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� ' <br /> CITY OF ORONO <br /> ` � 2750 KELLEY PARKWAY * 2 0 1 4 - 0 1 Z 0 1 * <br /> DATE ISSUED: 1 U25/2014 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 1420 SHORELINE DR <br /> PIN : ]1-117-23-22-OO15 <br /> LEGAL DESC : DRAGONFLY HILL <br /> : LOT 002 BLOCK 001 <br /> PERMIT TYPE : ADDITION/REMODEL/REPAIR <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR <br /> ACTIVITY : 434-RESIDENTIAL <br /> VALUATION : $ 128,000.00 <br /> NOTE: SEPARATE PF.RMITS REQUIRED: MECHANICAL,ELL;CTR[CAL(S"TATE) <br /> NOTF: PI,EASE NO'[E PR[OR TO RL?LASF-,.�-F�G,S� -MONEY,AN AS-BU[LT SURVEY AND HARDCOVER CALCIJLAT[ONS MUST BE <br /> SUBMITTED AND APPROVED. INITIAL`�J:�a� <br /> N01 E: SILT FENCE MUST E3E INS"I'ALLF,D AND INSPECTED BY C[TY PRIOR"1'O ANY WORK. INITIAL`��� <br /> NOTE: A MINIMUM OF 24 HOUR N01'ICE IS REQUIRED PRIOR TO AN INSPECTION. INITIAL:�_�/� <br /> APPLICANT PERMIT FEE SCHEDUI,E 1,224.75 <br /> STATE SURCHARGE(VALUATION) 64.00 <br /> JANETKA CONSTRUCTION CONSULTANTS TOTAL 1,288.75 <br /> 3505 COUNTY ROAD 19 Payment(s) <br /> MEDINA, MN 55340- <br /> (612)418-6708 CHECK 6�31 1,288.75 <br /> Minnesota State License#: BU[L-BC639945 <br /> OWNER <br /> FELDSHON, DAVID& ARCHELLE <br /> 1420 SHOREL[NE DR <br /> WAYZATA, MN 55391- <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for which this permit is issued shall be peri�ormed according to <br /> the approved plans and specifications,applicable City approvals,and the <br /> S[a[e L3uilding 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 N�ill <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 commcnced. <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 /> revoke time for ause. <br /> c <br /> � �-� /l-�/ � .-� ,a��/ <br /> p icant Permitee Signature Date Issue By Signature Date <br />