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CITY OF ORONO I I* II I I1111 II1111 I I I II 121 151 z II*I <br /> 2750 KELLEY PARKWAY DATE ISSUED: 09/28/2015 <br /> ORONO,MN 55356- <br /> , (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 2160 WAYZATA BLVD W <br /> PIN : 34-118-23-21-0002 <br /> LEGAL DESC : UNPLATTED 34 118 23 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : ADVANCED PLAN REVIEW <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ADVANCED PLAN REVIEW <br /> VALUATION : $ 20,000.00 <br /> NOTE: PLEASE FILL IN THE FOLLOWING: <br /> VALUATION OF PERMIT:$ 20,000.00 <br /> TYPE OF PERMIT THIS PAYMENT IS FOR: INTERIOR REMODEL <br /> PERMIT#THIS PRE-PAYMENT IS TIED TO:2015-01251 <br /> APPLICANT ADVANCED PLAN REVIEW 231.57 <br /> TOTAL 231.57 <br /> Orono Station West Payment(s) <br /> ERICKSON,BRAD&CHRISTY CHECK 5085 231.57 <br /> 2486 BOBOLINK RD <br /> LONG LAKE,MN 55356- <br /> (612)490-2371 <br /> OWNER <br /> Orono Station West <br /> ERICKSON,BRAD&CHRISTY <br /> 2486 BOBOLINK RD <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 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 180 days at any time after work has commenced. <br /> The applicant is responsible for assuring all required inspections are <br /> requested in conformance with the State Building Code.This permit may be I/ <br /> revoked at any time for due cause. r 1 <br /> •pplicant Permitee Signature Date Issued By Signage Date <br />