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f • CITY OF ORONO PERMIT NO.: 2011-00172 2750 KELLEY PARKWAY ORONO, MN 55356- DATE ISSUED: 06/15/2011 (952) 249-4600 FAX: (952) 249-4616 ADDRESS : 4700 WEST BRANCH RD PIN : 06-117-23-33-0004 LEGAL DESC : UNPLATTED 06 117 23 : LOT 000 BLOCK 000 PERMIT TYPE : ACCESSORY STRUCTURE PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : SHED> 120 SQ FT ACTIVITY : 328-OTHER NONRESIDENTIAL BUILDINGS VALUATION : $ 3,600.00 NOTE: SEPERATE PERMITS REQUIRED:ELECTRICAL(STATE) AFTER THE FACT PERMIT-SHED BUILT WITHOUT A PERMIT DOUBLE FEE FOR PERMIT PLAN REVIEW PAID IN THE AMT.OF$43.71 2011-00173 ADDITIONAL PLAN REVIEW FEE CHARGED FOR ADDITIONAL FINAL VALUATION APPLICANT PERMIT FEE SCHEDULE 103.25 PETERSON,RONALD PLAN REVIEW 23.40 4700 WEST BRANCH RD MOUND,MN 55364 STATE SURCHARGE(VALUATION) 1.80 MISC FEE 103.25 TOTAL 231.70 PAID WITH CASH -39.60 OWNER PAID WITH CC# 6186 PETERSON,RONALD 4700 WEST BRANCH RD MOUND,MN 55364 AGREEMENT AND SWORN STATEMENT The work for which this permit is issued shall be performed according to the approved plans and specifications,applicable City approvals,and the State Building Code. This permit is for only the work described and does not grant permission for additional or related work which requires separate permits. All provisions of laws and ordinances governing this type of work shall be compied with whether or not specified herein.This permit will expire and become null and void if construction authorized is not commenced within 180 days of the date of issuance,or if construction is suspended for a period of 180 days at any time after work has commenced. The applicant is responsible for assuring all required inspections are requested in conformance with the State Building Code.This permit may be • . -d at any t tkiihor due cause. `P. %Vain. / /5 / ( 0/144}A-- Applicant Permitee Signature Date sued F�y Signature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.