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CITY OF ORONO * 2 0 1 8 - 0 0 1 7 0 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 02/23/2018 <br /> ORONO,MN 55356- <br /> (952)249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 2248 SHADYWOOD RD <br /> PIN : 17-117-23-43-0126 <br /> LEGAL DESC : WILEYS PARK LAKE MTKA <br /> : LOT 007 BLOCK 001 <br /> PERMIT TYPE : ADVANCED PLAN REVIEW <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ADVANCED PLAN REVIEW <br /> VALUATION : $ 150,000.00 <br /> NOTE: PLEASE FILL IN THE FOLLOWING: <br /> VALUATION OF PERMIT:$ 150,000.00 <br /> TYPE OF PERMIT THIS PAYMENT IS FOR: REMODEL <br /> PERMIT#THIS PRE-PAYMENT IS TIED TO:2018-00171 <br /> APPLICANT ADVANCED PLAN REVIEW 926.20 <br /> TOTAL 926.20 <br /> PAiJL SORENSON CONSTRUCTION Payment(s) <br /> 525 COUNTY ROAD 92 CHECK 10979 926.20 <br /> MAPLE PLAIN,MN 55359- <br /> (612)86&5138 <br /> OWNER <br /> LAGERSTROM,ED <br /> 2248 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 dces <br /> not grant permission for additional or related work which requires sepazate <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 nuli and void if construction authorized is not <br /> commenced within I80 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 Signature Date <br />