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CITY OF ORONO * 2 0 1 8 - 0 0 0 3 0 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: Ol/10/2018 <br /> ORONO, MN 55356- <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 2780 SHADYWOOD RD <br /> PIN : 21-117-23-24-0041 <br /> LEGAL DESC : REG.LAND SURVEY NO. 1196 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : ADVANCED PLAN REVIEW <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ADVANCED PLAN REVIEW <br /> VALUATION : $ 20,000.00 <br /> NOTE: PLEASE FILL IN THE FOLLOWING: <br /> VALUATION OF PERMIT:$ 20000 <br /> TYPE OF PERMIT THIS PAYMENT IS FOR: INTERIOR REMODEL <br /> PERMIT#THIS PRE-PAYMENT IS TIED TO:2018-00029 <br /> APPLICANT ADVANCED PLAN REVIEW 231.54 <br /> PLEKKENPOL BUILDERS TOTAL 231.54 <br /> Payment(s) <br /> 401 W 78TH ST CREDIT CARD 6152 231.54 <br /> BLOOMINGTON,MN 55420- <br /> (952)888-2225 <br /> Minnesota State License#:BUIL-BCD01797 <br /> OWNER <br /> CARTER,RICHARD&JEANNE <br /> 2780 SHADYWOOD RD <br /> EXCELSIOR,MN 55331- <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 permission for additional or related work which requires separate <br /> permits. All provisions of Iaws 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 consVuction 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 ime f ca <br /> � ^ /�� � / / <br /> Appl' t Perm ee Sign Date Issued By Signature Date <br />