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, CITY OF ORONO * Z 0 1 7 - 0 0 1 4 9 * <br /> . 2750 KELLEY PARKWAY DATE ISSUED: OS/1 U2017 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 1750 SHADYWOOD RD <br /> Pllv : 17-117-23-21-0021 <br /> LEGAL DESC : SHADY-WOOD <br /> : LOT 016 BLOCK 000 <br /> PERMIT TYPE : NEW STRUCTURE <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : SINGLE FAMILY <br /> ACTIVITY : 101-SINGLE FAMILY HOUSES,DETACHED <br /> VALUATION : $ 880,000.00 <br /> NOTE: SEPARATE PERMITS REQUIRED:PLUMBING,MECHANICAL,FIREPLACE,GRADING,F[RE, SEWER CONNECTION, <br /> ELECTRICAL(S'I'ATE) <br /> NOTE: PLEASE SEE AND INITIAL NEW BUILDER ACKNOWLEDGEMENT FORM <br /> APPLICANT PERMIT FEE SCHEDULE 5,624.92 <br /> STATE SURCHARGE(VALUATION) 440.00 <br /> STONEWOOD, LLC TOTAL 6,064.92 <br /> 153 E LAKE STREET Payment(s) <br /> WAYZATA,MN 55391- CHECK 14751 6,064.92 <br /> (612)462-4000 <br /> Minnesota State License#: BUIL-BC594315 <br /> OWNER <br /> SHAW,GRETCHEN&LYLE <br /> 7001 KENESTON DR <br /> EDEN PRAIRIE,MN 55346- <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 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 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 after work has commenced. <br /> The applicant is responsible for assuring ail required inspections are , <br /> requested in confo with the State Building Code.This permit may be � i�� <br /> revoked at any � or se. <br /> � <br /> S lI � 7 �-c��c�> /��--� {�� � �� , � � <br /> pplic t Pe ' ee Signature ate Issued By Signature Date <br />