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CITY OF ORONO * 2 0 1 5 - 0 1 4 8 3 * <br /> � •� 2750 KELLEY PARKWAY DATE ISSUED: 11/19/2015 <br /> ORONO, MN 55356- <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 2000 SHADYWOOD RD <br /> PIN : 17-117-23-31-0001 <br /> LEGAL DESC : GUST S JOHNSONS ADDN <br /> : LOT 000 BLOCK 000 <br /> PERMTT TYPE : ADVANCED PLAN REVIEW <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTIOIv TYPE : ADVANCED PLAN REVIEW <br /> VALUATION : $ 631,720.00 <br /> NOTE: PLEASE FILL IN THE FOLLOWING: <br /> VALUATION OF PERMIT:$ 631,720.00 <br /> TYPE OF PERMIT THIS PAYMENT IS FOR: NEW HOME <br /> PERMIT#THIS PRE-PAYMENT IS TIED TO:2015-01482 <br /> APPLICANT ADVANCED PLAN REVIEW 2,809.90 <br /> TOTAL 2,809.90 <br /> SUSTAINABLE 9 DESIGN+BUILD Payment(s) <br /> 124 MAIN ST SE CHECK 6513 2,809.90 <br /> SUITE 343 <br /> MINNEAPOLIS,MN 55414 <br /> (612)234-4194 <br /> Minnesota State License#: BUIL-BC653457 <br /> OWNER <br /> KIRCHNER,ESTATE OF ROGER <br /> 2000 SHADYWOOD RD <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 separate <br /> permits. 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 construc[ion 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 are � <br /> requested in conformance with the State Building Code.This permit may be <br /> revoked at any time for d \ <br /> ���-�-s� I �� <br /> ►cq � �, , � <br /> Applic rtee i e Da e Issued By Signa re Date <br />