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CITY OF ORONO * Z 0 1 3 - 0 0 B 9 4 * <br /> ,� 2750 KELLEY PARKWAY DATE ISSUED: 08/30/2013 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 1700 SHORELINE DR <br /> PIN : 10-117-23-14-0014 <br /> LEGAL DESC : LJNPLATTED 10 117 23 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : ADVANCED PLAN REVIEW <br /> PROPERTY TYPE ; RESIDENTIAL <br /> CONSTRUCTION TYPE : ADVANCED PLAN REVIEW <br /> VALUATION : $ 75,000.00 <br /> NOTE: PLEASE FILL IN THE FOLLOWING: <br /> VALUATION OF PERMIT:$75,000.00 <br /> , <br /> TYPE OF PERMIT THIS PAYMENT IS FOR: REMODEL <br /> PERMIT#THIS PRE-PAYMENT IS TIED T02013-00895 <br /> APPLICANT ADVANCED PLAN REVIEW 565.01 <br /> HNH HOMES <br /> 13911 RIDGEDALE DRIVE#406D TOTAL 565.01 <br /> MINNETONKA,MN 55345- PAID WITH CASH -20.00 <br /> (952)288-3746 PAID WITH CC# 6746 <br /> Minnesota State License#: 654037 <br /> OWNER <br /> ETAL, IRWIN JACOBS <br /> 1700 SHORELINE DR <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 approva{s,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 construction 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 due cause. <br /> / / � 1'� 0 /d,U/ <br /> Applicant Permitee Signature Date Issued y Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />