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CITY OF ORONO PERMIT NO.: 2009-00592 <br /> 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- �ATE �ssuEn: 09/22/2009 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 1115 COX FARM RD <br /> PIN : 27-118-23-32-0016 <br /> LEGAL DESC : SHADOWOOD FARM <br /> : LOT 004 BLOCK 001 <br /> PERMIT TYPE : ACCESSORY STRUCTURE <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : SHED <br /> ACTIVITY : 328-OTHER NONRESIDENTIAL BU[LDINGS <br /> VALUATION : $ 2,000.00 <br /> NOTE: STORAGE SHED/PLAYHOUSE <br /> APPLICANT PERMIT FEE SCHEDULE 73.75 <br /> KOSTIAL, BRADFORD& SARAH PLAN REVIEW 47.94 <br /> 1115 COX FARM RD <br /> LONG LAKE, MN 55356 STATE SURCHARGE(VALUATION) 1.00 <br /> TOTAL 122.69 <br /> OWNER <br /> KOSTIAL, BRADFORD& SARAH <br /> 11 l 5 COX FARM RD <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 duilding Code. This permit is for only the work described and does <br /> no[grant permission for additional or rela[ed work which requires separate <br /> permits. All provisions of laws and ordinances governing 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 I 80 days of the date of issuance,or if 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 inspec[ions are <br /> requested in conformance with the State Building Code.This permit may be <br /> revoke�at�an �ti s for due c use. f <br /> �>� ��,� ��� G,� � � Z_z� 2Uc�'J � <br /> i iD� <br /> Applicant Permitee Signature Date Issu By Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />