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� � ' CITY OF ORONO * 2 0 1 4 - 0 0 0 8 5 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 0?✓18/2014 <br /> ORONO, MN 55356- <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 2655 NORTH SHORE DR <br /> PIN : 09-117-23-42-0001 <br /> LEGAL DESC : UNPLATTED 09 117 23 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : ADDITION/REMODEL/REPAIR <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR <br /> ACTIVITY : 434-RESIDENTIAL <br /> VALUATION : $ 210,000.00 <br /> NOTE: ADDITION <br /> APPLICANT PERMIT FEE SCHEDULE 1,716.75 <br /> PILLAR HOMES STATE SURCHARGE(VALUATION) 105.00 <br /> 1700 NIAGARA LANE N TOTAL 1,821.75 <br /> PLYMOUTH,MN 55447 Payment(s) <br /> (763)475-1700 CHECK 36052 1,821.75 <br /> OWNER <br /> VAN RIEMSDYK,JAMES <br /> 2655 NORTH SHORE DR <br /> WAYZATA, MN 55391- <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,applicabie 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 /> pertnits. 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 1 SO 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 time for due cause. <br /> � <br /> �,� ti f !� a-� l �' � <br /> Applicant Permitee Signature Da e Issu By Signature Date <br />