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� <br /> - � CITY OF ORONO * z 0 1 4 - 0 0 1 S 7 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 03/06/2014 <br /> ORONO, MN 55356- <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 : MINOR ALTERATIONS <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : DOORS <br /> ACTIVITY : O/S BUILDING - UNDEFINED <br /> VALUATTON : $ 988.00 <br /> APPLICANT PERMIT FEE SCHEDULE 41.25 <br /> STATE SURCHARGE(VALUAT[ON) 0.49 <br /> SCHERER BROS LUMBER MAIL-IN FEE 2.00 <br /> 10751 EXCELSIOR BLVD <br /> HOPKINS, MN 55343 TOTAL 43.74 <br /> (952)277-1600 Payment(s) <br /> Minnesota State License#: BUIL-BC239369 CREDIT CARD 3989 43.74 <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 specifica[ions,applicable City approvals,and [he <br /> Statc 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 whe[her or not specified herein.This permit will <br /> expire and become null and void it�construction authorized is not <br /> commenced within l80 days of the date of issuance,or ir 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 contbrmance with the State E3uilding Code.This permit may be <br /> revoked at anv time tbr due cause. <br /> �►�1.�-(.�C � / / <br /> Applicant Permitee Signature Date Issued B ignature � � Date <br />