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� � CITY OF ORONO * z 0 1 4 - 0 1 2 7 � <br /> 2750 KELLEY PARKWAY DATE ISSUED: 1U05/2014 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 1 165 FERNDALE RD W <br /> PIN : 02-117-23-43-0026 <br /> LEGAL DESC : NORTH SHORE COTTAGE ACRES LAKE <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : ADDITION /REMODEL/REPAIR <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ADDN/REMODEL/ REPAIR <br /> ACTIVITY : 434-RES[DENTIAL <br /> VALUATION : $ 175,000.00 <br /> \OTI:: SEPAR�1�l�E PGRMITS RI?QUIRI�;D: PI,UMI3ING. :Vll?CI IANICAL,FIRI�:PLACE, I�;LEC'1'RICAL(S"I'A"I'E) <br /> REMODEI, <br /> APPLICANT PERMIT FEE SCHEDULE 1,506.75 <br /> STREETER & ASSOCIATES STATE SURCHARGE(VALUATION) 87.50 <br /> 18312 M[NNETONKA BLVD TOTAL 1,594.25 <br /> WAYZATA, MN 55391 Payment(s) <br /> (612)449-9448 CREDIT CARD 2061 1,594.25 <br /> Minnesota State License#: BUIL-1380 <br /> OWNF.R <br /> BROOK, ROBERT <br /> I l65 FERNDALE RD W <br /> WAYZATA, MN 55391- <br /> AGREEMENT ANll SWORN STATEMENT <br /> "I�hc 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 Ihe N�ork 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 whether or no[specified herein.This permit will <br /> expire and become null and void if construction authorized is not <br /> commenced within ]80 days of the date of issuance,or if construction is <br /> suspended for a period of 180 days at any time atter work has commenced. <br /> The applicant is responsible for assuring all required inspections are <br /> requested in conformance with the State[iuildin��Code.This permit may bc <br /> revoked at anv time for duc cause. <br /> ����- /l , � , /� <br /> Applicant Permitee Signature Date Issued �Signature Date <br />