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t <br /> CITY OF ORONO * 2017 - 00026 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 02/10/2017 <br /> ORONO, MN 55356- <br /> (952)249-4600 FAX: (952)249-4616 <br /> ADDRESS : 540 WILLOW DR S <br /> PIN : 03-117-23-32-0018 <br /> LEGAL DESC : N/A <br /> LOT 002 BLOCK 001 <br /> PERMIT TYPE NEW STRUCTURE <br /> PROPERTY TYPE RESIDENTIAL <br /> CONSTRUCTION TYPE SINGLE FAMILY <br /> ACTIVITY 101-SINGLE FAMILY HOUSES,DETACHED <br /> VALUATION $ 1,105,000.00 <br /> NOTE: SEPARATE PERMITS REQUIRED:PLUMBING,MECHANICAL,SEPTIC,FIREPLACE,ELECTRICAL(STATE) <br /> NOTE:PLEASE SEE AND INITIAL NEW BUILDER ACKNOWLEDGEMENT FORM <br /> APPLICANT PERMIT FEE SCHEDULE 6,695.92 <br /> STATE SURCHARGE(VALUATION) 542.00 <br /> NOR-SON INC TOTAL 7,237.92 <br /> 700 LAKE STREET E Payment(s) <br /> WAYZATA,MN 55391- CREDIT CARD 6558 7,237.92 <br /> (952)767-7949 <br /> Minnesota State License#: BUIL-BC001969 <br /> OWNER <br /> BOHLANDER,LAURA <br /> 2260 FOX ST <br /> LONG LAKE,MN 55356- <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 all required inspections are <br /> requested in conformance with the State Building Code.This permit may be <br /> revoked at any time r due cause. <br /> Applic ermitee Signature Date Issued B ignature Date <br />