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� PERMIT <br /> CITY OF ORONO <br /> 1750 Kelley Parkway- PO Box 66 Permit Number: p08767 <br /> Crystal Bay, Minnesota 55323 Permit Type: <br /> Addirion/RemodeURepair <br /> (952) 249-4600 Date Issued: 6/15/2005 <br /> SITE ADDRESS: 565 Leaf Street Unit# <br /> Long Lake,MN 55356 <br /> P��� OS-117-23-41-0028 <br /> DESCRIPTION: UBC Occupancy R3 <br /> Construcrion Type VN <br /> Proposed Use: Residential Census Code 434 <br /> Permit Class: Building <br /> Permit Type: Addirion/RemodeURepair Permit Sub-type(s): Addn/RemodeURepair <br /> DETAILS: <br /> Approved per resolurion#: <br /> Separate permits required: Plumbing Mechanical Electrical(state) <br /> NOTICES/REMARKS: <br /> FEE SUMMARY: Pernut Fee: $ 1,273.75 Valuation: $ 150,000.00 <br /> Plan Review Fee: $ 827.94 <br /> State Surcharge Fee: $ 75.00 <br /> TOTAL FEE: $ 2,176.69 <br /> APPLICANT: Herman Renovarion OWNER: Kosierazki&Fox <br /> 5645 Eureka Rd. 565 Leaf Street <br /> Excelsior,MN 55331 Long Lake MN 55356 <br /> THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED <br /> AND AGREES TO DO ALL WORK IN STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF <br /> MINNESOTA BUILDING CODE REQUIREMENTS. <br /> 1 � � <br /> f CS�'Y�C-e-� <br /> APPLICANT PE E GNATURE ISSUED BY SIGNATURE <br /> Copies: 1-File(Signatures Required), 1-Applicant, 1-Monthly Reports, 1-Assessing,(If Septic, 1-Septic) Page 1 <br />