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CITY OF ORONO * 2 0 1 7 - 0 0 5 2 7 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 05/18/2017 <br /> ORONO, MN 55356- <br /> (952)249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 4380 SIXTH AVE N <br /> PIN : 31-118-23-12-0018 <br /> LEGAL DESC : UNPLATTED 31 118 23 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : ADVANCED PLAN REVIEW <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ADVANCED PLAN REVIEW <br /> VALUATION : $ 115,000.00 <br /> NOTE: PLEASE FILL IN THE FOLLOWING: <br /> VALUATION OF PERMIT:$ 115,000.00 <br /> TYPE OF PERMIT THIS PAYMENT IS FOR: ADDITION/REMODEL PERMIT <br /> PERMIT#THIS PRE-PAYMENT IS TIED TO:2017-00515 <br /> APPLICANT ADVANCED PLAN REVIEW 782.87 <br /> UNITED BUILDING CONTRACTORS TOTAL 782.87 <br /> 11162 ABERDEEN ST NE Payment(s) <br /> CREDIT CARD 1624 782.87 <br /> #B <br /> BLAINE,MN 55449- <br /> (763)45&0892 <br /> Minnesota State License#:BUIL-BC631205 <br /> OWNER <br /> MICHAEL DEMENGE&KURTIS WOLBECK <br /> 14226 NEBULA ST NE <br /> CIRCLE PINES,MN 55014- <br /> AGREEMENT AIVD 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 1 SO days at any time after work has commenced. <br /> The applicant is responsible for assuring all required inspections are <br /> requested in conforn►ance with the State Building Code.This permit may be <br /> revoked at any time for due cause. � <br /> � <br /> ����( �o rl ��..-� ��_`fs� Sl ( �� I�l <br /> Applicant Permitee Signature Date Issued By Signature Date <br />