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CITY OF ORONO * z 0 1 2 - 0 0 8 0 8 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 08✓17/2012 <br /> ORONO,MN 55356- <br /> (952)249-4600 FAX: (952)249-4616 <br /> ADDRESS : 2900 DEER RUN TR <br /> PIN : 04-117-23-24-0013 <br /> LEGAL DESC : OLD CRYSTAL BAY ROAD ADDN <br /> : LOT 008 BLOCK 004 <br /> PERMIT TYPE : ADVANCED PLAN REVIEW <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ADVANCED PLAN REVI�W <br /> VALUATION : $ 120,000.00 <br /> NOTE: PLEASE FILL IN THE FOLLOWING: <br /> VALUATION OF PERMIT:$ 120,000.00 <br /> TYPE OF PERMIT THIS PAYMENT IS FOR: SCREEN PORCH <br /> PERMIT#THIS PRE-PAYMENT IS TIED TO:2012-00809 <br /> APPLICANT ADVANCED PLAN REVIEW 764.89 <br /> MITTELSTAEDT INC TOTAL 764.89 <br /> P O BOX 454 <br /> WATERTOWN,MN 55388- <br /> (612)716-9595 <br /> Minnesota State License#:20012394 <br /> OWNER <br /> KACZKE,ROBERT&JILL <br /> 2900 DEER RUN TR <br /> LONG LAKE,MN 55356- <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 dces <br /> not grant permission for additional or related work which requires separate <br /> permits. All provisions of laws and ordinances goveming 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 aze <br /> requested in conformance with the State Building Code.This permit may be <br /> revoked at any time for due cause. <br /> � � / / <br /> Applicant Permitee Signature Date Issued By S�gnature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />