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CITY OF ORONO * Z 0 1 3 - 0 1 1 7 5 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: l U04/2013 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 3185 SIXTH AVE N <br /> PIN : 28-118-23-32-0006 <br /> LEGAL DESC : LJNPLATTED 28 118 23 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : ADVANCED PLAN REVIEW <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ADVANCED PLAN REVIEW <br /> VALUATION : $ 53,900.00 <br /> NOTE: PLEASE FILL IN THE FOLLOWING: �'� <br /> VALUATION OF PERMIT:$ 53,900.00 <br /> TYPE OF PERMIT THIS PAYMENT IS FOR: BUILDING PERMIT <br /> PERMIT#THIS PRE-PAYMENT IS TIED T0:2013-01176 <br /> APPLICANT ADVANCED PLAN REVIEW 462.64 <br /> MJS REPAIR AND REMODELING INC. TOTAL 462.64 <br /> 2327 LAFAYETTE RD <br /> WAYZATA, MN 55391- <br /> (952)270-5320 <br /> Minnesota State License#: BC626845 <br /> OWNER <br /> BRANTINGHAM,HENRY&NANCY <br /> 3185 SIXTH AVE N <br /> LONG LAKE, MN 55356- <br /> AGREEMENT A1VD 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 sepazate <br /> permi[s. 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 aze <br /> requested in conforman with the State Building Code.This permit may be <br /> rev ed at y time f ue cause. <br /> � L � � i i <br /> pplicant i e ign ture Date Issue By t nature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHE HAN DESCRIBED AB <br />