the date of issuance,or if construction is <br /> suspended Yor a period of 180 days at any time atter work has commenced. <br /> "Che applicant is responsible for assuring all required inspections are <br /> requested in confomiance with the Sta[e E3uilding Code.This permit may be <br /> revoked at any time for due c use. <br /> �, ���L i� l5, ll ��� , � <br /> Applicant Permi ee Signature Date Issue y Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />