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, CITY OF ORONO * 2 0 1 z — 0 1 0 4 a * <br /> . 2750 KELLEY PARKWAY DATE 1SSUED: 12/14/2012 <br /> , ORONO, MN 55356- <br /> � (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 3585 FREDERICK ST <br /> PIN : 20-117-23-12-0025 <br /> LEGAL DESC : TILLSONS VILLA CARMAN <br /> : LOT 005 BLOCK 001 <br /> PERMIT TYPE : ADDITION/REMODEL/REPAIR <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR <br /> ACTI V ITY : 434-RESIDENTIAL <br /> VALUATION : $ 22,365.05 <br /> NOTE: SEPERATE PFRM[TS RGQUIRED: FIREPLACE, ELGC'CRICAL(STA"CE) <br /> VALUA"f[ON WAS CHANGED 13Y CONTRnCTOR AS ORIGINAL VALUAT[ON [NCLUDED THG CAB[NETS. <br /> APPLICANT PERMIT FEE SCHEDULE 383.50 <br /> ERIK OLSEN PLAN REVIEW 249.28 <br /> ]161 WAYZATA BLVD E#308 <br /> WAYZATA, MN 55391- STATE SURCHARGE(VALUATION) (1.18 <br /> (952)473-3520 TOTAL 643.96 <br /> Minnesota State License#: BC468842 <br /> OWNER <br /> GORMAN,JOHN & SHERRY <br /> 3585 FREDERICK ST <br /> WAYZATA, MN 5539]- <br /> AGREEMENT AND SWORN STATEMENT <br /> The�a�ork for which this permit is issued shall be perfonned according to <br /> the approved plans and specifications,applicable City approvals,and the <br /> State E3uilding 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 whcther or not specified herein.This permit will <br /> expirc 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 atter work has commenccd. <br /> "Che applicant is responsible for assuring all requircd inspections are <br /> requested in conformance with the State[3uilding Code.This permit may be �� <br /> revoked at any_time for due ca ,7 <br /> '" J <br /> ���'�- i iz-t�, -�-��;z ���� /a--��/ —/�_ <br /> Appl�cant Permitce Signature �,yy;�� Date Issued By ignature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />