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CITY OF ORONO PERMIT NO.: 2011-00973 <br /> 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- DATE IssuEn: 08/3U2011 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 1978 SHADYWOOD RD <br /> PIN : 17-117-23-24-0026 <br /> LEGAL DESC : SHADY-WOOD <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : ADVANCED PLAN REVIEW <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ADVANCED PLAN REVIEW <br /> VALUATION : $ 10,000.00 <br /> NOTE: PLEASE FILL IN THE FOLLOWING: <br /> VALUATION OF PERMIT:$ 10,000.00 <br /> TYPE OF PERMIT THIS PAYMENT IS FOR: BUILDING PERMIT <br /> PERMTT#THIS PRE-PAYMENT IS TIED TO:2011-00974 ` <br /> � <br /> APPLICANT ADVANCED PLAN REVIEW 124.64 <br /> PETERS, BRIAN <br /> 1978 SHADYWOOD ROAD TOTAL 124.64 <br /> WAYZATA, MN 55391- <br /> OWNER <br /> PETERS, BRIAN <br /> 1978 SHADYWOOD ROAD <br /> WAYZATA, MN 55391- <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 does <br /> not grant permission for additional or related work which requires sepazate <br /> permits. A]l 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 authorized is not <br /> commenced within l80 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 the State Building Code.This permit may be <br /> revoked at any Yt1ne fon du ause. <br /> �, �� �' <br /> �li/LL.?�-�'�.c C�'� l �-�/ l :�% l l <br /> Applicant Permitee Signature Date Issued By gnature ate <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED AB . <br />