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CITY OF ORONO 1I I 1 11 I II 1 1 1 1* 1l011 � <br /> 2750 KELLEY PARKWAY DATE ISSUED: 08/25/2016 <br /> ORONO,MN 55356- <br /> (952)249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 540 OLD CRYSTAL BAY RD S <br /> PIN : 04-117-23-42-0023 <br /> LEGAL DESC : WHITE OAK OVERLOOK <br /> : LOT 001 BLOCK 001 <br /> PERMIT TYPE : ADDITION/REMODEL/REPAIR <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR <br /> ACTIVITY : 434-RESIDENTIAL <br /> VALUATION : $ 33,106.07 <br /> NOTE: SEPARATE PERMITS REQJIRED: PLUMBING,MECHANICAL,ELECTRICAL(STATE) <br /> WATER DAMAGE REPAIR <br /> APPLICANT PERMIT FEE SCHEDULE 535.28 <br /> PLAN REVIEW 347.93 <br /> LINDSTROM CLEANING&CONSTRUCTION STATE SURCHARGE(VALUATION) 16.55 <br /> 9621 10TH AVE N <br /> PLYMOUTH,MN 55441- TOTAL 899.76 <br /> (763)544-8761 Payment(s) <br /> Minnesota State License#:BUIL-I087 CHECK 307527 899.76 <br /> OWNER <br /> ROGOSHESKE,GEORGE FUND&JUDY <br /> 540 OLD CRYSTAL BAY RD S <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 separate <br /> permits. All previsions of laws and ordinances governing this type of work <br /> shall be compie4 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 ime 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 ti ue cause. <br /> - 6 <br /> Applicant Pertrlitee Signature Date Issued By Signature Date <br />