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CITY OF ORONO * 2 0 1 6 — 0 0 6 7 7 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 06/16/2016 <br /> r . � ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 115 SMITH AVE <br /> PIN : 02-117-23-21-0016 <br /> LEGAL DESC : ORONO ORCHARDS <br /> ' : LOT 063 BLOCK 000 <br /> PERMIT TYPE : ADDITION/REMODEL/REPAIR <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR <br /> ACTNITY : 434-RESIDENT[AL <br /> VALUATION : $ 4,000.00 <br /> NOTE: SEPARATE PERMITS REQUIRED: YLUMBING,MECI�IANICAL,ELECTRICAL(STATE) <br /> BATH REMODEL <br /> APPLICANT PERMIT FEE SCHEDULE 108.38 <br /> STATE SURCHARGE(VALUATION) 2.00 <br /> RAM HOMES INC TOTAL 110.38 <br /> 5524 DICKSON RD <br /> MINNETONKA,MN 55391- Payment(s) <br /> (612)239-5652 CREDIT CARD 3180 110.38 <br /> Minnesota State License#: BUIL-590103 <br /> OWNER <br /> MILLER,THOMAS <br /> 115 SMITH AVE <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,appiicable 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 t any time after work has commenced. <br /> The applicant is responsible for uring all required inspections are <br /> requested in conformance with e State Building Code.This permit may be <br /> revoked at any time for due use. 1�` 1 <br /> �l 1 <br /> r ( �? �� J�" l 1 �� l ( Ic.: <br /> �G <br /> Applicant Permitee Signature Date Issued B Signatu Date <br />