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" � CITY OF ORONO PERMIT NO.: 2008-00256 <br /> 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- DATE ISsuEn: 10/08/2008 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 2715 COUNTRYSIDE DR W <br /> PIN : 04-117-23-12-0019 <br /> LEGAL DESC : OLD CRYSTAL BAY ROAD ADDN <br /> : LOT 004 BLOCK 003 <br /> PERMIT TYPE : ADDITION/REMODEL/REPAIR <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR <br /> ACTI VITY : 434-RESIDENTIAL <br /> VALUATION : $ 20,000.00 <br /> NOTE: SEPERATE PERMITS REQUIRED: PLUMBING,ELECTRICAL(STATE) <br /> KITCHEN REMODEL-ALL INTERIOR WORK. <br /> APPLICAI�TT PERMIT FEE SCHEDULE 339.25 <br /> STONEWOOD DESIGN BUILD PLAN REVIEW 220.51 <br /> 7404 WAYZATA BLVD <br /> MINNEAPOLIS,MN 55426- STATE SURCHARGE(VALUATION) 10.00 <br /> (952)697-5075 TOTAL 569.76 <br /> Minnesota State License#: 20534541 <br /> OWNER <br /> WILSON, MARK& KIRSTIN <br /> 2715 COUNTRYSIDE DR W <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 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 /> suspen for a period of l 80 days at any time after work has commenced. <br /> The plic t is responsible for assuring all required inspections are <br /> requested� onformance with the State Building Code.This permit may be <br /> revoked y time for due cause. I <br /> ' oi z' i ° Q �r� /vl ��ll�g <br /> Appl't n Permitee Signature Date Is d By Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />