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, <br /> ' CITY OF ORONO * Z 0 1 4 - 0 PJ S 2 4 * <br /> 2750 KELLEY PARKWAY llATE ISSUED: 08/12/2014 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 2630 COUNTRYSIDE DR W <br /> PIN : 04-117-23-12-0015 <br /> LEGAL DESC : OLD CRYSTAL BAY ROAD ADDN <br /> : LOT 007 BLOCK 002 <br /> PERMIT TYPE : ADDITION/REMODEL/REPAIR <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ADDN!REMODEL/REPAIR <br /> ACTIVITY : 434-RESIDENTIAL <br /> VALUATION : $ 98,000.00 <br /> N07�F,: SEYARA�I���, PERMI"I�S REQUIRED: PLUMBING, Ml?C}��ANIC�11.. I�IRI�;PLnCI�:. I�:I.}�:C'�I�IZIC'�1L(S"I�A"I�F.) <br /> KI`I'CI[EN AND I,Ai1NDRY ROOM RFMODF,I. <br /> APPLICANT PERMIT FEE SCHEDULE 1,041.75 <br /> STATE SURCHARGE(VALUATION) 49.00 <br /> PHF,ASAN'I' RUN CONSTRUCTION TOTAL 1,090.75 <br /> 1 ]09 141ST LANE NE <br /> HAM LAKE, MN 55304 Nayment(s) <br /> (763) 862-2106 CREDI"I'CARD 4403 1,090.75 <br /> Minnesota State License#: BUIL-20193061 <br /> OWNER <br /> URNESS, TODD& KATHERING <br /> 2630 COUNTRYSIDE DR W <br /> LONG LAKE, MN 55356 <br /> AGREEMENT AND SWORN STATEMENT <br /> t�he ti�ork tbr which this pemii[is issued shall be peribnned according to <br /> the approved plans and specifications,applicable City approvals,and the <br /> Sta[e Building Code. This permit is for only the work described and docs <br /> not erant permission for additional or related work which requires separatc <br /> permits. All provisions of laws and ordinances governing this type ofwork <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 /> conune;nced within 180 days of the date of issuance,or if construction is <br /> suspended for a period of 180 days at any time after���ork has commenced. <br /> The applicant is responsible for assuring all required inspections are <br /> requestcd in confbrmance with the State Building Code.This permit may bc <br /> revoked at any tin�c f<>r due cause. <br /> � <br /> _�"" ) <br /> -- ,-, ------.._._..___ � -/� -i� = .-��---�-� , , <br /> Appl��frf` e itee Signature Date Issued B��Si� iture te <br />