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, . CITY OF ORONO * Z 0 1 3 - 0 0 2 8 3 * 2750 KELLEY PARKWAY DATE ISSUED: 07/10/2013 ORONO, MN 55356- (952) 249-4600 FAX: (952) 249-4616 ADDRESS : 106 CHEVY CHASE DR PIN : 36-118-23-41-0033 LEGAL DESC : HILL O'WAY MANOR : LOT 028 BLOCK 001 PERMIT TYPE : ADDITION/REMODEL/REPAIR PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR ACT[VITY : 434-RESIDENTIAL VALUATION : $ 51,400.00 NOTE: SEPERATE PERMITS REQUIRED: ELECTRICAL(S"I�ATE) ADDITION-PORCH - DECK APPLICANT PERMIT FEE SCHEDULE 696.75 BAUER BUILDING CO. STATE SURCHARGE(VALUATION) 25.70 4628 S LAKE SARAH DR. TOTAL 722.45 MAPLE PLAIN, MN 55359 (612)382-2880 PAID WITH CC# 5361 Minnesota State License#: 20626864 OWNER JOHNSON, MR. & MRS. 106 CHEVY CHASE DR WAYZATA, MN 55391- AGREEMENT AND SWORN STATEMENT The work tbr 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 Yor 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 specitied 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 afrer work has commenced. Thc applicant is responsible for assuring all required inspections are requeste onformanc ith the State Building Code.This permit may be revoked t a y tim �or e cause. L 7 - /t�- f �j n.,_,j� a / / 1 J � �l �(.�/ � Applicant Permitee Signature Date Issued Signature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.