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1111111111114111111 IN CITY OF ORONO * 2 0 1 6 — 0 1 0 9 9 2750 KELLEY PARKWAY DATE ISSUED: 09/0812016 ORONO,MN 55356- (952)249-4600 FAX: 952 2494616 ADDRESS 200 TRUFFULA TR PIN 33-118-23-44-0039 LEGAL DESC MEADOW WOOD POND LOT 005 BLOCK 001 PERMIT TYPE ADVANCED PLAN REVIEW PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADVANCED PLAN REVIEW ACTIVITY : 434-RESIDENTIAL VALUATION : $ 10,000.00 NOTE: PLEASE FILL IN THE FOLLOWING: VALUATION OF PERMIT:$ 10,000.00 TYPE OF PERMIT THIS PAYMENT IS FOR: BASEMENT BATRHROOM/WET BAR PERMIT#THIS PRE-PAYMENT IS TIED TO:2015-01100 APPLICANT ADVANCED PLAN REVIEW 130.86 LECY BROS HOMES TOTAL 130.86 Payments) 15012 HWY 7 CREDIT CARD 5637 130.86 MINNETONKA,MN 55345- (952)944-9499 Minnesota State License#:BUIL-20325555 OWNER ADAMS,DONALD&SHEILA 200 TRUFFULA TR LONG LAKE,MN 55356- AGREEMENT AND SWORN STATEMENT The work for which this permit is issued shall be performed according to the approved plans and specifications,applicable City approvals,and the State Building Code. This permit is for only the work described and does not grant permission for additional or related work which requires separate permits. All provisions of laws and ordinances governing this type of work shall be compied with whether or not specified herein.This permit will expire and become null and void if construction authorized is not commenced within 180 days of the date of issuance,or if construction is suspended for a period of 180 days at any time after work has commenced. The applicant is responsible for assuring all required inspections are requested in conformance with the State Building Code.This permit may be revoked at any time for due cause. Applicant Permitee Signature Date Issued By Signature Date