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� ' CITY OF ORONO PERMIT NO.: 2011-00803 <br /> 2750 KELLEY PARKWAY <br /> ORONO, MN 5535C- DATE ISSUED: 08/17/2011 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 2740 KELLY AVE <br /> PIN : 21-117-23-23-0037 <br /> LEGAL DESC : VERN-MAR MANOR <br /> : LOT 012 BLOCK 000 <br /> PERMIT TYPE : ADDITION/REMODEL/REPAIR <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR <br /> ACTIVITY : 434-RESIDENTIAL <br /> VALUATION : $ 82,000.00 <br /> NOTE: SEPERATE PERMITS REQUIR�D: PLUMBING,MECHANICAL, ELECTRICAL(STATE) <br /> GARAGG ADDITION <br /> * EXISTING DRIVEWAY AND SIDEWALK TO BE REMOVED AND ETATED PRIOR TO RELEASE OF ESCROW.��"`"NIT) <br /> * AS BUILT SURVEY REQUIRED PRIOR TO RELEASE OF ESCROW��(INITIAL) <br /> APPLICANT PERMIT FEE SCHEDULE 921.75 <br /> AUTUMN RIDGE HOMES INC STATE SURCHARGE(VALUATION) 41.00 <br /> P O BOX 375 TOTAL 962.75 <br /> DELANO, MN 55328- <br /> (763)269-2697 <br /> Minnesota State License#: 20637701 <br /> OWNER <br /> O'MALLEY,PHYLLIS <br /> 2740 KELLY AVE <br /> EXCELSIOR, MN 55331- <br /> AGREEMENT AND SWORN STATEMENT <br /> Thc work for which this pennit is issued shall be performed according to <br /> the approved plans and specifications,applicable City approvals,and [he <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[his type of work <br /> shall be compied with whether 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 constr�ction is <br /> suspended for a period of l80 days at any time atter work has commenced. <br /> The applicant is responsible for assuring all required inspections are <br /> requested in confonnance wi[h the State Building Code.This permit may be <br /> revoked at or due cause. <br /> � , � , > �', 17, 1 <br /> �cant P ee Si tu Date Iss y Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />