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CITY OF ORONO � <br /> 2750 KELLEY PARKWAY * Z 0 1 3 - 0 PJ 7 6 9 * <br /> DATE ISSUED: 08/06/2013 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS ; 2102 SUGARWOOD DR <br /> PIN : 34-118-23-21-0021 <br /> LEGAL DESC : SUGAR WOODS <br /> : LOT 002 BLOCK 004 <br /> PERMIT TYPE : ADVANCED PLAN REVIEW <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ADVANCED PLAN REVIEW <br /> ACTIVITY : 434-RESIDENTIAL <br /> VALUATION : $ 15,000.00 <br /> NOTE: PLEASE FILL IN THE FOLLOWING: <br /> VALUATION OF PERMIT:$15,000.00 <br /> TYPE OF PERMIT THIS PAYMENT IS FOR: SWIMMING POOL PERMIT <br /> PERMIT#THIS PRE-PAYMENT IS TIED TO:2013-00767 <br /> APPLICANT ADVANCED PLAN REVIEW 172.58 <br /> CUSTOM POOLS TOTAL 172.58 <br /> 8960 EXCELSIOR BLVD <br /> HOPKINS, MN 55343 PAID WITH CC# 2674 <br /> (612)933-2255 <br /> Minnesota State License#: 5023 <br /> OWNER <br /> JASPER,THOMAS F&JENNIFER J <br /> 2102 SUGARWOOD DR <br /> LONG LAKE, MN 55356- <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 sepazate <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 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 /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />