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CITY OF ORONO � �'� I� ''I L �' �r <br /> ' - 2750 KELLEY PARKWAY * DATE ISSUED: 09/10/2014 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952)249-4616 <br /> ADDRESS : 490 OLD LONG LAKE RD <br /> PIN : 36-118-23-34-0010 <br /> LEGAL DESC : SUMMIT STATION <br /> : LOT 003 BLOCK 001 <br /> PERMIT TYPE : MINOR ALTERATIONS <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : REPAIR <br /> ACTIVITY : 0/S BUILDING-UNDEFINED <br /> VALUATION : $ 10,000.00 <br /> NOTE: REAPIR-WATER DAMAGE <br /> • <br /> APPLICANT PERMIT FEE SCHEDULE 191.75 <br /> VUJOVICH DESIGN BUILD STATE SURCHARGE(VALUATION) 5.00 <br /> 275 MARKET STREET TOTAL 196.75 <br /> MINNEAPOLIS, MN 55405- <br /> Payment(s) <br /> (612)366-1883 CREDIT CARD 2567 196.75 <br /> Minnesota State License#: BUIL-BC006077 <br /> OWNER <br /> WIKEN, LAWRENCE&BARBARA <br /> 490 OLD LONG LAKE 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. eriod of 180 days at any time after work has commenced. <br /> The applican/responsible for Suring all required inspections are <br /> requested i onformance witb t a State Building Code.This permit may be <br /> revoked . y time for due pa se. <br /> / I <br /> ./.107P‘174� ` 9 / /0, /1 <br /> •pplicant Permitee Si ure Date Issue. ,y Signature Date <br />