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, CITY OF ORONO <br /> 2750 KELLEY PARKWAY * Z 0 1 2 - PJ 0 9 1 9 * <br /> .. DATE ISSUED: 09/28/2012 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 1669 NORTH FARM RD <br /> PIN : 27-118-23-44-0008 <br /> LEGAL DESC : THE FARM AT LONG LAKE <br /> : LOT 00'1 BLOCK 001 <br /> PERMIT TYPE : ADDITION/REMODEL/REPAIR <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR <br /> ACTNITY : 434-RESIDENTIAL <br /> VALUATION : $ 62,500.00 <br /> NOTE: SEPERATE PERMITS REQUIRED: PLUMBING,ELECTRICAL(STATE) <br /> PHASE I OF A 3-YEAR PROJECT-KITCHEN/LIVING ROOM REMODEL <br /> APPLICANT pERMIT FEE SCHEDULE 779.25 <br /> ELITE REMODELING SERVICES INC PLAN REVIEW 506.51 <br /> 18061 PILOT KNOB ROAD <br /> FARMINGTON,MN 55024- STATE SURCHARGE(VALUATION) 31.25 <br /> (952)646-2480 TOTAL 1,317.01 <br /> Minnesota State License#:BC638744 <br /> OWNER <br /> BEENDERS&PETER MONTGOMERIE,ANTOINETTE <br /> 1669 NORTH 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 Building Code. This permit is for only the work described and does <br /> not grant permission for additional or related work which requires sepazate <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 180 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 aze <br /> requested in conformance with the State Building Code.This permit may be <br /> revoked at any�ime for due cause. <br /> (/�- fr�--'� `I i2� , ry , .2 <br /> � 2�r / <br /> Applicant Permitee Signature Date Issu By Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />