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, CITY OF ORONO * z 0 1 3 - 0 1 1 3 4 * <br /> * 2750 KELLEY PARKWAY DATE ISSUED: 1U27/2013 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 2775 COUNTRYSIDE DR W <br /> PIN : 04-117-��-12-0016 <br /> LEGAL DESC : OLD CRYSTAL BAY ROAD ADDN <br /> : LOT 001 BLOCK 003 <br /> PF.RMIT TYPE : ADDI'I�ION! REMODEL/REPAIR <br /> PROPERTY TYNE : RESIDGNTIAL <br /> CONSTRUCTION TYPE : ADDN /REMODGL/ RFPAIR <br /> ACTIVITY : 434-RESIDENTIAL <br /> VALUATION : $ 150,000.00 <br /> NO�fF:: SEPnRnTE PERMI"I�S REQU[RF.D: PLUMRING. MF.CI Ii1NICAL, I:LI�:CTRICAL(S"I�A'I'E) <br /> APPLICANT PERM[T FEE SCHEDULE 1,356.75 <br /> SHOREL[NE E3UILDERS STATE SURCHARGE(VALUATION) 75.00 <br /> 2184 SHADYWOOD RD TOTAL 1,431.75 <br /> WAYZATA, MN 55391- <br /> (763) 506-0629 <br /> Minnesota State License l#: BC630814 <br /> OWNER <br /> MURLEY, TODD& MARY <br /> 2755 COUNTRYSIDE DR W <br /> LONG LAKE, MN 55356 <br /> AGREEMFNT AND SWORN STATEMENT <br /> �I�he��urk for which this permit is issucd shall be perfonned according to <br /> the anpro��ed plans and specifications,applicable City approvals,and the <br /> Sttite f�uilding Code. 'I�his permit is for onl��the work described and does <br /> nul grant permission for additional ur related work���hich requires separate <br /> permits. All provisions of laws and ordinances govcrning this typc of work <br /> ,hall be compied�+�ith whether or not specitied herein.This permit will <br /> expire and hecume n I and void if construction authorized is n��t <br /> commenced�vithin 80 dav,of the date of issuance,or if construction is <br /> ,uspendcd for��p iod ol 180 days at an��time after�vork has commenced. <br /> �I'hc applicant i� esponsible for assuring all rcyuired inspections are <br /> reyuested i formance with Ihe State E3uilding Code.This pemiit ma��bc <br /> recokcd� � ime tor due causc. <br /> �� ��� �i, �-7, -l� <br /> , , <br /> npplf�ant Perm� ee Signature ��it� Issued By Si ure e <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED A VE. <br />