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CITY OF ORONO I* 2 0 1 1 7 i� 0 1'' 1 41I 7 II* <br /> 2750 KELLEY PARKWAY DATE ISSUED: 10/05/2017 <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 : ADDITION/REMODEL/REPAIR <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR <br /> ACTIVITY : 434-RESIDENTIAL <br /> VALUATION : $ 100,000.00 <br /> NOTE: SEPARATE PERMITS REQUIRED: PLUMBING,MECHANICAL,FIREPLACE,ELECTRICAL(STATE) <br /> INTERIOR REMODEL <br /> APPLICANT PERMIT FEE SCHEDULE 1,109.92 <br /> DESTINY HOMES STATE SURCHARGE(VALUATION) 50.00 <br /> 4201 SUNSET DRIVE TOTAL 1,159.92 <br /> SPRING PARK,MN 55384- Payment(s) <br /> (612)554-5476 CHECK 34251 1,159.92 <br /> Minnesota State License#:BUIL-BC5300986 <br /> OWNER <br /> LITSEY,CAL&CHRISTINE <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 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 info ance with the State Building Code.This permit may be <br /> revoked at an time for due cause. <br /> `` <br /> Applicant Permitee Si ture l I Date Issuqu Signature Date <br />