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i� .- <br /> CITY O� ORONO * 2 B 1 4 — 0 0 5 5 2 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 06/03/2014 <br /> ORONO,MN 55356- <br /> 952 249-4600'FAX: 952 249-4616 <br /> ADDRESS : 1645 SHADYWOOD RD ' <br /> PIN : 17-117-23-22-0013 <br /> LEGAL DESC : UNPLATTED 17 11�23 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : ADVANCED PLAN REVIEW <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ADVANCED PLAN REVIEW <br /> ACTIVITY : 434-RESIDENTIAL <br /> VALUATION : $ 325,000.00 <br /> NOTE: PLEASE FILL IN THE FOLLOWING: <br /> VALUATION OF PERMIT:$ 325,000.00 <br /> TYPE OF PERMIT THIS PAYMENT IS FOR: ADV PLAN REVIEW FOR NEW STRUCTURE <br /> PERMIT#THIS PRE-PAYMENT IS TIED TO:201400553 <br /> APPLICANT ADVANCED PLAN REVIEW 1,564.39 <br /> TOTAL 1,564.39 <br /> ATi,AS HOMES INC Payment(s) <br /> 14450 11TTH AVE N CHECK 009142 1,564.39 <br /> D�,YTON,MN 55369- <br /> (763)691-9044 <br /> Minnesota State License#:BUIL-BC20269686 � ' ` • --, ' , ` � ;. <br /> ; �_`ity o�'�r�aa , � <br /> .�tt t��l�y Pat�kway �`� ; <br /> �,:� t3� 1� ,S"� :� E4�9�4� , �:y.:; <br /> OWNER j ,: ��1•� ##0`.3:�33#�l#4�� ° 3� �s ��4 " . ;. <br /> LANDSOURCE �,` • � � • � <br /> 550 25TH AVE N �.` •��ia� F�e�.,ReBi �set�t.l.� : <br /> ST CLOUD,MN 56301- t . ' � °� r ' J <br /> � =` �ev�'�ala�4s �+ ;� ,� '� `..'I <br /> � ° �a�.#�,: � ' . ',� <br /> � �1�� ��45 ''�,� 39 <br /> ` �i R$ t` <br /> I <br /> AGREEMENT AND SWORN STATEMENT , ��� '�� � . _ : I <br /> I� . .P1a�r t�t�Stte-.�Ex�p �� . <br /> The work for which this permit is issued shall be performed according to � _,,,� ��. <br /> the approved plans and spec�cations,applicable City approvals,and the k � T��1�p, , f i <br /> State Building Code. This permit is for only ffie work described and does t � .- t` . ��� ,! <br /> not grant permission for additional or related work which requires separate ( : �'!IE'Ck ; ' i <br /> permits. All provisions of laws and ordinances goveming this type of work ; �k �!1G �i�f?9I+� - 1��:� � <br /> sh a ll b e com pi e d wi t h wh e t h e r o r n o t s p e c i fi e d h e r e i n.T h i s p e r m i t w i ll �' ' � � <br /> expire and become null and void if construction authorized is not � �+�������I �5@�fi �,f"r�'. j <br /> commenced within 1 80 days o f the date of issuance,or if construction is f' ' � fi��a�'�p��d`+:,�. gy���� � <br /> suspended for a period of 180 days at any time after work has commenced. � � •�'-°+---�=+�•. ,:; <br /> The applicant is responsible for asswing all requ'ued inspections are � �� ���` �'� .�# + <br /> requested in conformance with thc State Building Code.This permit may be �"`----*~�—T•--- t� <br /> revoked at any time for due cause. ' `����� �f�. . - `� <br /> i <br /> i <br /> ,. � � <br /> Applicant Permitee Signature Date Issued By Signature Date <br />