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CITY OF ORONO * 2 0 1 6 - 0 1 4 6 1 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: i U23/2016 <br /> . y ORONO,MN 55356- <br /> (952)249-4600 FAX: (952 249-4616 <br /> ADDRESS : 3186 NORTH SHORE DR <br /> PIN : 09-117-23-32-0010 <br /> LEGAL DESC : CRYSTAL BAY PARK <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 : $ 11,946.00 <br /> NOTE: SEPARATE PERMITS REQUIRED: PLUMBING,MECHANICAL,ELECTRICAL(STATE) <br /> APPLICANT PERMIT FEE SCHEDULE 232.30 <br /> PLAN REVIEW 151.00 <br /> JONES,MICHEAL&NATELE STATE SURCHARGE(VALUATION) 5.97 <br /> 3186 NORTH SHORE DR <br /> WAYZATA,MN 55391- TOTAL 389.27 <br /> Payment(s) <br /> CHECK 5139 389.27 <br /> OWNER <br /> JONES,MICHEAL&NATELE <br /> 3186 NORTH SHORE DR <br /> WAYZATA,MN 55391- <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 Ciry approvals,and the <br /> State Building Code. This permit is for only the work described and dces <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 specified herein.This permit will <br /> expire and become null and void if construction authorized is not <br /> commenced within I80 days of the date of issuance,or if construction is <br /> suspended for a period of l80 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 time for due caus <br /> . <br /> �v �/ �z3�/� <br /> Applicant Permitee Signature Date ssued Signature Date <br />