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� <br /> �! <br /> ' CITY OF ORONO * 2 0 1 6 - 0 1 3 6 5 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 1U0U2016 <br /> ORONO,MN 55356- <br /> (952)249-4600 FAX: (952)249-4616 <br /> ADDRESS : 3010 SOMERSET LA <br /> PIIv : 04-117-23-22-0029 <br /> LEGAL DESC : OLD CRYSTAL BAY ROAD 2ND ADDN <br /> : LOT 001 BLOCK 003 <br /> PERMIT TYPE : ADDITION/REMODEL/REPAIR <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR <br /> ACTIVITY : 434-RESIDENTIAL <br /> VALUATION : $ 13,000.00 <br /> NOTE: SEPARATE PERMITS REQUIRED: PLUMBING,MECHANICAL,ELECTRICAL(STATE) <br /> BATHROOM REMODEL <br /> APPLICANT PERMIT FEE SCHEDULE 247.79 <br /> PLAN REVIEW 161.06 <br /> FAIR&SQUARE REMODELING STATE SURCHARGE(VALUATION) 6.50 <br /> 210 EAST DEAN AVE <br /> CHAMPLIN,MN 55316- TOTAL 415.35 <br /> (612)245-5826 Payment(s) <br /> Minnesota State License#: BUIL-BC638907 CREDIT CARD 7582 415.35 <br /> OWNER <br /> BUTLER,PATRICK&JILL <br /> 3010 SOMERSET LA <br /> LONG LAKE,MN 5535Cr <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 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 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 all required inspections are <br /> requested in conformance with the State Building Code.This permit may be <br /> revoked at any time for due cause. <br /> �G 4� /� � D/� /(o <br /> pplicant Permitee Si Date Issued By ignature Date <br />