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1 <br /> �, � CITYOFORONO * z016 - 0PJ838 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 08/18/2016 <br /> ORONO, MN 55356- <br /> (952)249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 2040 SPATES AVE <br /> PIN : 10-117-23-31-0090 <br /> LEGAL DESC : ORA PARK ON LAKE MTKA <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : NEW STRUCTURE <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : SINGLE FAMILY <br /> ACTIVITY : 101-SINGLE FAMILY HOUSES,DETACHED <br /> VALUATION : $ 600,000.00 <br /> NOTE: SAC PAID#8459 OS/08/1986 <br /> SEPARATE PERMITS REQUIRED:PLUMBING,MECHANICAL,FIREPLACE,WATER CONNECTION,SEWER CONNECTION,WELL, <br /> ELECTRICAL(STATE) <br /> NOTE:PLEASE SEE AND INITIAL NEW BUILDER ACKNOWLEDGEMENT FORM <br /> APPLICANT PERMIT FEE SCHEDULE 4,154.92 <br /> STATE SURCHARGE(VALUATION) 300.00 <br /> CITY HOMES TOTAL 4,454.92 <br /> 3918 SLTNNYSIDE RD <br /> EDINA, MN 55424 Payment(s) <br /> (952)486-4567 CHECK 1030 4,454.92 <br /> Minnesota State License#: BUIL-BC673138 <br /> O W ivER <br /> DAMMEN,SUSAN <br /> 2040 SPATES AVE <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[ime afrer 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 time for due cause. <br /> �_� y ' <br /> , __------ <br /> � , _ _ __.�/.F> /� , �'i � i �,�j <br /> �'Applicant itee Signature te Issued Signature Date <br />