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CITY OF ORONO * 2 0 1 3 - 0 0 3 4 2 * <br /> ' ' 2750 KELLEY PARKWAY DATE ISSUED: 06/04/2013 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 1795 SHADYWOOD RD <br /> PIN : 17-117-23-21-0008 <br /> LEGAL DESC : REG. LAND SURVEY NO. 0702 <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 : $ 12,000.00 <br /> NOTE: PF,RMIT FOR DECK <br /> ADV PLAN REVIEW PD 2013-00341$143.81 <br /> CONTACT THE MCWD TO SEE 1P THIS PROJECT TRIGGERS ANY OF THEIR REQUIREM�NTS. ��(INITIAL) <br /> APPLICANT PERM[T FEE SCHEDULE 22].25 <br /> BETZ BUILDERS INC. STATE SURCHARGE(VALUATION) 6.00 <br /> 300 CRESTVIEW AVE. <br /> LONG LAKE, MN 55356 TOTAL 227.25 <br /> (612)221-2963 <br /> Minnesota State License#: BC3515 <br /> OWNER <br /> DIERCKS, MICHAELA <br /> 1795 SHADYWOOD RD <br /> P.O. BOX 81(NAVARRE <br /> WAYZATA, MN <br /> AGREEMENT AND SWORN STATEMENT <br /> The worh for which this permit is issued shall be performed according to <br /> the approved plans and specifications,applicable City approvals,and the <br /> State Building Code. This permit is for only[he work described and does <br /> not grant permission for additional or related work which requires separate <br /> permi[s. 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 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 afrer work has commenced. <br /> The applicant is responsible for assuring all required inspections are <br /> requeste �n conformance with the State Building Code.This permit may be <br /> revo a any time for ue c se. <br /> �//w,�� �G�' / /� / // <br /> Applicant Permitee Signatu Date Is d By Signature Da e <br /> EPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />