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, , . CITY OF ORONO * 2 0 1 7 - 0 1 4 1 8 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: il/OU2017 <br /> ORONO,MN 55356- <br /> (952)249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 1680 SHADYWOOD RD <br /> PIN : 17-117-23-21-0016 <br /> LEGAL DESC : SHADY-WOOD <br /> : LOT 009 BLOCK 000 <br /> PERMIT TYPE : ADVANCED PLAN REVIEW <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ADVANCED PLAN REVIEW <br /> VALUATION : $ 4,000.00 <br /> APPLICANT ADVANCED PLAN REVIEW 70.45 <br /> TOTAL 70.45 <br /> CROSSROADS REMODELING LLC payment(s) <br /> 7256 MACIVER AVE NE CREDIT CARD 0640 70.45 <br /> ALBERTVILLE,MN 55301- <br /> (952)217-0148 <br /> Minnesota State License#:BUIL-BC 721767 <br /> OWNER <br /> DOLEMAN,JOHN <br /> 1680 SHADYWOOD RD <br /> WAYZATA,MN 55391- <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for which this pertnit 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 pertnission for additional or related work which requires separate <br /> pertnits. 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 suthorized 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 are <br /> requested in conformance with the State Building Code.This permit may be <br /> revoked at any tic i e for due cause. <br /> G� 1� l l y l / <br /> Applicant Permitee Signature D e Issued By Signature Date <br />