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CITY OF ORONO PERMIT NO.: 2011-00257 <br /> 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- DATE ISSUED: 04/29/2011 <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 1930 WEST FARM RD <br /> PIN : 27-118-23-43-0021 <br /> LEGAL DESC : THE FARM AT LONG LAKE <br /> : LOT 022 BLOCK 001 <br /> PERMIT TYPE : ADVANCED PLAN REVIEW <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ADVANCED PLAN REVIEW <br /> VALUATION : $ 135,000.00 <br /> APPLICANT ADVANCED PLAN REVIEW 823.39 <br /> LAKE COUNTRY BUILDERS, LTD TOTAL 823.39 <br /> 339 2ND STREET <br /> EXCELSIOR,MN 55331 PAID WITH CC# 4185 <br /> (952)474-7121 <br /> Minnesota State License#: 20349679 <br /> OWNER <br /> LYONS,MICHAEL&DEBRA <br /> 1930 WEST FARM 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 <br /> revoked at any time for due cause. <br /> Applicant Permitee Signature Date Issued By Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />