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� <br /> CITY OF ORONO * 2 0 1 4 - 0 0 1 0 3 * <br /> , 2750 KELLEY PARKWAY DATE ISSUED: 02/06/2014 <br /> ORONO, MN 55356- <br /> ' (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 753 BOULDER DR <br /> PIN : 33-118-23-11-0074 <br /> LEGAL DESC : STONEBAY THIRD ADDITION <br /> : LOT 002 BLOCK 002 <br /> PERMIT TYPE : ADDITION/REMODEL/REPAIR <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR <br /> ACTIVITY : 434-RESIDENTIAL <br /> VALUATION : $ 33,387.00 <br /> NO"I'E: SEPARATE PERMI"CS REQUIRED: PLUMB[NG,MF,C}�[ANICAL,FIRF,PLACE, ELECTRICAL(STATE) <br /> REPAIR WATER DAMAGE <br /> APPLICANT PERMIT FEE SCHEDULE 509.75 <br /> STATE SURCHARGE(VALUATION) 16.69 <br /> GIERTSEN COMPANY TOTAL 526.44 <br /> 8385 I OTH AVE N <br /> GOLDEN VALLEY, MN 55427- Payment(s) <br /> (763)546-1300 CREDIT CARD 3846 526.44 <br /> Minnesota State License#: BUIL-BC1796 <br /> OWNER <br /> MASCHOFF, JOHN &DEBRA <br /> 2670 KELLEY PKWY <br /> ORONO, MN 55356- <br /> AGREEMENT AND SWORN STATEMENT <br /> l�he work for which this permit is issued shall be performed according to <br /> the approved plans and specitications,applicable City approvals,and the <br /> State E3uilding 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 whe[her 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 suance,or if construction is <br /> suspended for a period of 180 days at a time after work has commenced. <br /> The applican[is respon�ible for assu g all required inspections are <br /> requested in conformance with th ,tate Building Code.This permit may be <br /> revoked at any time for due c e. <br /> �� /�='�� ---��`� <br /> � /' � � <br /> �'`��� � / / i <br /> A-�ptrc�I ermitee Signature Da �� Issued By � nature Date <br />