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CITY OF ORONO PERMIT NO.: 2009-00696 <br /> - 2750 KELLEY PARKWAY <br /> � ORONO, MN 55356- DATE ISSUEu: 1U04/2009 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 95 HACKBERRY H[LL <br /> PIN : 33-118-23-44-0013 <br /> LEGAL DESC : DANIELS LONG LAKE HEICHTS <br /> : LOT 007 BLOCK 002 <br /> PERMIT TYPE : ADDITION /REMODEL/REPAIR <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR <br /> ACTIVITY : 434-RESIDENTIAL <br /> VALUAT[ON : $ 47,345.00 <br /> NOTE: SEPERATE PERMITS REQUIRED: PLUMBING, MECHANICAL, ELECTR[CAL(STA"IE) <br /> ESCROW PAYMENT RECEIVED 10/16/09$2500.00 2009-00714 <br /> PLAN KEVIEW FEF,RECEIVED 10/12/09$429.16 2009-00695 <br /> APPLICANT PERMIT FEE SCHEDULE 660.25 <br /> M& M HOME CONTRACTORS STATE SURCHARGE(VALUATION) 23.67 <br /> 205 WINKLER TRAIL <br /> COLOGNE,MN 55322- MISC FEE 0.00 <br /> (612)554-2556 TOTAL 683.92 <br /> Minnesota State License#: 20560376 <br /> OWNER <br /> SULANDER, DUANE <br /> 95 HACKBERRY H[LL <br /> LONG LAKE, MN 55356 <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 I3uilding 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 goveming this type of work <br /> shall be compied with whether or not specitied 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 consVuction is <br /> suspended for a period of 180 days at any time afrer 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 y time for due cause. <br /> C,�� �S-u�.�-�,...�.e�, l( / � / 0 � �l/ D 7� � <br /> Applicant Permitee Signature Date I s By Signature Date <br /> SEPARATE PERMITS REQU[RED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />