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CITY OF ORONO * 2 0 1 6 — 0 1 2 2 1 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 09/29/2016 <br /> ` ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 1725 FAGERNESS POINT RD <br /> P[I� : 17-117-23-22-0036 <br /> LEGAL DESC : MAPLEGATE INLET <br /> : LOT 005 BLOCK 002 <br /> PERMIT TYPE : MINOR ALTERATIONS <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : MINOR ALTERATIONS(MULITIPLE ITEMS) <br /> VALUATION : $ 22,629.00 <br /> NOTE: REPLACE:3 WINDOWS,3 DOORS,PATCH ROOF,REPAIR SIDING <br /> APPLICANT PERMIT FEE SCHEDULE 402.69 <br /> STATE SURCHARGE(VALUATION) 11.31 <br /> DENALI CUSTOM HOMES, INC. TOTAL 414.00 <br /> 18352 MINNETONKA BLVD payment(s) <br /> WAYZATA, MN 55391- CHECK 10540 414.00 <br /> (952)476-2679 <br /> Minnesota State License#: BUIL-20175394 <br /> OWNER <br /> Denali Custom Homes <br /> 18352 MINNETONKA BLVD <br /> DEEPHAVEN,MN 55331- <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 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 l80 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 inspections are <br /> requested in conformance with the State Building Code.This permit may be �;�-•� <br /> revoked at any time for due cause. ��"�/ <br /> ;'/ <br /> ��� ��c�-e--c `�--��-�z-' `l' � �`r� /�r <br /> Applicant Permitee Signature ' Date Issued By Signature Date <br />