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CITY OF ORONO * Z 0 1 5 - 0 0 7 5 5 * <br /> ,, 2750 KELLEY PARKWAY DATE ISSUE�: 06/1U2015 <br /> E ORONO, MN 55356- <br /> 952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 2760 SHADYWOOD RD <br /> PIN : 21-117-23-24-0040 <br /> LEGAL DESC : REG. LAND SURVEY NO. 1196 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : ADVANCED PLAN REVIEW <br /> PROPERTY TYPE : RESIDENT[AL <br /> CONSTRUCTION TYPE : ADVANCED PLAN REVIEW <br /> VALUAT[ON : $ 110,000.00 <br /> NOTE: PLEASE FILL IN THE FOLLOW[NG: <br /> VALUATION OF PERM[T:$ 110,000.00 <br /> TYPE OF PERMIT THIS PAYMENT IS FOR: ATTACHED GARAGE <br /> PERMIT#THIS PRE-PAYMENT[S TIED TO:2015-00754 <br /> APPLICANT ADVANCED PLAN REVIEW 762.18 <br /> CREATIVE BUILDERS [NC. TOTAL 76218 <br /> 5958 FENNING AVE SE Payment(s) <br /> DELANO,MN 55328- CHECK 7032 762.18 <br /> (952)955-3062 <br /> Minnesota State License#: BUIL-BC037260 <br /> i'i��, �;r ur�,no <br /> OWNER 21u�� Kellry Parkway <br /> Ornno MN 55;�56 952-249-�460U <br /> ENGLER,JEFF Receipt No: �.013610 .ii.�n 1 I, �016 <br /> 3330 MARTHA LANE <br /> MINNETONKA, MN 55345- Creatide Builders Inc <br /> f�revious Balance: ��� <br /> Permits <br /> AGREEMENT AND SWORN STATEMENT ZR��-�0755 276U Shadywood 70�.�g <br /> The work for which this permit is issued shall be performed according to 101-34410 <br /> the approved plans and specifications,applicable City approvals,and the Plan Cherk/Si te EXam Fees <br /> State Building Code. This permit is for only the work described and does TUtc�l: � <br /> not gran[permission for additional or related work which requires sepazate 76L,1 i? <br /> permi[s. All provisions of laws and ordinances governing this type of work ('f'ie�k ` <br /> shall be compied with whether or not specified herein.This permit will ChecK N0: 7032 762.��� <br /> expire and become null and void if construction authorized is not Payor: <br /> commenced within l80 days ofthe date of issuance,or ifconstruction is _ Greative Bui lders If1C <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 /> cevoked at any time for due cause. � <br /> s i� ��' � <br /> �lj�� 5 ��.�� � � d[ � C� <br /> Applicant Pe ignature Date Issued By Signature Date <br />