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• - � CITY OF ORONO I II I Il 111113 II I 11111111111111111111 <br /> * 20 1 2 - 00583 <br /> 2750 KELLEY PARKWAY DATE ISSUED: 06/22/2012 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 2875 WEAR CIR <br /> PIN : 33-118-23-34-0004 <br /> LEGAL DESC : UNPLATTED 33 118 23 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : ADVANCED PLAN REVIEW <br /> City of Orono <br /> PROPERTY TYPE : RESIDENTIAL 2750 Kelley Parkway <br /> MN 356 <br /> CONSTRUCTION TYPE : ADVANCED PLAN REVIEW Orono 4` -249-4600 <br /> VALUATION : $ 1,500.00 Receipt No: 3.007100 Jun 22, 2012 <br /> NOTE: PLEASE FILL IN THE FOLLOWING: <br /> Nicole Van Patten <br /> VALUATION OF PERMIT:$ 1,500.00 previous Balance: •00 <br /> TYPE OF PERMIT THIS PAYMENT IS FOR: ATTACHED DECK <br /> Permits <br /> PERMIT#THIS PRE-PAYMENT IS TIED TO: 2012-00582 2875 Hear Cir 37.38 <br /> 101-34410 <br /> Plan Check/Site Exam Fees <br /> __Y_____Y____ <br /> Total: 37.38 <br /> Check <br /> Check No: 1079 37.38 <br /> Payor: <br /> Nicole Van Patten 37.38 <br /> Total Applied: --8 <br /> Change Tendered: .0_ <br /> 06/22/2012 08:04AM <br /> APPLICANT ADVANCED PLAN REVIEW 37.38 <br /> VANPATTEN, MICHEAL&NICOLE <br /> 2875 WEAR CIR TOTAL 37.38 <br /> LONG LAKE, MN 55356- <br /> OWNER <br /> GUIMOND ET AL, SHARON R <br /> 2875 WEAR CIR <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 <br /> revoked at any time for due cause. ,Q y <br /> Applicant Permitee Signature Date Issued BySiDate <br /> g <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />