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CITY OF ORONO * 2 0 1 7 — 0 0 3 3 3� <br /> 2750 KELLEY PARKWAY DATE ISSUED: 04/06/2017 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDI:�SS�. : 1700 SHORELINE DR <br /> PIN : 10-117-23-14-0022 <br /> LEGAL DESC : UNPLATTED 10 117 23 <br /> : LOT 4 BLOCK 1 <br /> PERMIT TYPE : ADVANCED PLAN REVIEW <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ADVANCED PLAN REVIEW <br /> VALUATION : $ 200,000.00 <br /> NO'I'E: PLEASE FILL IN THE FOLLOWING: <br /> VALUAT[ON OF PERM[T:$ 20Q000.00 <br /> TYPE OF PERMIT THIS PAYMENT IS FOR: NEW CARE"I'AKER'S HOUSE <br /> PERM[T#TfiIS PRE-PAYMENT IS TIED TO:2017-00332 <br /> APPLICANT ADVANCED PLAN REVIEW 1,130.95 <br /> HNH HOMES TOTAL 1,130.95 <br /> Payment(s) <br /> 1391 1 RIDGEDALE DRIVE#406D CREDIT CARD 3005 1,130.95 <br /> MINNETONKA, MN 55345- <br /> (952)288-3746 <br /> Minnesota State License#: BUIL-654037 <br /> OW1vER <br /> IRWIN JACOBS REV TRUST <br /> 1700 SHORELINE DR <br /> WAYZATA, MN 55391- <br /> AGREEMENT AND SWORN STATEMENT <br /> "1'he 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 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 l80 days at any time after work has commenced. <br /> The applicant is responsible for assuring alI required inspections are <br /> requested in conformance-y�ith the State Building Code.This permit may be � <br /> revoked at any tim r e cause. f(�� <br /> - / 7 ;���c �t /'�e-�`'�; �� 1 � � <br /> pplica er e Sig ture Dat w Issued By Signatu e Date —T— <br />