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iiiiiiiiiiiiiiiiiiiiiillillillillillillilliilillim <br /> CITY OF ORONO * 2013 - 00886 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 09/04/2013 <br /> ORONO,MN 55356- <br /> (952)249-4600 FAX: (952)249-4616 <br /> ADDRESS 2496 OLD BEACH RD <br /> PIN 21-117-23-22-0006 <br /> LEGAL DESC SHORE HILLS <br /> : LOT 005 BLOCK 000 <br /> PERMIT TYPE ADDITION/REMODEL/REPAIR <br /> PROPERTY TYPE RESIDENTIAL <br /> CONSTRUCTION TYPE ADDN/REMODEL/REPAIR <br /> ACTIVITY 434-RESIDENTIAL <br /> VALUATION S 11,000.00 <br /> NOTE: NEW DECKING <br /> APPLICANT PERMIT FEE SCHEDULE 206.50 <br /> BENCHMARK CONTRACTING STATE SURCHARGE(VALUATION) 5.50 <br /> 2331 DRIFTWOOD <br /> MOUND,MN 55364 TOTAL 212.00 <br /> (612)978-5603 <br /> Minnesota State License#: BC 180592 <br /> OWNER <br /> CARLSON,GERALD&DIANE <br /> 2496 OLD BEACH RD <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,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 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 are <br /> requested in c form a State Building Code.This permit may be <br /> revoked a anor due c se. <br /> or <br /> Ap tcant ee Signature Date Issued y Si re -Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER TIYAN DESCRIBED ABOVE. <br />