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� ' CITY OF ORONO * z 0 1 4 - P1 0 7 1 8 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 07/10/2014 <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 : $ 58,000.00 <br /> NOTE: PLEASE FILL IN THE FOLLOWING: <br /> VALUATION OF PERMIT:$58,000.00 <br /> TYPE OF PERMIT THIS PAYMENT IS FOR: ELEVATOR ADDITION <br /> PERMIT#THIS PRE-PAYMENT IS TIED TO:2014-00719 <br /> APPLICANT ADVANCED PLAN REVIEW 482.14 <br /> HNH HOMES TOTAL 482.14 <br /> Payment(s) <br /> 13911 RIDGEDALE DRIVE#406D CREDIT CARD 0348 482.14 <br /> MINNETONKA,MN 55345- <br /> (952)288-3746 <br /> Minnesota State License#: BUIL-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 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 goveming 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 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 />